The Temporal Control of Repetitive Articulatory Movements in Parkinson’s Disease (original) (raw)
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A nonspeech investigation of tongue function in Parkinson's disease
The journals of gerontology. Series A, Biological sciences and medical sciences, 2005
Background. Nonspeech investigations of tongue function in persons with Parkinson's disease (PD) have generally reported impaired tongue strength, endurance, and fine force control. However, these investigations did not specifically evaluate the relative contribution of age effects to the deficits in tongue function observed. Furthermore, the relationship between these nonspeech measures of tongue function and the speech disorder present in PD remains equivocal. Therefore, the current study investigated the strength, rate of repetitive movement, fine force control, and endurance of the tongue in three groups of participants.
Orofacial function and temporomandibular disorders in Parkinson’s Disease: a case-controlled study
BMC Oral Health, 2023
Background The difficulties and challenges faced by people with Parkinson's disease (PD) in performing daily orofacial function are not systematically investigated. In this study, specific orofacial non-motor and motor symptoms and functions were systematically examined in PD patients in comparison to a matched control group. Methods The clinical case-controlled study was conducted from May 2021 to October 2022 and included persons with PD and age-and gender-matched persons without PD. The participants with PD were outpatients diagnosed with PD at the Department of Neurology at Bispebjerg University Hospital in Copenhagen, Denmark. The participants underwent a systematic clinical and relevant self-assessment of the orofacial function and temporomandibular disorders (TMD). The primary outcomes were objective and subjective assessments of the general orofacial function, mastication, swallowing, xerostomia and drooling. The secondary outcomes were the prevalence of TMD and orofacial pain. The difference in outcome measures between the two groups was analysed using chi-square and Mann-Whitney U test. Results The study included 20 persons with PD and 20 age-and gender-matched persons without PD. Both objectively and subjectively, persons with PD had poorer orofacial function than the control group. Persons with PD had also a significantly more severe limitation of jaw mobility and jaw function. The objective masticatory function was also significantly reduced for persons with PD compared to the control group, and 60% of persons with PD found it difficult to eat foods with certain consistencies while 0% of the control group reported that problem. Persons with PD could swallow less water per second and the average swallowing event was significantly longer for PD persons. Even though PD persons reported more xerostomia (58% for persons with PD and 20% for control persons), they also reported significantly more drooling than the control group. Additionally, orofacial pain was more prevalent in PD persons. Conclusions Persons with PD have a compromised orofacial function. Furthermore, the study indicates a link between PD and orofacial pain. In order to screen and treat persons with PD accordingly, healthcare professionals should be aware of and address these limitations and symptoms.
Movement Disorders, 2002
We studied the various physiological aspects of oropharyngeal swallowing in Parkinson's disease (PD). Fifty-eight patients with PD were investigated by clinical and electrophysiological methods that measured the oropharyngeal phase of swallowing. All patients except 1 had mild to moderate degree of disability score. Dysphagia was demonstrated in 53% of all patients in whom the test of dysphagia limit was abnormal. All PD patients with or without dysphagia displayed the following abnormalities: (1) the triggering of the swallowing reflex was prolonged probably due to inadequate bolus control in the mouth and tongue and/or a specific delay in the execution of the swallowing reflex; (2) the duration of the pharyngeal reflex time was extremely prolonged due to slowness of the sequential muscle movements, especially those of the suprahyoidsubmental muscles; (3) cricopharyngeal muscle of the upper oesophageal sphincter was found to be electrophysiologically normal; and (4) the electrophysiological phenomena in PD patients could not be strongly correlated with the degree of the disability and clinical score of the PD. It was concluded that various motor disorders of PD have considerable influence on oropharyngeal swallowing: hypokinesia, reduced rate of spontaneous swallowing, and the slowness of segmented but coordinated sequential movements rather than any abnormalities in the central pattern generator of the bulbar center. Some compensatory mechanisms in the course of PD may explain the benign nature of swallowing disorder until the terminal stage of the disease. Similarly, the swallowing problems of PD are not only related with the dopamine deficiency; some other nondopaminergic mechanisms may also be involved.
2018
Introduction Parkinson’s disease (PD) can influence the function of respiration, pho‐ nation and articulation, quality of speech, swallowing, salivation, and graphomotor skills. Aim and methodology: This chapter is based on research of the degree of impairments of speech, phonation, salivation, swallowing, and handwriting in 64 patients with PD. The results of maximal phonation time (MPT) were compared with two control groups of healthy young (N = 35) and healthy elderly (N = 35) subjects. The degree of impairment of these functions was measured by the Unified Parkinson Disease Rating Scale (UPDRS) subtests. Results and discussion: In the group with PD, speech impairments of various degrees were present in 82.81% of patients. The problem of salivation control of different degrees was present in 68.75% of the sample. Swallowing difficulty of different degrees was present in 53.15% of the sample. Difficulty writing of various degrees had 84.38% of the sample. The average MPT in group ...
