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Speech and swallowing disorders in Parkinson disease

Sapir, Shimona; Ramig, Lorraineb,c,d; Fox, Cynthiac

Current Opinion in Otolaryngology & Head and Neck Surgery: June 2008 - Volume 16 - Issue 3 - p 205–210
doi: 10.1097/MOO.0b013e3282febd3a
Speech therapy and rehabilitation: Edited by Bernice Klaben
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Purpose of review To review recent research and clinical studies pertaining to the nature, diagnosis, and treatment of speech and swallowing disorders in Parkinson disease.

Recent findings Although some studies indicate improvement in voice and speech with dopamine therapy and deep brain stimulation of the subthalamic nucleus, others show minimal or adverse effects. Repetitive transcranial magnetic stimulation of the mouth motor cortex and injection of collagen in the vocal folds have preliminary data supporting improvement in phonation in people with Parkinson disease. Treatments focusing on vocal loudness, specifically LSVT LOUD (Lee Silverman Voice Treatment), have been effective for the treatment of speech disorders in Parkinson disease. Changes in brain activity due to LSVT LOUD provide preliminary evidence for neural plasticity. Computer-based technology makes the Lee Silverman Voice Treatment available to a large number of users. A rat model for studying neuropharmacologic effects on vocalization in Parkinson disease has been developed. New diagnostic methods of speech and swallowing are also available as the result of recent studies.

Summary Speech rehabilitation with the LSVT LOUD is highly efficacious and scientifically tested. There is a need for more studies to improve understanding, diagnosis, prevention, and treatment of speech and swallowing disorders in Parkinson disease.

aDepartment of Communication Sciences and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel

bDepartment of Speech, Language, Hearing Science, University of Colorado, Boulder, USA

cNational Center for Voice and Speech, Denver, Colorado, USA

dColumbia University Teacher's College, New York, New York, USA

Correspondence to Shimon Sapir, PhD, Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Mount Carmel, Haifa 31905, Israel Tel: +972 4 8240517; fax: +972 4 8249507; e-mail: sapir@research.haifa.ac.il

© 2008 Lippincott Williams & Wilkins, Inc.