Speech and Swallowing Problems in PD

Speech and Swallowing Problems in People with Parkinson DiseaseBackgroundMost people know about the common symptoms of Parkinson disease (PD), which include tremor, slowness of movement, and stiffness. As we've talked about in previous issues of WE MOVE News, people with PD also develop nonmotor symptoms. These symptoms usually have nothing to do with movement. One of the nonmotor symptoms that may occur impair a person's ability to speak and swallow. Up to 90% of people with PD have problems with swallowing and speech at some time during their illness. These problems affect their health, ability to communicate, psychological well-being, and quality of life. Voice difficulties include lack of volume and pitch, poor vocal quality, rushed speech, and difficulty enunciating or "saying" words. Problems with swallowing may cause difficulty in getting enough to eat, resulting in poor nutrition. Swallowing problems may also lead to serious illnesses like pneumonia.Who were the researchers and what did they do?Drs. Sapir, Raming, and Fox reviewed all published studies on the treatment of speech and swallowing problems in PD. Some studies showed an improvement in speech and swallowing when patients were treated surgically with deep brain stimulation (DBS) or with drugs typically used to treat PD. Other studies showed the opposite effect, with the speech and swallowing problems actually becoming worse with these treatments. Dr. Sapir and his coworkers also identified two other techniques, transcranial magnetic stimulation and injections of collagen into the vocal cords, that may be helpful in improving speech, but these treatments need to be studied in more patients before they can be recommended. The researchers did identify one treatment, called LSVT-LOUD (which stands for Lee Silverman Voice Treatment method), that helps most people with PD. This intensive speech therapy focuses on increasing loudness of speech and then teaching the patient, through behavior therapy, how to use the new skills in everyday life. Further research is needed to study the effects of therapy on swallowing difficulties in patients with PD.Sapir S, L Ramig, Fox C. Speech and swallowing disorders in Parkinson disease. Curr Opin Otolaryngol Head Neck Surg 2008;16:205-210.For more information on speech and on swallowing problems, please visit http://go.reachmail.net/go.asp?tid=152608&eid=7827&sb_id=245200,245200 and http://go.reachmail.net/go.asp?tid=152609&eid=7827&sb_id=245200,245200GlossaryNonmotor signs and symptoms of Parkinson disease include apathy, anxiety, bladder problems, constipation, dementia, depression, fatigue, hyperhidrosis (excessive sweating), numbness, pain, psychosis, sexual dysfunction, sialorrhea (excessive drooling), sleep disorders, and speech and swallowing problems.