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DOI: 10.1055/s-0033-1358367
Early Identification and Treatment of Communication and Swallowing Deficits in Parkinson Disease
Publication History
Publication Date:
28 October 2013 (online)
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Abstract
Parkinson disease (PD) is a complex, progressive, neurodegenerative disorder that leads to a wide range of deficits including fine and gross sensorimotor impairment, autonomic dysfunction, mood disorders, and cognitive decline. Traditionally, the focus for diagnosis and treatment has been on sensorimotor impairment related to dopamine depletion. It is now widely recognized, however, that PD-related pathology affects multiple central nervous system neurotransmitters and pathways. Communication and swallowing functions can be impaired even in the early stages, significantly affecting health and quality of life. The purpose of this article is to review the literature on early intervention for communication and swallowing impairment in PD. Overarching themes were that (1) studies and interpretation of data from studies in early PD are limited; (2) best therapy practices have not been established, in part due to the heterogeneous nature of PD; and (3) as communication and swallowing problems are pervasive in PD, further treatment research is essential.
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References
- 1 de Lau LM, Giesbergen PC, de Rijk MC, Hofman A, Koudstaal PJ, Breteler MM. Incidence of parkinsonism and Parkinson disease in a general population: the Rotterdam Study. Neurology 2004; 63 (7) 1240-1244
- 2 Bernheimer H, Birkmayer W, Hornykiewicz O, Jellinger K, Seitelberger F. Brain dopamine and the syndromes of Parkinson and Huntington. Clinical, morphological and neurochemical correlations. J Neurol Sci 1973; 20 (4) 415-455
- 3 Braak H, Ghebremedhin E, Rüb U, Bratzke H, Del Tredici K. Stages in the development of Parkinson's disease-related pathology. Cell Tissue Res 2004; 318 (1) 121-134
- 4 Hawkes CH, Del Tredici K, Braak H. A timeline for Parkinson's disease. Parkinsonism Relat Disord 2010; 16 (2) 79-84
- 5 Dauer W, Przedborski S. Parkinson's disease: mechanisms and models. Neuron 2003; 39 (6) 889-909
- 6 Michou E, Hamdy S. Dysphagia in Parkinson's disease: a therapeutic challenge?. Expert Rev Neurother 2010; 10 (6) 875-878
- 7 Bonifati V, Dekker MC, Vanacore N , et al; Italian Parkinson Genetics Network. Autosomal recessive early onset parkinsonism is linked to three loci: PARK2, PARK6, and PARK7. Neurol Sci 2002; 23 (Suppl. 02) S59-S60
- 8 Guo JF, Wang L, He D , et al. Clinical features and [11C]-CFT PET analysis of PARK2, PARK6, PARK7-linked autosomal recessive early onset Parkinsonism. Neurol Sci 2011; 32 (1) 35-40
- 9 Logemann JA, Fisher HB, Boshes B, Blonsky ER. Frequency and cooccurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. J Speech Hear Disord 1978; 43 (1) 47-57
- 10 Trail M, Fox C, Ramig LO, Sapir S, Howard J, Lai EC. Speech treatment for Parkinson's disease. NeuroRehabilitation 2005; 20 (3) 205-221
- 11 Sapir S, Ramig L, Fox C. Speech and swallowing disorders in Parkinson disease. Curr Opin Otolaryngol Head Neck Surg 2008; 16 (3) 205-210
- 12 Müller J, Wenning GK, Verny M , et al. Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Arch Neurol 2001; 58 (2) 259-264
- 13 Dickson JM, Grünewald RA. Somatic symptom progression in idiopathic Parkinson's disease. Parkinsonism Relat Disord 2004; 10 (8) 487-492
- 14 Volonté MA, Porta M, Comi G. Clinical assessment of dysphagia in early phases of Parkinson's disease. Neurol Sci 2002; 23 (Suppl. 02) S121-S122
- 15 Bird MR, Woodward MC, Gibson EM, Phyland DJ, Fonda D. Asymptomatic swallowing disorders in elderly patients with Parkinson's disease: a description of findings on clinical examination and videofluoroscopy in sixteen patients. Age Ageing 1994; 23 (3) 251-254
