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Download Speech Impairment in Parkinson`s Disease is Improved by
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Speech Impairment in Parkinson’s Disease is Improved by Transcranial Application of Electromagnetic Fields By: Reuven Sandyk Parkinson’s Disease • Frequently associated with speech disturbance • Affects 50-70% of patients • An even greater percentage in advanced stages of disease Parkinsonian Speech Impairment • • • • Monotonous pitch Slow rate Decrease in volume (hypophonia) Symptoms generally worse when patient is tired or anxious • In mid to advanced stages – Phonemes are less articulated • Produces a hypokinetic dysarthria (stuttering) – Festinating speech • Dysfluency may become worse as disease progresses Hypothesis • Treatment with weak electromagnetic fields (EMFs) applied transcranially Case Report • 52 year old radiologist • Freezing of gate, increased difficulties with hypophonia and with articulation • Mental depression, chronic insomnia • Anxiety and autonomic symptoms • Hyperkinetic dysarthria-particulaly severe during periods of mental stress • Started on serotonergic medication one month before treatment started Treatment • Four years, one treatment session each week • Treatment session • Patient continued to take serotonergic and antiParkinsonian medications Results • • • • 80-90% improvement in speech Impact of treatment is best the day after Effect of treatment lasts 5-6 days Continues to experience “on-off” fluctuations • Dramatic improvement in cognitive functions • Speech impairment was one of first symptoms to reappear Discussion • Stuttering observed in young children • Acquired stuttering is rarely observed in adults • Transient stuttering-left hemispheric lesions • Acquired stuttering-bilateral cerebral lesions • Prefrontal lobe, caudate-putamen, limbic system • Many symptoms associated with decreased levels of serotonin • SSRIs may improve speech impairment • Mechanisms by which EMFs improved speech impairment – Synaptic level – Synergistic interaction Conclusion Transcranial applications of EMFs may provide a novel, nonpharmacologic approach to the management of speech impairment associated with Parkinsonism
