Background: Changes in communicative functions are common in Parkinson’s disease (PD), but there are only limited data provided by individuals with PD on how these changes are perceived, what their consequences are, and what type of intervention is provided. Aim: To present self-reported information about speech and communication, the impact on communicative participation, and the amount and type of speech-language pathology services received by people with PD. Methods: Respondents with PD recruited via the Swedish Parkinson’s Disease Society filled out a questionnaire accessed via a Web link or provided in a paper version. Results: Of 188 respondents, 92.5% reported at least one symptom related to communication; the most common symptoms were weak voice, word-finding difficulties, imprecise articulation, and getting off topic in conversation. The speech and communication problems resulted in restricted communicative participation for between a quarter and a third of the respondents, and their speech caused embarrassment sometimes or more often to more than half. Forty-five percent of the respondents had received speech-language pathology services. Conclusions: Most respondents reported both speech and language symptoms, and many experienced restricted communicative participation. Access to speech-language pathology services is still inadequate. Services should also address cognitive/linguistic aspects to meet the needs of people with PD.
With current progress in genetic research, autosomal, dominant, hereditary, neurodegenerative diseases, affecting the cerebellum and cerebellar connections, are increasingly diagnosed as spinocerebellar ataxias (SCA). In the present study speech samples from 21 subjects with spinocerebellar ataxia (SCA), and 21 matched control subjects were analyzed using perceptual and acoustic methodology. Dysarthria assessment showed that subjects had mild or mild-moderate dysarthria. Perceptual analysis indicated that equalized stress, imprecise consonants, vocal instability, monotony and reduced speech rate were the speech parameters that yielded the highest mean perceptual ratings. A factor analysis of perceptual speech parameters revealed two main factors: Factor 1 was associated with articulatory timing and Factor 2 with vocal quality. Acoustic analysis revealed significantly reduced speech rate during text reading, reduced alternating and sequential motion rates (AMR/SMR), significantly longer and more variable syllable and pause durations, and significantly higher vocal instability for subjects with SCA compared to control subjects.
BackgroundParkinson’s disease (PD) affects many physiological systems essential for balance control. Recent studies suggest that intensive and cognitively demanding physical exercise programs are capable of inducing plastic brain changes in PD. We have developed a highly challenging balance training (the HiBalance) program that emphasizes critical aspects of balance control through progressively introducing more challenging exercises which incorporates dual-tasking. Earlier studies have shown it to be effective in improving balance, gait and dual-tasking. The study design has thereafter been adjusted to link intervention-induced behavioral changes to brain morphology and function. Specifically, in this randomized controlled trial, we will determine the effects of the HiBalance program on balance, gait and cognition and relate this to task-evoked functional MRI (fMRI), as well as brain-derived neurotrophic factor (BDNF) in participants with mild-moderate PD.MethodsOne hundred participants with idiopathic PD, Hoehn & Yahr stage 2 or 3, ≥ 60 years of age, ≥ 21 on Montreal Cognitive Assessment will be recruited in successive waves and randomized into either the HiBalance program or to an active control group (the HiCommunication program, targeting speech and communication). Both interventions will be performed in small groups, twice a week with 1 h sessions for 10 weeks. In addition, a 1 h, once a week, home exercise program will also be performed. A double-blinded design will be used. At the pre- and post-assessments, participants will be assessed on balance (main outcome), gait, cognitive functions, physical activity, voice/speech function, BDNF in serum and fMRI (3 T Philips) during performance of motor-cognitive tasks.DiscussionSince there is currently no cure for PD, findings of neuroplastic brain changes in response to exercise would revolutionize the way we treat PD, and, in turn, provide new hope to patients for a life with better health, greater independence and improved quality of life.Trial registrationClincalTrials.gov: NCT03213873, first posted July 11, 2017.
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