- 16 Potulska A, Friedman A, Królicki L, Spychala A. Swallowing disorders in Parkinson's disease. Parkinsonism Relat Disord 2003; 9 (6) 349-353
- 17 Mahler L, Ramig LO, Logemann J, Halpern A. Description of subjective and objective swallow characteristics for people with PD. Poster session presented at: the International Movement Disorders Society; June 26, 2008; Chicago, IL
- 18 Miller N, Allcock L, Hildreth AJ, Jones D, Noble E, Burn DJ. Swallowing problems in Parkinson disease: frequency and clinical correlates. J Neurol Neurosurg Psychiatry 2009; 80 (9) 1047-1049
- 19 Sung HY, Kim JS, Lee KS , et al. The prevalence and patterns of pharyngoesophageal dysmotility in patients with early stage Parkinson's disease. Mov Disord 2010; 25 (14) 2361-2368
- 20 Rusz J, Cmejla R, Ruzickova H, Ruzicka E. Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson's disease. J Acoust Soc Am 2011; 129 (1) 350-367
- 21 Holmes RJ, Oates JM, Phyland DJ, Hughes AJ. Voice characteristics in the progression of Parkinson's disease. Int J Lang Commun Disord 2000; 35 (3) 407-418
- 22 Stewart C, Winfield L, Hunt A , et al. Speech dysfunction in early Parkinson's disease. Mov Disord 1995; 10 (5) 562-565
- 23 Harel B, Cannizzaro M, Snyder PJ. Variability in fundamental frequency during speech in prodromal and incipient Parkinson's disease: a longitudinal case study. Brain Cogn 2004; 56 (1) 24-29
- 24 Harel BT, Cannizzaro MS, Cohen H, Reilly N, Snyder PJ. Acoustic characteristics of Parkinsonian speech: a potential biomarker of early disease progression and treatment. J Neurolinguist 2004; 17: 439-453
- 25 Rusz J, Cmejla R, Růžičková H , et al. Evaluation of speech impairment in early stages of Parkinson's disease: a prospective study with the role of pharmacotherapy. J Neural Transm 2013; 120 (2) 319-329
- 26 Illes J. Neurolinguistic features of spontaneous language production dissociate three forms of neurodegenerative disease: Alzheimer's, Huntington's, and Parkinson's. Brain Lang 1989; 37 (4) 628-642
- 27 Illes J, Metter EJ, Hanson WR, Iritani S. Language production in Parkinson's disease: acoustic and linguistic considerations. Brain Lang 1988; 33 (1) 146-160
- 28 Ho AK, Bradshaw JL, Iansek R. For better or worse: the effect of levodopa on speech in Parkinson's disease. Mov Disord 2008; 23 (4) 574-580
- 29 Kompoliti K, Wang QE, Goetz CG, Leurgans S, Raman R. Effects of central dopaminergic stimulation by apomorphine on speech in Parkinson's disease. Neurology 2000; 54 (2) 458-462
- 30 Raskin SA, Sliwinski M, Borod JC. Clustering strategies on tasks of verbal fluency in Parkinson's disease. Neuropsychologia 1992; 30 (1) 95-99
- 31 Tinaz S, Schendan HE, Stern CE. Fronto-striatal deficit in Parkinson's disease during semantic event sequencing. Neurobiol Aging 2008; 29 (3) 397-407
- 32 Zgaljardic DJ, Borod JC, Foldi NS, Mattis P. A review of the cognitive and behavioral sequelae of Parkinson's disease: relationship to frontostriatal circuitry. Cogn Behav Neurol 2003; 16 (4) 193-210
- 33 Cooper JA, Sagar HJ, Jordan N, Harvey NS, Sullivan EV. Cognitive impairment in early, untreated Parkinson's disease and its relationship to motor disability. Brain 1991; 114 (Pt 5) 2095-2122
- 34 Flowers KA, Robertson C, Sheridan MR. Some characteristics of word fluency in Parkinson's disease. J Neurolinguist 1995; 9 (1) 33-46
- 35 Lewis SJ, Dove A, Robbins TW, Barker RA, Owen AM. Cognitive impairments in early Parkinson's disease are accompanied by reductions in activity in frontostriatal neural circuitry. J Neurosci 2003; 23 (15) 6351-6356
- 36 Kim Y, Kent RD, Weismer G. An acoustic study of the relationships among neurologic disease, dysarthria type and severity of dysarthria. J Speech Lang Hear Res 2011; 54 (2) 417-429
