Broadfoot C K, Abur D, Hoffmeister J D, Stepp C E, Ciucci M R
Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI.
Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA.
Perspect ASHA Spec Interest Groups. 2019 Oct;4(5):825-841. doi: 10.1044/2019_pers-sig3-2019-0001. Epub 2019 Oct 11.
Individuals with Parkinson disease (PD) present with complex and variable symptoms, with recent findings suggesting that the etiology of PD extends beyond the involvement of just the basal ganglia. These symptoms include significant impairments in the speech and swallowing domains, which can greatly affect quality of life and therefore require therapeutic attention. This research-based update reviews the neurophysiological basis for swallowing and speech changes in PD, the effectiveness of various types of treatments, and implications for symptom evaluation and management.
The mechanisms responsible for swallowing and speech symptoms in PD remain largely unknown. Dopaminergic medication and deep-brain-stimulation do not provide consistent benefits for these symptoms suggesting a non-dopaminergic network is involved. Importantly, evidence suggests that symptoms of dysphagia and hypokinetic dysarthria may be early indications of PD, so it is critical to investigate the cause of these changes.
帕金森病（PD）患者表现出复杂多样的症状，近期研究结果表明，PD的病因不仅局限于基底神经节受累。这些症状包括言语和吞咽方面的显著障碍，这会极大地影响生活质量，因此需要进行治疗。本次基于研究的更新回顾了PD吞咽和言语变化的神经生理学基础、各种治疗方法的有效性以及对症状评估和管理的意义。
PD吞咽和言语症状的发病机制在很大程度上仍不清楚。多巴胺能药物和深部脑刺激对这些症状并未提供一致的益处，这表明涉及非多巴胺能网络。重要的是，有证据表明吞咽困难和运动减少性构音障碍症状可能是PD的早期迹象，因此调查这些变化的原因至关重要。
