Progression of Self-Perceived Speech and Swallowing Impairment in Early Stage Parkinson's Disease: Longitudinal Analysis of the Unified Parkinson's Disease Rating Scale

Abstract

Purpose: The purpose of this study was to investigate the presence and progression of self-perceived speech and swallowing impairments in newly diagnosed people with Parkinson's disease (PD) longitudinally across 6 years. Method: Longitudinal data from the Parkinson's Progression Markers Initiative were analyzed across six consecutive years in a cohort of 269 newly diagnosed people with PD, and a subset of those ( n = 211) who were assessed at every time point across the 6 years. Dependent variables included self-perceived ratings of speech and swallowing impairment severity from the Unified Parkinson's Disease Rating Scale. Patient-centered factors of age at diagnosis and motor phenotype were also assessed to determine if they were related to the change in self-perceived speech and swallowing impairments. Results: Overall, self-perceived speech and swallowing impairments were present in newly diagnosed people with PD, although over time, the degree of severity for both remained in the mild range. However, the rate of change over time was significant for perceived speech impairment, F (5.5, 1158.8) = 21.1, p < .001), and perceived swallowing impairment, F (5.2, 1082.6) = 8.6, p < .001. Changes for speech and swallowing impairment were both in the direction of progressive severity. There were no effects of age at diagnosis or motor phenotype on the degree of change for either speech or swallowing. Conclusions: Self-perceptions of speech and swallowing impairment changed significantly over time in newly diagnosed people with PD (PWPD). Consistent with existing literature, self-perceptions of speech impairment were rated as more severe than those of swallowing impairment. These findings reveal that even in the early years postdiagnoses, PWPD are experiencing changes to speech and swallowing function, albeit within the mildly severe range. The presence of self-perceived mild speech and swallowing impairments in the initial years postdiagnosis may support the need for intervention to improve and or sustain function over time.

Laryngeal symptoms related to motor phenotypes in Parkinson's disease: A systematic review

“…Brown and Spencer 18 found no differences between phenotypes, while Burk and Watts 19 found lower cepstral peak prominence in the PIGD phenotype. Finally, one study (20%) included self‐assessment of vocal symptoms 21,23 . Dumican and Watts 21 found worse voice quality, as assessed by the Voice‐Related Quality of Life and a custom questionnaire, in the PIGD‐phenotype.…”

“…Finally, one study (20%) included self-assessment of vocal symptoms. 21,23 Dumican and Watts 21 found worse voice quality, as assessed by the Voice-Related Quality of Life and a custom questionnaire, in the PIGD-phenotype.…”

Swallowing outcomes in dysphagia interventions in Parkinson’s disease: a scoping review

“…Just 6 of the 19 included studies assessed swallowing-related quality of life and five studies included self-perception of swallowing as patient-reported outcomes. This is a relatively small number, as patient-reported outcomes are considered critical for evidence-based practice and for assessing treatment effectiveness 43. It should be noted that specifically in people with PD the self-assessment may differ from objective or investigator-reported outcomes due to sensorimotor deficits44 45 and hence, both types of assessments should be included.…”

Evaluation of the Psychometric Properties of a Newly Developed Chinese Screening Tool for Speech Disorders in Patients With Parkinson’s Disease

“…Studies and interpretation of data from studies in early PD are limited, and best practices of speech therapy have not been established (Ciucci et al, 2013). The presence of self-perceived mild speech impairment in the initial years of post-diagnosis in patients with PD may support the need for intervention to improve or sustain function over time (Watts & Zhang, 2022).…”