- 37 Miller N, Noble E, Jones D, Burn D. Hard to swallow: dysphagia in Parkinson's disease. Age Ageing 2006; 35 (6) 614-618
- 38 Ali GN, Wallace KL, Schwartz R, DeCarle DJ, Zagami AS, Cook IJ. Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson's disease. Gastroenterology 1996; 110 (2) 383-392
- 39 Troche MS, Sapienza CM, Rosenbek JC. Effects of bolus consistency on timing and safety of swallow in patients with Parkinson's disease. Dysphagia 2008; 23 (1) 26-32
- 40 Leopold NA, Kagel MC. Laryngeal deglutition movement in Parkinson's disease. Neurology 1997; 48 (2) 373-376
- 41 Leopold NA, Kagel MC. Pharyngo-esophageal dysphagia in Parkinson's disease. Dysphagia 1997; 12 (1) 11-18 , discussion 19–20
- 42 El Sharkawi A, Ramig L, Logemann JA , et al. Swallowing and voice effects of Lee Silverman Voice Treatment (LSVT): a pilot study. J Neurol Neurosurg Psychiatry 2002; 72 (1) 31-36
- 43 Fuh JL, Lee RC, Wang SJ , et al. Swallowing difficulty in Parkinson's disease. Clin Neurol Neurosurg 1997; 99 (2) 106-112
- 44 Nagaya M, Kachi T, Yamada T, Igata A. Videofluorographic study of swallowing in Parkinson's disease. Dysphagia 1998; 13 (2) 95-100
- 45 Robbins JA, Logemann JA, Kirshner HS. Swallowing and speech production in Parkinson's disease. Ann Neurol 1986; 19 (3) 283-287
- 46 Wintzen AR, Badrising UA, Roos RA, Vielvoye J, Liauw L. Influence of bolus volume on hyoid movements in normal individuals and patients with Parkinson's disease. Can J Neurol Sci 1994; 21 (1) 57-59
- 47 Eadie MJ, Tyrer JH. Alimentary disorder in Parkinsonism. Australas Ann Med 1965; 14: 13-22
- 48 Ertekin C, Tarlaci S, Aydogdu I , et al. Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson's disease. Mov Disord 2002; 17 (5) 942-949
- 49 Beyer MK, Herlofson K, Årsland D, Larsen JP. Causes of death in a community-based study of Parkinson's disease. Acta Neurol Scand 2001; 103 (1) 7-11
- 50 D'Amelio M, Ragonese P, Morgante L , et al. Long-term survival of Parkinson's disease: a population-based study. J Neurol 2006; 253 (1) 33-37
- 51 Hely MA, Reid WGJ, Adena MA, Halliday GM, Morris JGL. The Sydney multicenter study of Parkinson's disease: the inevitability of dementia at 20 years. Mov Disord 2008; 23 (6) 837-844
- 52 Plowman-Prine EK, Sapienza CM, Okun MS , et al. The relationship between quality of life and swallowing in Parkinson's disease. Mov Disord 2009; 24 (9) 1352-1358
- 53 Rosenbek JC, Jones H. Dysphagia in Movement Disorders. San Diego, CA: Plural Publishing; 2009
- 54 Baijens LW, Speyer R. Effects of therapy for dysphagia in Parkinson's disease: systematic review. Dysphagia 2009; 24 (1) 91-102
- 55 Pinto S, Ozsancak C, Tripoliti E, Thobois S, Limousin-Dowsey P, Auzou P. Treatments for dysarthria in Parkinson's disease. Lancet Neurol 2004; 3 (9) 547-556
- 56 De Letter M, Santens P, Estercam I , et al. Levodopa-induced modifications of prosody and comprehensibility in advanced Parkinson's disease as perceived by professional listeners. Clin Linguist Phon 2007; 21 (10) 783-791
- 57 D'Alatri L, Paludetti G, Contarino MF, Galla S, Marchese MR, Bentivoglio AR. Effects of bilateral subthalamic nucleus stimulation and medication on parkinsonian speech impairment. J Voice 2008; 22 (3) 365-372
- 58 Pinto S, Thobois S, Costes N , et al. Subthalamic nucleus stimulation and dysarthria in Parkinson's disease: a PET study. Brain 2004; 127 (Pt 3) 602-615
- 59 Narayana S, Jacks A, Robin DA , et al. A noninvasive imaging approach to understanding speech changes following deep brain stimulation in Parkinson's disease. Am J Speech Lang Pathol 2009; 18 (2) 146-161
- 60 Sapir S, Spielman JL, Ramig LO, Story BH, Fox C. Effects of intensive voice treatment (the Lee Silverman Voice Treatment [LSVT]) on vowel articulation in dysarthric individuals with idiopathic Parkinson disease: acoustic and perceptual findings. J Speech Lang Hear Res 2007; 50 (4) 899-912
