Forms Of Repetitive Speech Phenomena In Parkinson’s Disease
An analysis and comparison of the transcribed iterations indicated that they could be grouped in two types. repetitive speech phenomena type 1, formally resembling palilalia were hyperfluent repetitions uttered fast and with increasing speech rate due to their often poor articulation and decreasing loudness they became increasingly blurred or murmured. By contrast, repetitive speech phenomena type 2 were dysfluent, prolonged, stuttering-like iterations which were relatively well articulated at a constant rate and loudness. As both types of speech repetitions were so phenomenologically distinct, it was thought that there was no need to establish interrater reliabilities. A small percentage of repetitive speech phenomena did not fit into one of both categories or was impossible to differentiate according to the above described criteria . Example utterances of the two most common types are summarised in table.
Characteristics of two repetitive speech phenomena in Parkinson’s disease
Lewy Body Dementia Vs Parkinsons Disease Dementia
Diagnoses of Lewy body dementia include dementia with Lewy bodies and Parkinsons disease dementia. Symptoms in both of these diagnoses can be similar.
Lewy body dementia is a progressive dementia caused by abnormal deposits of a protein called alpha-synuclein in the brain. Lewy bodies are also seen in Parkinsons disease.
The overlap in symptoms between Lewy body dementia and Parkinsons disease dementia include movement symptoms, rigid muscles, and problems with thinking and reasoning.
This seems to indicate that they could be linked to the same abnormalities, though more research is needed to confirm that.
The later stages of Parkinsons disease have more severe symptoms that may require help moving around, around-the-clock care, or a wheelchair. Quality of life can decline rapidly.
Risks of infection, incontinence, pneumonia, falls, insomnia, and choking increase.
Hospice care, memory care, home health aides, social workers, and support counselors can be a help in later stages.
Parkinsons disease itself isnt fatal, but complications can be.
Research has shown a median survival rate of about
Does Parkinson’s Cause Constipation
Constipation is a common complication of Parkinson’s disease, but it can be managed with lifestyle changes such as adding extra fibre to your diet, or medical treatment. Many people who have Parkinson’s disease notice difficulties with constipation before they notice motor symptoms such as tremor or stiffness.
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Let’s Talk About Talking With Parkinson’s Disease
In this short interview with a speech-language pathologist , the interviewer asks about common reasons someone with PD will see an SLP, what signs indicate it is time to see an SLP, what a typical SLP therapy session involves, reasons someone with mild PD symptoms may benefit from seeing and SLP, and thoughts about singing and choir programs for PD. There are tips for having a conversation in a loud room, and more tips and takeaways.
Other Types Of Tremor
In addition to the tremors described above, they are other forms of tremor that are less common and some of them have only been reported in a few case studies. Of these, dystonic tremor is worth mentioning as many patients with dystonia have tremor and it is sometimes difficult to distinguish dystonic tremors from static tremors associated with dystonia, which occur unspecifically in regions unaffected by dystonia. Dystonic tremor is mainly a postural and kinetic tremor in an extremity or body part affected by dystonia and is not usually seen during complete rest. It is now considered as a distinct entity from ET, as it is irregular, has a broad range of frequencies , and remains localised. A typical example is tremulous spasmodic torticollis. The tremor tends to be localised, asymmetric, and irregular in amplitude and periodicity. Many patients with dystonic tremor use their own tricks to reduce the tremor amplitude. These together with the absence of attempts at suppressing the tremor by voluntary muscle contractions are a fairly reliable diagnostic sign. Head tremor is common in patients with cervical dystonia and treatment with botulinum toxin often results in significant improvement of tremor as well as dystonia.
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My Parkinson’s Story: Speech And Swallowing
This 8-minute video alternates between an interview with a man and his wife and healthcare professionals. The man and his wife share how Parkinson’s has affected his speech and swallowing. The healthcare professionals explain how Parkinson’s affects speech and swallowing. Speech therapy can improve speech volume and enunciation as well as swallowing control and drooling. They also advise specific changes to eating habits and avoiding some types of foods to prevent choking.
How Can Listeners Help People Who Have Difficulty Speaking And Communicating
Here are some ways friends and family of people with Parkinsons disease can ease speaking and communication difficulties:
- Talk to the person with Parkinsons disease face-to-face only, and look at the person as he or she is speaking.
- Ask questions that require a simple “yes” or “no” answer.
- Repeat the part of the sentence that you understood.
- Ask the person to repeat what he or she said, to speak more slowly or spell out the words you did not understand.
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What Is Nonverbal Communication
Nonverbal communication, also called augmentative and alternative communication , is a method of communicating without spoken words.
When communication needs cannot be met through speech, the following techniques can help:
- Make the best use out of what speaking ability is left.
- Use expressions and gestures to communicate.
Non-verbal communication can help people with speech difficulties actually speak better by:
- Reducing the frustration and stress of being unable to communicate.
- Alleviating the pressure to speak.
- Allowing the person to be more relaxed and come across in a more understandable manner.
Living With Parkinson Disease
These measures can help you live well with Parkinson disease:
- An exercise routine can help keep muscles flexible and mobile. Exercise also releases natural brain chemicals that can improve emotional well-being.
