Abstract
ABSTRACTIntroduction: Dysfunction in the basal ganglia circuits is a determining factor in the physiopathology of the classic signs of Parkinson's disease (PD) and hypokinetic dysarthria is commonly related to PD. Regarding speech disorders associated with PD, the latest four-level framework of speech complicates the traditional view of dysarthria as a motor execution disorder. Based on findings that dysfunctions in basal ganglia can cause speech disorders, and on the premise that the speech deficits seen in PD are not related to an execution motor disorder alone but also to a disorder at the motor programming level, the main objective of this study was to investigate the presence of sensorimotor disorders of programming (besides the execution disorders previously described) in PD patients. Methods: A cross-sectional study was conducted in a sample of 60 adults matched for gender, age and education: 30 adult patients diagnosed with idiopathic PD (PDG) and 30 healthy adults (CG). All types of articulation errors were reanalyzed to investigate the nature of these errors. Interjections, hesitations and repetitions of words or sentences (during discourse) were considered typical disfluencies; blocking, episodes of palilalia (words or syllables) were analyzed as atypical disfluencies. We analysed features including successive self-initiated trial, phoneme distortions, self-correction, repetition of sounds and syllables, prolonged movement transitions, additions or omissions of sounds and syllables, in order to identify programming and/or execution failures. Orofacial agility was also investigated. Results: The PDG had worse performance on all sensorimotor speech tasks. All PD patients had hypokinetic dysarthria. Conclusion: The clinical characteristics found suggest both execution and programming sensorimotor speech disorders in PD patients.
Highlights
Dysfunction in the basal ganglia circuits is a determining factor in the physiopathology of the classic signs, and hypokinetic dysarthria is commonly related to Parkinson’s disease (PD).[1]
Regarding speech disorders associated with PD, the latest four-level framework of speech sensorimotor control[2] proposed complicates the traditional view of dysarthria as just a motor execution disorder
Based on findings that dysfunctions in basal ganglia can cause fluency of speech deficits, and on the premise that the speech deficits seen in PD are not related to an execution motor disorder alone and to a disorder at the motor programming level, the main objective of this study was to investigate the presence of sensorimotor disorders of programming in PD patients
Summary
Dysfunction in the basal ganglia circuits is a determining factor in the physiopathology of the classic signs of Parkinson’s disease (PD) and hypokinetic dysarthria is commonly related to PD. Regarding speech disorders associated with PD, the latest four-level framework of speech complicates the traditional view of dysarthria as a motor execution disorder. Regarding speech disorders associated with PD, the latest four-level framework of speech sensorimotor control[2] proposed complicates the traditional view of dysarthria as just a motor execution disorder. This model proposes different phases of the transformation of speech code involving the different neural structures. During the execution phase, the hierarchy of plans and programs is transformed into non-learned automatic motor adjustments.[2]
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