Quantitative assessment of oral and pharyngeal function in Parkinson's disease
Dysphagia, 1996
Oral and pharyngeal dysfunction is common in Parkinson's disease. To reveal the frequency of swallowing dysfunction and correlate swallowing dysfunction with locomotor disturbances, we studied 75 patients with Parkinson's disease staged I-IV according to the Hoehn and Yahr score. We assessed oral and pharyngeal swallow during optimal medication by a quantitative test of swallowing (the ROSS test) measuring the suction pressure, bolus volume, swallowing capacity, and time for important events in the swallowing cycle. We found abnormal results in 7/12 patients (58%) in stage 1 of the Hoehn and Yahr score, in 13/14 patients (93%) in stage 2, in 29/32 patients (91%) in stage 3, and in 16/17 patients (94%) in stage 4. Abnormal test results in stages, 1, 2, and 3 were seldom related to swallowing difficulties noticed by the patients. In advanced disease (Hoehn and Yahr stage 4), the abnormal results were often considerable, with swallowing difficulties obvious to the patient. Two of 17 patients coughed during or immediately after the test and 3/ 17 patients were unable to complete the test. The degree of swallowing disturbance increased during stress (forced, repetitive swallow). The Hoehn and Yahr score and the results in the ROSS test did not correlate, indicating that swallowing disturbances are due to nondopaminergic degeneration. Silent swallowing impairment may interfere with the nutrition and quality of life in Parkinson's disease, thus it is of interest to monitor this in clinical practice.
The Journal of the Acoustical Society of America
This investigation aimed at determining whether an acoustic quantification of the oral diadochokinetic (DDK) task may be used to predict the perceived level of speech impairment when speakers with Parkinson's disease (PD) are reading a standard passage. DDK sequences with repeated [pa], [ta], and [ka] syllables were collected from 108 recordings (68 unique speakers with PD), along with recordings of the speakers reading a standardized text. The passage readings were assessed in five dimensions individually by four speech-language pathologists in a blinded and randomized procedure. The 46 acoustic DDK measures were merged with the perceptual ratings of read speech in the same recording session. Ordinal regression models were trained repeatedly on 80% of ratings and acoustic DDK predictors per dimension in 10-folds, and evaluated in testing data. The models developed from [ka] sequences achieved the best performance overall in predicting the clinicians' ratings of passage readings. The developed [pa] and [ta] models showed a much lower performance across all dimensions. The addition of samples with severe impairments and further automation of the procedure is required for the models to be used for screening purposes by non-expert clinical staff. V
Disorders of the Oral Cavity in Parkinson’s Disease and Parkinsonian Syndromes
Parkinson's Disease, 2015
Awareness of nonmotor symptoms of Parkinson's disease is growing during the last decade. Among these, oral cavity disorders are, although prevalent, often neglected by the patients, their caregivers, and physicians. Some of these disorders include increased prevalence of caries and periodontal disease, sialorrhea and drooling, xerostomia, orofacial pain, bruxism, and taste impairment. Though many of these disorders are not fully understood yet and relatively few controlled trials have been published regarding their treatment, physicians should be aware of the body of evidence that does exist on these topics. This paper reviews current knowledge regarding the epidemiology, pathophysiology, and treatment options of disorders of the oral cavity in Parkinson's disease patients.
Articulatory Consequences of Parkinson's Disease: Perspectives from Two Modalities
Brain and Cognition, 1999
Language production involves complex yet productively varying motor behavior. Rule-governed combinations yield a finite set of formational units combined in an infinite number of ways. The creativity of language ensures that no particular articulation will be highly automatized. Linguistic articulation is highly complex and varied. As such, it differs from the other more automatized motor behaviors typically studied such as learned movements in apraxia studies or repetitive behavior as occurs in walking or other everyday activities. Language also strives to maintain a balance between ease of articulation and ease of perception, while maintaining linguistically relevant distinctions. We report here a number of studies on the articulatory consequences of Parkinson's disease (PD) in the spoken and signed modalities. Our goal is to highlight the commonalities and distinctions between the two modalities of speech and sign that will allow us to better understand the impingements of PD on language production in general.
Punding in Parkinson's disease: The impact of patient's awareness on diagnosis
Movement Disorders, 2010
Hiccups can be an uncommon side effect of anti-parkinsonian therapy, recently reported in the literature. In these reports, dopamine agonists (DAs) (pramipexole, piribedil, and pergolide) 1,2 seem to play a causative role as hiccups began increasing the dose and subsided when the drug was stopped. In the first case, 2 hiccups started with pramipexole 3 mg per day and ended after drug discontinuation; another patient had hiccups after piribedil 100 mg per day 2 which stopped after tapering the dose to 50 mg per day, whereas in another case pergolide was associated with hiccups at high and not at low doses. 3 Very recently also levodopa (L-dopa) intake 500 mg per day lead to severe hiccups in an old patient with de novo parkinsonism 1 and some cases were also described in the past in a French vigilance survey 4 after L-dopa therapy.
Pathophysiology and Symptomatology of Drooling in Parkinson’s Disease
Healthcare, 2022
Drooling can present in patients with Parkinson’s disease (PD), and it is manifested as an excessive pooling of saliva inside the oral cavity. Currently, the exact pathophysiological mechanism of drooling in PD is not yet fully explicated. Thus, it becomes crucial to understand if some clinical characteristics may emphasize drooling or if they are just concomitant. In PD, excessive drooling has been associated with a higher burden of non-motor symptoms, such as cognitive impairment, sleep problems, autonomic dysfunction, constipation and orthostatic hypotension, and of worse severity of motor fluctuations and bradykinesia. PD patients with excessive drooling also showed a reduction of striatal DAT availability at DaTSCAN imaging. Excessive drooling in patients with Parkinson’s cannot be attributed to a single factor but to a mixture of factors, including but not limited to impaired nigrostriatal pathways.