Speech and swallowing disorders in Parkinson disease.
OBJECTIVE
To review recent research and clinical studies pertaining to the nature, diagnosis, and treatment of speech and swallowing disorders in Parkinson disease.


RESULTS
Although some studies indicate improvement in voice and speech with dopamine therapy and deep brain stimulation of the subthalamic nucleus, others show minimal or adverse effects. Repetitive transcranial magnetic stimulation of the mouth motor cortex and injection of collagen in the vocal folds have preliminary data supporting improvement in phonation in people with Parkinson disease. Treatments focusing on vocal loudness, specifically LSVT LOUD (Lee Silverman Voice Treatment), have been effective for the treatment of speech disorders in Parkinson disease. Changes in brain activity due to LSVT LOUD provide preliminary evidence for neural plasticity. Computer-based technology makes the Lee Silverman Voice Treatment available to a large number of users. A rat model for studying neuropharmacologic effects on vocalization in Parkinson disease has been developed. New diagnostic methods of speech and swallowing are also available as the result of recent studies.


CONCLUSIONS
Speech rehabilitation with the LSVT LOUD is highly efficacious and scientifically tested. There is a need for more studies to improve understanding, diagnosis, prevention, and treatment of speech and swallowing disorders in Parkinson disease.
Sapir
Shimon
S
Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel. sapir@research.haifa.ac.il
Ramig
Lorraine
L
Fox
Cynthia
C
D003680:Deglutition Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control / Q000534:rehabilitation; D006801:Humans; D010300:Parkinson Disease / Q000503:physiopathology*; D013064:Speech Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control / Q000534:rehabilitation; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods; D014833:Voice Quality; D014834:Voice Training