Treatments for dysarthria in Parkinson's disease.
Dysarthria in Parkinson's disease can be characterised by monotony of pitch and loudness, reduced stress, variable rate, imprecise consonants, and a breathy and harsh voice. Use of levodopa to replenish dopamine concentrations in the striatum seems to improve articulation, voice quality, and pitch variation, although some studies show no change in phonatory parameters. Traditional speech therapy can lead to improvement of dysarthria, and intensive programmes have had substantial beneficial effects on vocal loudness. Unilateral surgical lesions of subcortical structures are variably effective for the alleviation of dysarthria, whereas bilateral procedures typically lead to worsening of speech production. Among deep-brain stimulation procedures, only stimulation of the subthalamic nucleus improves some motor components of speech although intelligibility seems to decrease after surgery. Due to the variable treatment effects on parkinsonian speech, management of dysarthria is still challenging for the clinician and should be discussed with the patient.
Pinto
Serge
S
Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology London, UK. S.Pinto@ion.ucl.ac.uk
Ozsancak
Canan
C
Tripoliti
Elina
E
Thobois
Stéphane
S
Limousin-Dowsey
Patricia
P
Auzou
Pascal
P
D015259:Dopamine Agents / Q000627:therapeutic use; D004401:Dysarthria / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D004599:Electric Stimulation Therapy; D006801:Humans; D019635:Neurosurgical Procedures; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology; D013070:Speech Therapy
D015259:Dopamine Agents