Parkinsonism after glycine‐derivate exposure (original) (raw)
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Short-term effect of dopaminergic medication on speech in early-stage Parkinson’s disease
npj Parkinson's Disease
The effect of dopaminergic medication on speech has rarely been examined in early-stage Parkinson’s disease (PD) and the respective literature is inconclusive and limited by inappropriate design with lack of PD control group. The study aims to examine the short-term effect of dopaminergic medication on speech in PD using patients with good motor responsiveness to levodopa challenge compared to a control group of PD patients with poor motor responsiveness. A total of 60 early-stage PD patients were investigated before (OFF) and after (ON) acute levodopa challenge and compared to 30 age-matched healthy controls. PD patients were categorised into two clinical subgroups (PD responders vs. PD nonresponders) according to the comparison of their motor performance based on movement disorder society-unified Parkinson’s disease rating scale, part III. Seven distinctive parameters of hypokinetic dysarthria were examined using quantitative acoustic analysis. We observed increased monopitch (p &...
Frontiers in Neurology, 2021
Importance: The effects of dopaminergic treatment on speech in patients with Parkinson's disease (PD) are often mixed and unclear. The aim of this study was to better elucidate those discrepancies.Methods: Full retrospective data from advanced PD patients before and after an acute levodopa challenge were collected. Acoustic analysis of spontaneous monologue and sustained phonation including several quantitative parameters [i.e., maximum phonation time (MPT); shimmer local dB] as well as the Unified Parkinson's Disease Rating Scale (UPDRS) (total scores, subscores, and items) and the Clinical Dyskinesia Rating Scale (CDRS) were performed in both the defined-OFF and -ON conditions. The primary outcome was the changes of speech parameters after levodopa intake. Secondary outcomes included the analysis of possible correlations of motor features and levodopa-induced dyskinesia (LID) with acoustic speech parameters. Statistical analysis included paired t-test between the ON and OF...
Parkinsonian speech disfluencies: effects of l-dopa-related fluctuations
Journal of Fluency Disorders, 2003
The excess dopamine theory of stuttering contends that stuttering may be related to excess levels of the neurotransmitter dopamine in the brain. As Parkinson's disease (PD) patients commonly exhibit changes in dopamine levels accompanied by changes in motor performance, the present study examined disfluency in PD patients to gain information on the role of dopamine in speech disfluencies. Nine PD patients with no history of developmental stuttering were recorded once before and twice after taking their morning medication (on separate days). They read a passage and produced a monologue. Within-word and overall speech disfluencies were calculated at each recording. Through motor testing, it was inferred that participants had relatively low dopamine levels before taking medication, and relatively high dopamine levels after taking medication. There were no group changes in disfluency levels when the low-dopamine and high-dopamine states were compared. There were, however, significant differences in percent disfluencies between the PD participants and age-matched controls. The results of this study do not strongly support the excess dopamine theory of stuttering. Rather, the disfluency changes exhibited by individual participants support a hypothesis that speech disfluencies may be related to increases or decreases in dopamine levels in the brain.
For better or worse: The effect of levodopa on speech in Parkinson's disease
Movement Disorders, 2008
While the beneficial effect of levodopa on traditional motor control tasks have been well documented over the decades, its effect on speech motor control has rarely been objectively examined and the existing literature remains inconclusive. To examine the effect of levodopa on speech in patients with Parkinson's disease, it was hypothesized that levodopa would improve preparatory motor set related activity and alleviate hypophonia. Patients fasted and abstained from levodopa overnight. Motor examination and speech testing was performed the following day, pre-levodopa during their "off " state, then at hourly intervals postmedication to obtain the best "on " state. All speech stimuli showed a consistent tendency for increased loudness and faster rate during the "on " state, but this was accompanied by a greater extent of intensity decay. Pitch and articulation remained unchanged. Levodopa effectively upscaled the overall gain setting of vocal amplitude and tempo, similar to its well-known effect on limb movement. However, unlike limb movement, this effect on the final acoustic product of speech may or may not be advantageous, depending on the existing speech profile of individual patients.
