Sapir Shimon, Ramig Lorraine, Fox Cynthia
Department of Communication Sciences and Disorders, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel.
Curr Opin Otolaryngol Head Neck Surg. 2008 Jun;16(3):205-10. doi: 10.1097/MOO.0b013e3282febd3a.
To review recent research and clinical studies pertaining to the nature, diagnosis, and treatment of speech and swallowing disorders in Parkinson disease.
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.
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.
综述帕金森病言语和吞咽障碍的性质、诊断及治疗方面的近期研究和临床研究。
尽管一些研究表明多巴胺疗法和丘脑底核深部脑刺激可改善嗓音和言语，但其他研究显示效果甚微或有不良影响。经颅磁刺激口部运动皮层及在声带注射胶原蛋白的初步数据支持帕金森病患者发声改善。专注于嗓音响度的治疗，特别是LSVT LOUD（李·西尔弗曼嗓音疗法），对帕金森病言语障碍治疗有效。LSVT LOUD引起的大脑活动变化为神经可塑性提供了初步证据。基于计算机的技术使大量用户能够使用李·西尔弗曼嗓音疗法。已开发出一种研究帕金森病中神经药理学对发声影响的大鼠模型。近期研究也带来了言语和吞咽的新诊断方法。
LSVT LOUD言语康复疗效显著且经过科学验证。需要更多研究以增进对帕金森病言语和吞咽障碍的理解、诊断、预防及治疗。