- 61 Ramig LO, Sapir S, Fox C, Countryman S. Changes in vocal loudness following intensive voice treatment (LSVT) in individuals with Parkinson's disease: a comparison with untreated patients and normal age-matched controls. Mov Disord 2001; 16 (1) 79-83
- 62 Russell JA, Ciucci MR, Connor NP, Schallert T. Targeted exercise therapy for voice and swallow in persons with Parkinson's disease. Brain Res 2010; 1341: 3-11
- 63 Schulz GM, Grant MK. Effects of speech therapy and pharmacologic and surgical treatments on voice and speech in Parkinson's disease: a review of the literature. J Commun Disord 2000; 33 (1) 59-88
- 64 Gallena S, Smith PJ, Zeffiro T, Ludlow CL. Effects of levodopa on laryngeal muscle activity for voice onset and offset in Parkinson disease. J Speech Lang Hear Res 2001; 44 (6) 1284-1299
- 65 Ramig LO, Verdolini K. Treatment efficacy: voice disorders. J Speech Lang Hear Res 1998; 41 (1) S101-S116
- 66 Herd CP, Tomlinson CL, Deane KH , et al. Comparison of speech and language therapy techniques for speech problems in Parkinson's disease. Cochrane Database Syst Rev 2012; 8: CD002814
- 67 Ramig LO, Countryman S, O'Brien C, Hoehn M, Thompson L. Intensive speech treatment for patients with Parkinson's disease: short-and long-term comparison of two techniques. Neurology 1996; 47 (6) 1496-1504
- 68 Baumgartner CA, Sapir S, Ramig TO. Voice quality changes following phonatory-respiratory effort treatment (LSVT) versus respiratory effort treatment for individuals with Parkinson disease. J Voice 2001; 15 (1) 105-114
- 69 Ramig LO, Sapir S, Countryman S , et al. Intensive voice treatment (LSVT) for patients with Parkinson's disease: a 2. year follow up. J Neurol Neurosurg Psychiatry 2001; 71 (4) 493-498
- 70 Spielman J, Ramig LO, Mahler L, Halpern A, Gavin WJ. Effects of an extended version of the Lee Silverman voice treatment on voice and speech in Parkinson's disease. Am J Speech Lang Pathol 2007; 16 (2) 95-107
- 71 Searl J, Wilson K, Haring K, Dietsch A, Lyons K, Pahwa R. Feasibility of group voice therapy for individuals with Parkinson's disease. J Commun Disord 2011; 44 (6) 719-732
- 72 Narayana S, Fox PT, Zhang W , et al. Neural correlates of efficacy of voice therapy in Parkinson's disease identified by performance-correlation analysis. Hum Brain Mapp 2010; 31 (2) 222-236
- 73 Cannito MP, Suiter DM, Beverly D, Chorna L, Wolf T, Pfeiffer RM. Sentence intelligibility before and after voice treatment in speakers with idiopathic Parkinson's disease. J Voice 2012; 26 (2) 214-219
- 74 Ciucci MR, Barkmeier-Kraemer JM, Sherman SJ. Subthalamic nucleus deep brain stimulation improves deglutition in Parkinson's disease. Mov Disord 2008; 23 (5) 676-683
- 75 Lengerer S, Kipping J, Rommel N , et al. Deep-brain-stimulation does not impair deglutition in Parkinson's disease. Parkinsonism Relat Disord 2012; 18 (7) 847-853
- 76 Logemann JA, Gensler G, Robbins J , et al. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson's disease. J Speech Lang Hear Res 2008; 51 (1) 173-183
- 77 Pitts T, Bolser D, Rosenbek J, Troche M, Okun MS, Sapienza C. Impact of expiratory muscle strength training on voluntary cough and swallow function in Parkinson disease. Chest 2009; 135 (5) 1301-1308
- 78 Troche MS, Okun MS, Rosenbek JC , et al. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology 2010; 75 (21) 1912-1919
- 79 Manor Y, Mootanah R, Freud D, Giladi N, Cohen JT. Video-assisted swallowing therapy for patients with Parkinson's disease. Parkinsonism Relat Disord 2013; 19 (2) 207-211
- 80 Speyer R, Baijens L, Heijnen M, Zwijnenberg I. Effects of therapy in oropharyngeal dysphagia by speech and language therapists: a systematic review. Dysphagia 2010; 25 (1) 40-65