- High protein meals can benefit your brain chemistry
- Physical, occupational, and speech therapy can help your ability to care for yourself and communicate with others
- If you or your family has questions about Parkinson disease, want information about treatment, or need to find support, you can contact the American Parkinson Disease Association.
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What Else Can I Do To Sleep Better With Parkinsons Disease
Practicing healthy sleep hygiene habits may also promote more restful sleep.
- Get outside during the day. Bright light tells your body its time to be awake.
- Keep your body moving during the day. Even if all you feel up to is a short walk or two, all physical activity offers benefits.
- Try at-home remedies, such as massage or a warm bath. Relaxing your mind may help your body fall asleep.
Dont:
- Take long naps during the day.
- Use stimulants, such as caffeine, within six hours of bedtime.
- Use your bedroom for activities other than sleeping. Go to another room to read, watch TV or work.
Ii Characteristics Of Dysarthria In Parkinsons Disease
Speech rate characteristics as well as dysfluency in PD also deserve comment. Speech rates vary widely in persons with PD. Instrumental measures suggest that some speakers with PD have a normal rate, other individuals have a speech rate that is slower than normal and other persons have a speech rate that is faster than normal. In fact, hypokinetic dysarthria, which is the type of dysarthria most often associated with PD, is the only dysarthria for which rate may be faster than normal.21 Perceptual impressions of rate in PD must be confirmed with instrumental measures, as listeners perception of the rate of Parkinsonian speech grows abnormally rapidly.36 That is, for a sentence produced at the same physical rate by a speaker with PD and a neurologically normal speaker, the sentence produced by the speaker with PD will be perceived by listeners to be faster. Imprecise articulation and monopitch or reduced variation in voice fundamental frequency in the acoustic speech signal of PD have been proposed as potential explanations. Dysfluency occurs in approximately 15 to 45% of persons with PD, typically at the beginning of utterances or after a pause.37 The dysfluency is typically mild in severity and is characterized by rapid, blurred phoneme repetitions.
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Compensatory And Therapeutic Swallowing Techniques
Compensatory strategies control the flow of food and help to eliminate symptoms, but do not alter the swallow physiology. Compensatory strategies used in the treatment of PD to be discussed include postural changes, increasing sensory input, and altering food consistencies. Eating while upright with the chin tucked to the chest or the head tilted forward at a 45 degree angle may be helpful for patients with a delay in triggering the pharyngeal swallow, reduced tongue base retraction, or reduced airway entrance closure or protection.43 Increasing sensory input may benefit patients who are delayed in triggering the pharyngeal swallow. Foods that help to increase sensory input include highly seasoned food, cold foods, sour foods, and possibly carbonated beverages. Altering food consistencies or elimination of consistencies from the diet should be explored only after other compensatory strategies have been examined.43 In general, thick viscous consistencies will be difficult for patients with PD to swallow who experience reduced tongue base retraction and pharyngeal contraction. Emphasizing foods that are moist and form a cohesive bolus has been suggested for patients with poor pharyngeal contraction, and blenderized food that requires minimal chewing may be necessary for patients with severe dysphagia.2 Similarly, thin liquids are typically the most difficult consistency for patients with reduced laryngeal closure.
How Parkinsons Affects Speech And Communications
Some people living with Parkinsons will not experience speech and communication difficulties. However, a large number of people do develop problems with speech and non-verbal communication. The stage when these problems might emerge is different for everyone. The symptoms will vary from person to person but may include:
- Reduced volume of speech
- Reduced body language, including hand gestures
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Diagnosis And Treatment Of Parkinsons Sleep Problems
Parkinsons disease is chronic and progressive, meaning it tends to get worse over time. However, there are treatment options that can help manage symptoms and allow patients to get more restful sleep.
The simplest way to start sleeping better with Parkinsons disease is by adopting healthy sleep habits. Sleep hygiene tips for Parkinsons disease sufferers include:
- Sticking to regular bedtimes
- Following a consistent bedtime routine with soothing activities such as listening to music or reading a calming book
- Getting regular exercise, preferably early in the day
- Getting adequate exposure to light, whether outdoors or through light therapy
- Avoiding long naps and naps late in the day
- Creating a cool, dark, and comfortable sleeping environment
- Restricting bedtime activities to sex and sleep only
- Turning off screens an hour before bedtime
- Reducing liquid intake before bedtime
- Avoiding caffeine, alcohol, and tobacco
- Eating a healthy diet and avoiding large meals at night
Light therapy, exercise, and deep brain stimulation have been successfully used to improve overall sleep quality and to treat specific conditions, such as REM sleep behavior disorder, in patients with Parkinsons disease. Cognitive behavioral therapy for insomnia has proven effective at reducing insomnia in healthy adults, although further research is needed on the effects of CBT in patients with Parkinsons disease.
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Problems With Speech And Voice
If you experience problems with your speech and voice you may find your speech sounds slurred or unclear, or that you speak more quickly than before. You may also find you have to slow down to make yourself understood. It can also become harder to control how quickly you speak.
