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特发性帕金森病中的构音障碍与病程、严重程度及左旋多巴剂量

Articulation disorders and duration, severity and L-dopa dosage in idiopathic Parkinson's disease.

作者信息

Pawlukowska Wioletta, Gołąb-Janowska Monika, Safranow Krzysztof, Rotter Iwona, Amernik Katarzyna, Honczarenko Krystyna, Nowacki Przemysław

机构信息

Department of Medical Rehabilitation, Pomeranian Medical University, Szczecin, Poland.

Clinic of Neurology, Pomeranian Medical University, Szczecin, Poland.

出版信息

Neurol Neurochir Pol. 2015;49(5):302-6. doi: 10.1016/j.pjnns.2015.07.002. Epub 2015 Jul 30.

Abstract

BACKGROUND

Parkinson's disease (PD) is one of the most common diseases of the central nervous system (CNS). It is frequently heralded by speech disturbances, which are one of its first symptoms.

AIM

The aim of this paper is to share our own experience concerning the correlation between the severity of speech disorders and the PD duration, its severity and the intake of L-dopa.

MATERIAL AND METHODS

The research included 93 patients with idiopathic PD, aged 26-86 years (mean age 65.1 years). Participants were examined neurologically according to the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr Scale. They were also assessed by Frenchay Dysarthria Assessment.

RESULTS

Considerable and severe disorders were concurrent with impairments in the mobility of the tongue, lips, the jaw as well as the pitch and loudness of the voice. The strongest correlation but at a moderate level was found to exist between the severity of labial impairment, voice loudness and the length of the disease. There was also a positive correlation between lip movement while the motions were being diversified, lip arrangement while speaking and the intake of L-dopa.

CONCLUSIONS

As PD progresses a significant decline in vocal articulation can be observed, which is due to reduced mobility within the lips and the jaw. Exacerbation of articulation disorders resulting from progression of the disease does not materially influence the UPDRSS scores. L-dopa has been found to positively affect the mobility of the lips while the patient is speaking and their arrangement at rest.

摘要

背景

帕金森病(PD)是中枢神经系统(CNS)最常见的疾病之一。它常常以言语障碍为先兆,而言语障碍是其最早出现的症状之一。

目的

本文旨在分享我们自身关于言语障碍严重程度与帕金森病病程、病情严重程度以及左旋多巴摄入量之间相关性的经验。

材料与方法

该研究纳入了93例年龄在26 - 86岁(平均年龄65.1岁)的特发性帕金森病患者。参与者根据统一帕金森病评定量表(UPDRS)和霍恩与雅尔分级量表进行神经学检查。他们还接受了法国ay构音障碍评估。

结果

严重和极严重的障碍与舌、唇、颌的活动障碍以及音高和响度异常同时存在。唇功能障碍严重程度、声音响度与病程之间存在最强但为中等程度的相关性。在动作多样化时的唇运动、说话时的唇形以及左旋多巴摄入量之间也存在正相关。

结论

随着帕金森病的进展,可以观察到言语清晰度显著下降,这是由于唇和颌的活动减少所致。疾病进展导致的构音障碍加重对UPDRSS评分没有实质性影响。已发现左旋多巴对患者说话时唇的活动及其静止时的形态有积极影响。

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