Attention/memory complaint is correlated with motor speech disorder in Parkinson\u2019s disease

Ying Liu,Yuchang Gui,Jianwen Xu,Fengkun Zhou,Shanshan Liang,Jincui Hu,Yuanfang Zhou,Yujian Li,Sixia Mo

doi:10.1186/s12883-019-1535-8

Abstract

BackgroundThe mechanisms underlying the online modulation of motor speech in Parkinson’s disease (PD) have not been determined. Moreover, medical and rehabilitation interventions for PD-associated motor speech disorder (MSD) have a poor long-term prognosis.MethodsTo compare risk factors in PD patients with MSD to those without MSD (non-MSD) and determine predictive independent risk factors correlated with the MSD phenotype, we enrolled 314 PD patients, including 250 with and 64 without MSD. We compared demographic, characteristic data, as well as PD-associated evaluations between the MSD group and non-MSD group.ResultsUnivariate analysis showed that demographic characteristics, including occupation, educational level, monthly income and speaking background; clinical characteristics, including lesions in the frontal and temporal lobes, and concurrent dysphagia; and PD-associated evaluations, including the activity of daily living (ADL) score, non-motor symptoms scale (NMSS) domain 4 score (perceptual problem), and NMSS domain 5 score (attention/memory) were all significantly different between the MSD and non-MSD group (all P < 0.05). Multivariate logistic regression analysis showed that educational level, frontal lesions, and NMSS domain 5 score (attention/memory) were independent risk factors for PD-associated MSD (all P < 0.005).ConclusionsWe determined an association between MSD phenotype and cognitive impairment, reflected by low-level education and related clinical profiles. Moreover, attention and memory dysfunction may play key roles in the progression of MSD in PD patients. Further studies are required to detail the mechanism underlying abnormal speech motor modulation in PD patients. Early cognitive intervention may enhance rehabilitation management and motor speech function in patients with PD-associated MSD.

Highlights

Parkinson’s disease (PD) is a common movement disorder that occurs in more than 1 % of the population worldwide, especially in those over the age of 60 years
We found that the motor speech disorder (MSD) group had a higher NMMSS domain 5 score than the non-MSD group
Consistent with several previous findings, we found that the invalidation of anti-PD medication was more remarkable in PD patients who developed MSD and other non-motor manifestations (NMM) than in tremor-dominant patients

Summary

Introduction

Parkinson’s disease (PD) is a common movement disorder that occurs in more than 1 % of the population worldwide, especially in those over the age of 60 years. Routine speech therapy and medical interventions using anti-PD drugs are the two main therapeutic approaches for PD-associated MSD. The fact that routine speech therapy is mainly aimed at the articulation organs and muscles, rather than the root lesions in the neural substrates responsible for speech motor control, makes it a short-term approach and less effective [8, 9]. The current interventions for PD-associated MSD are still insufficient This may be attributed to insufficient information on the primary cause of PD-associated MSD, with the pathophysiological mechanisms underlying abnormal motor speech modulation in PD not yet understood. The mechanisms underlying the online modulation of motor speech in Parkinson’s disease (PD) have not been determined. Medical and rehabilitation interventions for PD-associated motor speech disorder (MSD) have a poor long-term prognosis

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