- 81 Konerth M, Childers J. Exercise: a possible adjunct therapy to alleviate early Parkinson disease. JAAPA 2013; 26 (4) 30-33
- 82 Smith ME, Ramig LO, Dromey C, Perez KS, Samandari R. Intensive voice treatment in Parkinson disease: laryngostroboscopic findings. J Voice 1995; 9 (4) 453-459
- 83 Elefant C, Baker FA, Lotan M, Lagesen SK, Skeie GO. The effect of group music therapy on mood, speech, and singing in individuals with Parkinson's disease—a feasibility study. J Music Ther 2012; 49 (3) 278-302
- 84 Cruise KE, Bucks RS, Loftus AM, Newton RU, Pegoraro R, Thomas MG. Exercise and Parkinson's: benefits for cognition and quality of life. Acta Neurol Scand 2011; 123 (1) 13-19
- 85 Haneishi E. Effects of a music therapy voice protocol on speech intelligibility, vocal acoustic measures, and mood of individuals with Parkinson's disease. J Music Ther 2001; 38 (4) 273-290
- 86 de Angelis EC, Mourão LF, Ferraz HB, Behlau MS, Pontes PA, Andrade LA. Effect of voice rehabilitation on oral communication of Parkinson's disease patients. Acta Neurol Scand 1997; 96 (4) 199-205
- 87 Aminoff MJ, Christine CW, Friedman JH , et al; National Parkinson Foundation Working Group on Hospitalization in Parkinson's Disease. Management of the hospitalized patient with Parkinson's disease: current state of the field and need for guidelines. Parkinsonism Relat Disord 2011; 17 (3) 139-145
- 88 Smith SK, Roddam H, Sheldrick H. Rehabilitation or compensation: time for a fresh perspective on speech and language therapy for dysphagia and Parkinson's disease?. Int J Lang Commun Disord 2012; 47 (4) 351-364
- 89 Melo A, Monteiro L. Swallowing improvement after levodopa treatment in idiopathic Parkinson's disease: lack of evidence. Parkinsonism Relat Disord 2013; 19 (3) 279-281
- 90 Deane KH, Whurr R, Clarke CE, Playford ED, Ben-Shlomo Y. Non-pharmacological therapies for dysphagia in Parkinson's disease. Cochrane Database Syst Rev 2001; (1) CD002816
- 91 Van Lieshout PH, Steele CM, Lang AE. Tongue control for swallowing in Parkinson's disease: effects of age, rate, and stimulus consistency. Mov Disord 2011; 26 (9) 1725-1729
- 92 South AR, Somers SM, Jog MS. Gum chewing improves swallow frequency and latency in Parkinson patients: a preliminary study. Neurology 2010; 74 (15) 1198-1202
- 93 Bushmann M, Dobmeyer SM, Leeker L, Perlmutter JS. Swallowing abnormalities and their response to treatment in Parkinson's disease. Neurology 1989; 39 (10) 1309-1314
- 94 Felix VN, Corrêa SM, Soares RJ. A therapeutic maneuver for oropharyngeal dysphagia in patients with Parkinson's disease. Clinics (Sao Paulo) 2008; 63 (5) 661-666
- 95 Nagaya M, Kachi T, Yamada T. Effect of swallowing training on swallowing disorders in Parkinson's disease. Scand J Rehabil Med 2000; 32 (1) 11-15
- 96 Robertson SJ, Thomson F. Speech therapy in Parkinson's disease: a study of the efficacy and long term effects of intensive treatment. Br J Disord Commun 1984; 19 (3) 213-224
- 97 Hunter PC, Crameri J, Austin S, Woodward MC, Hughes AJ. Response of parkinsonian swallowing dysfunction to dopaminergic stimulation. J Neurol Neurosurg Psychiatry 1997; 63 (5) 579-583
- 98 Heijnen BJ, Speyer R, Baijens LW, Bogaardt HC. Neuromuscular electrical stimulation versus traditional therapy in patients with Parkinson's disease and oropharyngeal dysphagia: effects on quality of life. Dysphagia 2012; 27 (3) 336-345
- 99 Baijens LW, Speyer R, Passos VL, Pilz W, Roodenburg N, Clavé P. The effect of surface electrical stimulation on swallowing in dysphagic Parkinson patients. Dysphagia 2012; 27 (4) 528-537
- 100 Regan J, Walshe M, Tobin WO. Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic Parkinson's disease. Dysphagia 2010; 25 (3) 207-215
- 101 Robertson SJ , ed. Robertson Dysarthria Proflile. Bicester, UK: Winslow Press; 1982