Speech disorders of Parkinsonism: a review.
Open Access
- 1 September 1981
- journal article
- review article
- Published by BMJ in Journal of Neurology, Neurosurgery & Psychiatry
- Vol. 44 (9) , 751-758
- https://doi.org/10.1136/jnnp.44.9.751
Abstract
Study of the speech disorders of Parkinsonism provides a paradigm of the integration of phonation, articulation and language in the production of speech. The initial defect in the untreated patient is a failure to control respiration for the purpose of speech and there follows a forward progression of articulatory symptoms involving larynx, pharynx, tongue and finally lips. There is evidence that the integration of speech production is organised asymmetrically at thalamic level. Experimental or therapeutic lesions in the region of the inferior medial portion of ventro-lateral thalamus may influence the initiation, respiratory control, rate and prosody of speech. Higher language functions may also be involved in thalamic integration: different forms of anomia are reported with pulvinar and ventrolateral thalamic lesions and transient aphasia may follow stereotaxis. The results of treatment with levodopa indicates that neurotransmitter substances enhance the clarity, volume and persistence of phonation and the latency and smoothness of articulation. The improvement of speech performance is not necessarily in phase with locomotor changes. The dose-related dyskinetic effects of levodopa, which appear to have a physiological basis in observations previously made in post-encephalitic Parkinsonism, not only influence the prosody of speech with near-mutism, hesitancy and dysfluency but may affect work-finding ability and in instances of excitement (erethism) even involve the association of long-term memory with speech. In future, neurologists will need to examine more closely the role of neurotransmitters in speech production and formulation.Keywords
This publication has 43 references indexed in Scilit:
- PEAK-DOSE DYSPHONIA IN PARKINSONISMThe Lancet, 1976
- L-Dopa in Parkinsonism and the Influence of Previous ThalamotomyBMJ, 1971
- AMANTADINE IN PARKINSON'S DISEASEThe Lancet, 1970
- Suggestions for Physiological Research in DysarthriaCortex, 1967
- Cinefluorographic Analysis of Tongue Thrusting Present in Parkinson PatientsFolia Phoniatrica et Logopaedica, 1967
- Bilateral Stereotaxic Lesions in the Management of Parkinsonism and the DyskinesiasBMJ, 1964
- CLASSIFICATION OF DYSARTHRIASActa Psychiatrica Scandinavica, 1957
- Anterior Choroidal Artery Ligation for Involuntary MovementsScience, 1953
- SELF-MUTILATION IN CHRONIC ENCEPHALITIS. Avulsion of Both Eyeballs and Extraction of TeethThe Lancet Healthy Longevity, 1933
- Experimentalphonetische Untersuchungen bei Erkrankungen des extrapyramidalen SystemsArchiv Fur Psychiatrie Und Nervenkrankheiten, 1925