Speech disorders in Parkinson’s disease - characteristics, assessment and treatment

Abstract

Introduction. Parkinson?s disease belongs to the group of extrapyramidal neurodegenerative diseases and occurs as a consequence of the loss of dopaminergic neurons in the substantia nigra of the mesencephalon. Persons with Parkinson?s disease may experience a wide range of motor and non-motor symptoms. Material and Methods. A literature search was conducted using electronic databases on the Internet and electronic databases of Serbian libraries. Results. Speech disorders in Parkinson?s disease are classified in the group of hypokinetic dysarthria. Empirical data show that the basic characteristics of dysarthria in people with Parkinson?s disease are changes in voice quality, difficulties in articulating consonants, abnormalities in vowel production, monotonous speech, changes in speech rate, rough and breathy voice, increased voice nasality, reduced intensity of voice, involuntary pauses during speech, and palilalia. Methods used in the assessment of speech disorders include perceptual voice analysis, such as the overall dysphonia Grade, Roughness, Breathiness, Asthenia, Strain and Consensus Auditory Perceptual Evaluation of Voice scales, acoustic voice analysis (e.g., Multi-Dimensional Voice Program), and voice quality self-assessment methods (e.g., Voice Handicap Index and the Dysarthria Impact Profile). In the treatment of dysarthria, various behavioral methods of speech therapy are used, among which the Lee Silverman method is particularly important. Conclusion. Speech disorders in Parkinson?s disease manifest as altered patterns of respiration, phonation, resonance, articulation and prosody. The best results in the treatment are achieved by combination of medical, surgical, and behavioral therapy, through the cooperation of experts of different profiles as well as with family members of the patient.