Your voice can also change. It may sound:
- unsteady and flat
- difficulty putting enough power into your movements
Speech and language therapists are healthcare professionals who can provide assessment and advice on all aspects of communication, from facial expression and body language to speech and communication aids.
Clinical guidelines recommend that your GP, specialist or Parkinsons nurse should consider referring you to a speech and language therapist with experience of Parkinsons when youre in the early stages of the condition.
This is important because you may not notice changes to your speech and communication if they are subtle. But a speech and language therapist can uncover any issues, help you manage them and stop them becoming worse.
You may find it helpful to have regular check-ups. This will allow your speech and language therapist to monitor whether there are any changes with your speech. If there are, they can recommend specific exercises or programmes to help you.
Another recommendation in the guidelines is that youre given equipment to help you communicate if you need it .
Medication such as levodopa may help improve how loudly and clearly you speak.
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Language Problems Of Parkinsons Disease
Besides the frustrating speech and voicing problems of PD, there may also be language problems. These language problems very likely make the speech problems more difficult to deal with, so it is important to identify these language difficulties when they appear.
Speech is about expressing ideas via the use of language. Language is a cognitive ability that can be present even when you cannot speak. In the case of people with PD, they may exhibit word-finding difficulties and grammatical difficulties. They tend, for example, to use simplified sentence structures with an increase in the ratio of open-class items to closed-class items , as well as an increase in the frequency and duration of hesitations and pauses.
When listening to others speak, it’s sometimes hard for persons with PD to understand the others language, if they use complicated sentences to express their ideas. Thus, in both the production of language and comprehension of language, people with PD sometimes experience significant difficulties.
Whats Missing In Parkinsons Disease Treatments
Dr. Abraham Hoffer andDr. Harold Foster believe that there is a second step missing from currentmedical Parkinsons Disease treatments.
They found that this second setof Parkinsons symptoms diminished voluntary movements and increasedinvoluntary movements can indeed be delayed, reduced and even prevented.How?
Dr.Foster explains:
I believe that there are twotypes of symptoms seen in Parkinsons disease patients:
The first set is effectivelytreated with L-Dopa.
This second set of Parkinsons symptoms is different:
- Even with medication, the situationworsens with the appearance of a second set of symptoms, thataccording to Drs. Foster and Hoffer, seems to result from thederivatives, such as the dangerous toxin dopachrome, that is produced by thebreakdown of dopamine.
As a result, slowly but surely, the L-Dopa increases these secondarysymptoms until the patient becomes demented and often dies.
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What Happens When Parkinson Patient Stops Eating
Difficulty swallowing, called dysphagia, can happen at any stage of Parkinson disease. Signs and symptoms can range from mild to severe and may include: difficulty swallowing certain foods or liquids, coughing or throat clearing during or after eating/drinking, and feeling as if food is getting stuck…. see details
Trouble Staying Asleep Or Getting Restful Sleep
Some conditions, including Parkinsons disease, can interrupt sleep or make it less restful. Sleep fragmentation or interrupted sleep is one of the most common sleep complaints in Parkinsons patients. Poor sleep can lead to problems with attention and thinking, among other issues.
Several factors can lead to sleep interruptions in Parkinsons disease. These include the symptoms of the disease returning when medications wear off , frequent nighttime urination , hallucinations or altered dreams, and sleep apnea.
A large study of almost 3,200 patients found that sleep apnea was more common in people with Parkinsons than others.
Another study showed that women with sleep apnea may be at higher risk of getting Parkinsons disease.
Motor dysfunction of the laryngopharynx, the area where air and food pass through the throat, could also be involved in sleep apnea in Parkinsons disease patients, according to another study.
Sleep apnea can be treated with oral appliances or airway pressure devices such as a CPAP to keep the airways open. If these are unsuccessful, surgery might be an option.
REM sleep behavioral disorder, restless legs syndrome, and periodic limb movements in sleep are other issues that can lead to less restful or interrupted sleep. These disorders, which involve unwanted movements of the body, have a higher prevalence in Parkinsons patients and may have similar underlying causes.
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Diagnosis Of Parkinsons Disease
There are currently no blood or laboratory tests to diagnose non-genetic cases of Parkinsons. Doctors usually diagnose the disease by taking a persons medical history and performing a neurological examination. If symptoms improve after starting to take medication, its another indicator that the person has Parkinsons.
A number of disorders can cause symptoms similar to those of Parkinsons disease. People with Parkinsons-like symptoms that result from other causes, such as multiple system atrophy and dementia with Lewy bodies, are sometimes said to have parkinsonism. While these disorders initially may be misdiagnosed as Parkinsons, certain medical tests, as well as response to drug treatment, may help to better evaluate the cause. Many other diseases have similar features but require different treatments, so it is important to get an accurate diagnosis as soon as possible.
What Is Transient Incontinence
Transient Incontinence refers to continence issues that can and do resolve when the condition that’s causing it heals or is cured. What conditions cause Transient Incontinence? A weakened pelvic floor muscle. If you’re able to exercise and strengthen the muscle then you will be able to regain control.
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