Prosody and levodopa in Parkinsons disease

Azevedo, Luciana Lemos de; Reis, César; Souza, Irene Soares de; Cardoso, Francisco

doi:10.1590/0004-282x20130141

Cited by 10 publications

(12 citation statements)

References 15 publications

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“…DA treatment does not have an effect on prosody, however it improves speech speed (Azevedo et al, 2013). DA treatment improved articulation, pitch variance, intensity and overall voice quality (Rusz et al 2013).…”

Section: Speech Problemsmentioning

confidence: 99%

“…The findings from these two studies suggest that areas that are affected by PD also play a role in the cognitive component of speech production. In addition, Azevedo and colleagues suggested that bradykinesia may affect the prosody of the patients' speech (Azevedo, Reis, Souza, & Cardoso, 2013).…”

Section: Neural Substratesmentioning

confidence: 99%

“…Although dopamine replacement therapies are effective at treating rigidity and bradykinesia, they can either impair or have no effect on speech disorders (Maillet et al, 2012) or speech performance (Azevedo et al, 2013). This indicate that dopaminergic and non-dopaminergic deficits might contribute to the occurrence of speech disorders in PD.…”

Section: Effects Of Dopamine Medications and Dbsmentioning

confidence: 99%

See 2 more Smart Citations

Motor symptoms in Parkinson’s disease: A unified framework

Moustafa

Chakravarthy

Phillips

et al. 2016

Neuroscience & Biobehavioral Reviews

301

156

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Parkinson's disease (PD) is characterized by a range of motor symptoms. Besides the cardinal symptoms (akinesia and bradykinesia, tremor and rigidity), PD patients show additional motor deficits, including: gait disturbance, impaired handwriting, grip force and speech deficits, among others. Some of these motor symptoms (e.g., deficits of gait, speech, and handwriting) have similar clinical profiles, neural substrates, and respond similarly to dopaminergic medication and deep brain stimulation (DBS). Here, we provide an extensive review of the clinical characteristics and neural substrates of each of these motor symptoms, to highlight precisely how PD and its medical and surgical treatments impact motor symptoms. In conclusion, we offer a unified framework for understanding the range of motor symptoms in PD. We argue that various motor symptoms in PD reflect dysfunction of neural structures responsible for action selection, motor sequencing, and coordination and execution of movement.

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Section: Speech Problemsmentioning

confidence: 99%

Section: Neural Substratesmentioning

confidence: 99%

Section: Effects Of Dopamine Medications and Dbsmentioning

confidence: 99%

See 1 more Smart Citation

Motor symptoms in Parkinson’s disease: A unified framework

Moustafa

Chakravarthy

Phillips

et al. 2016

Neuroscience & Biobehavioral Reviews

301

156

View full text Add to dashboard Cite

show abstract

“…A recent study 25 reported that the Parkinson disease does not make the patient use prosody to express his/her attitudes differently from the control group, however, when the attitudes were not taken into account, it was observed that levodopa was effective in the improvement of the parameter of duration. This finding reinforces the importance of the association of speech therapy to medication aiming to improve the communicative performance of parkinsonian patients.…”

Section: Discussionmentioning

confidence: 96%

Effect of speech therapy and pharmacological treatment in prosody of parkinsonians

Azevedo

Souza²,

Oliveira

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective: Parkinsonian patients usually present speech impairment. The aim of this study was to verify the influence of levodopa and of the adapted Lee Silverman Vocal Treatment 1 method on prosodic parameters employed by parkinsonian patients. Method: Ten patients with idiopathic Parkinson's disease using levodopa underwent recording of utterances produced in four stages: expressing attitudes of certainty and doubt and declarative and interrogative modalities. The sentences were recorded under the effect of levodopa (on), without the effect of levodopa (off); before and after speech therapy during the on and off periods. Results: The speech therapy and its association with drug treatment promoted the improvement of prosodic parameters: increase of fundamental frequency measures, reduction of measures of duration and greater intensity. Conclusion: The association of speech therapy to medication treatment is of great value in improving the communication of parkinsonian patients.

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“…Within this context, the paper published in this issue of Arquivos de Neuro-Psiquiatria by Azevedo et al 6 adds an important attempt to assess prosody using several acoustic and temporal speech measurements. In addition to extracting 12 selected parameters relating to the oral communication impact of PD, the authors aimed to investigate differences in expressing attitudes (certainty and doubt) and in modes of speech (declarative and interrogative), which have singular melodic patterns.…”

mentioning

confidence: 99%

Prosodic expression and levodopa in Parkinson's disease

Behlau

2013

Arq. Neuro-Psiquiatr.

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Prosody is an important supra-segmental aspect of speech. Through prosodic variation, many cues regarding message intention, affected expression and type of interpersonal relationship are given to the listener. The main characteristics involved in prosody are fundamental frequency and loudness variability, speech rate, duration of pauses, vowel length, force of articulation and rhythm.Prosody pattern is an individual characteristic that requires an intact central and peripheral nervous system. It is highly influenced by biological factors, cultural features, personality traits, emotional states and aging. It is easy to understand that many neurological and mental disorders can produce a direct impact on prosodic expression. For example, maniacal episodes are vocally characterized by uncontrolled intensity and excessive frequency variability; on the other hand, vocal fold paralysis can severely limit frequency and loudness control, impairing the speaking and singing voice.Parkinson's disease (PD) patients suffer from reduction of the extent of all movements relating to speech, involving three subsystems: respiratory, phonatory and articulatory. In addition, swallowing may also be impaired 1 . Rigidity, bradykinesia and tremor are also present in oral communication, at several degrees of intensity that are not always directly related to the Hoehn and Yahr stages. PD patients' respiratory limitations do not provide proper breathing support for them to produce normal phrases and loudness variation; at the phonatory level, the vocal folds present reduced elongation, with restricted and unstable adduction impact on vocal quality and voice range profile; finally, at the articulatory level, speech sound imprecision and resonance imbalance contributes towards lower intelligibility scores. Patients with PD are usually characterized as presenting lower fundamental frequency (low pitch voice), monopitch and monoloudness (which gives the impression of a monotonous speech), phonoasthenia and lack of articulatory integrity 1 . The psychodynamics of individual with these characteristics are mostly negative: listeners may evaluate these patients as boring, unattractive and unhealthy, and even as having lower cognitive resources than their real condition permits 2,3 . Moreover, since message intelligibility may be reduced, misinterpretations due to the lack of sound precision and reduced intonation patterns will possibly decrease communicative interactions, lead to greater social isolation and limit quality of life 3 .Studies on voice and speech among PD patients, before and after treatment, frequently focus on the fundamental frequency and its variability and loudness levels in sustained vo wels or selected phrases 4,5 . Within this context, the paper published in this issue of Arquivos de Neuro-Psiquiatria by Azevedo et al. 6 adds an important attempt to assess prosody using several acoustic and temporal speech measurements. In addition to extracting 12 selected parameters relating to the oral communication impact of PD, the au...

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Prosody and levodopa in Parkinsons disease

Cited by 10 publications

References 15 publications

Motor symptoms in Parkinson’s disease: A unified framework

Motor symptoms in Parkinson’s disease: A unified framework

Effect of speech therapy and pharmacological treatment in prosody of parkinsonians

Prosodic expression and levodopa in Parkinson's disease

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