title: Articulation disorders and duration, severity and L-dopa dosage in idiopathic Parkinson's disease.
abstract: BACKGROUND
  Parkinson's disease (PD) is one of the most common diseases of the central nervous system (CNS). It is frequently heralded by speech disturbances, which are one of its first symptoms.
  
  
  OBJECTIVE
  The aim of this paper is to share our own experience concerning the correlation between the severity of speech disorders and the PD duration, its severity and the intake of L-dopa.
  
  
  METHODS
  The research included 93 patients with idiopathic PD, aged 26-86 years (mean age 65.1 years). Participants were examined neurologically according to the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Scale. They were also assessed by Frenchay Dysarthria Assessment.
  
  
  RESULTS
  Considerable and severe disorders were concurrent with impairments in the mobility of the tongue, lips, the jaw as well as the pitch and loudness of the voice. The strongest correlation but at a moderate level was found to exist between the severity of labial impairment, voice loudness and the length of the disease. There was also a positive correlation between lip movement while the motions were being diversified, lip arrangement while speaking and the intake of L-dopa.
  
  
  CONCLUSIONS
  As PD progresses a significant decline in vocal articulation can be observed, which is due to reduced mobility within the lips and the jaw. Exacerbation of articulation disorders resulting from progression of the disease does not materially influence the UPDRSS scores. L-dopa has been found to positively affect the mobility of the lips while the patient is speaking and their arrangement at rest.
authors.affiliation: Department of Medical Rehabilitation, Pomeranian Medical University, Szczecin, Poland. Electronic address: wsna@o2.pl.
authors.forename: Wioletta
authors.initials: W
authors.lastname: Pawlukowska
authors.affiliation: Clinic of Neurology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Gołąb-Janowska
authors.affiliation: Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Safranow
authors.affiliation: Department of Medical Rehabilitation, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Rotter
authors.affiliation: Clinic of Otolaryngology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Amernik
authors.affiliation: Clinic of Neurology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Krystyna
authors.initials: K
authors.lastname: Honczarenko
authors.affiliation: Clinic of Neurology, Pomeranian Medical University, Szczecin, Poland.
authors.forename: Przemysław
authors.initials: P
authors.lastname: Nowacki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001184:Articulation Disorders / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007568:Jaw / Q000503:physiopathology; D007980:Levodopa / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D008046:Lip / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D010699:Phonation / Q000187:drug effects; D010700:Phonetics; D016059:Range of Motion, Articular / Q000187:drug effects; D012021:Reflex, Abnormal; D012119:Respiration / Q000187:drug effects; D012720:Severity of Illness Index
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Dysarthria; Parkinson disease; Speech disturbances; Speech therapy