Speech and Voice Response to a Levodopa Challenge in Late-Stage Parkinson's Disease
Frontiers in neurology, 2017
Parkinson's disease (PD) patients are affected by hypokinetic dysarthria, characterized by hypophonia and dysprosody, which worsens with disease progression. Levodopa's (l-dopa) effect on quality of speech is inconclusive; no data are currently available for late-stage PD (LSPD). To assess the modifications of speech and voice in LSPD following an acute l-dopa challenge. LSPD patients [Schwab and England score <50/Hoehn and Yahr stage >3 (MED ON)] performed several vocal tasks before and after an acute l-dopa challenge. The following was assessed: respiratory support for speech, voice quality, stability and variability, speech rate, and motor performance (MDS-UPDRS-III). All voice samples were recorded and analyzed by a speech and language therapist blinded to patients' therapeutic condition using Praat 5.1 software. 24/27 (14 men) LSPD patients succeeded in performing voice tasks. Median age and disease duration of patients were 79 [IQR: 71.5-81.7] and 14.5 [IQR: ...
Current Medicinal Chemistry, 2002
The purpose of this paper was to examine the effects of speech therapy and various pharmacological treatment approaches on the voice and speech of persons with Parkinson s disease (PD). Approximately 80% of PD patients have voice and speech problems including reduced vocal intensity, reduced vocal pitch, monopitch and monoloudness, and imprecise articulation. Research prior to 1970&amp;amp;amp;amp;amp;#39;s had not demonstrated significant improvements following speech therapy. However, recent research has shown that speech therapy (when persons with PD are optimally medicated) has proven to be the most efficacious therapeutic method for improving voice and speech function. Across research studies, pharmacological methods of treatment in isolation do not appear to significantly improve voice and speech function in PD. In a single subject study, however, the dopamine agonist Mirapex was shown to have beneficial effects on vocal intensity. Possible explanations for the differential responses to treatment are discussed. It is suggested that the goal of future studies should be investigations of the effects of combined treatment approaches.
The Journal of the Acoustical Society of America, 2000
In Parkinsonian patients, abnormal vocal qualities are frequently observed. Previous research has suggested that laryngeal muscle rigidity may be responsible for the vocal symptoms. While rigidity is one of the most responsive symptoms to dopaminergic therapy, studies investigating speech changes following dopaminergic therapy are very limited. In this study, phonatory responses to dopaminergic stimulation were examined using a double-blind, placebo-controlled design. Ten Parkinsonian patients with speech impairment served as subjects. They were given placebo or apomorphine during two consecutive visits. Data were collected at baseline and 30 minutes post-injection during each visit. Subjects produced maximally sustained, and comfortably phonated vowels. Instrumental analysis was used to assess changes in phonatory function. Nonspeech motor functions were assessed using the Unified Parkinson's Disease Rating Scale. While nonspeech motor functions improved significantly following the dopaminergic stimulation, the vocal parameters showed no changes. This suggests that dopaminedepletion may not be responsible for the laryngeal dysfunction.
Characteristics of speech disfluency in Parkinson disease
Journal of Neurolinguistics, 2010
The purpose of this study was to describe speech disfluency characteristics in a group of 32 individuals with Parkinson disease (PD). Individuals with PD read a standard passage, and percentages of within-word and between-word disfluencies were calculated. The disfluency percentages exhibited by the individuals with PD were significantly greater than age-matched control speakers. Similarity was found between PD-related disfluencies and disfluencies seen in developmental stuttering, as the PD participants produced primarily motoric-based within-word disfluencies, including both repeated movements and fixed postures. A relationship was also found between self-ratings of medication effectiveness and disfluency levels, and this relationship is interpreted relative to the dopamine hypothesis of stuttering. Finally, significant reductions in within-word disfluencies were seen during a clear-speech task, along with an increase in disfluency levels during a monologue compared to a reading task.
Speech disorders in Parkinson’s disease - characteristics, assessment and treatment
Medical review, 2021
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 percept...
Verbal fluency in Parkinson’s disease patients on/off dopamine medication
Introduction: Parkinson's disease (PD) is associated with dopamine depletion in the fronto-striatal network which affects some language aspects such as verb processing. Some experiments have demonstrated that dopamine deficiency plays a role in the normal functioning of the lexico-semantic system. As a result, the verbal fluency task could be a useful tool to assess the function of the semantic system, by examining both the number of words generated and the frequency of use of those words. Objective: The aim of this study was to find out how dopamine affects the performance of PD patients using a verbal fluency task, focussing on action-word fluency.