Parkinson Disease is a progressive disease of the central nervous system. The disease predominately affects an area in the brain called the Substantia Nigra. In a healthy functioning brain, cells within the Substantia Nigra produce a chemical called Dopamine that allows the transmission of messages to other structures of the brain e.g. those important for movement control. In Parkinson Disease, the dopamine producing cells progressively degenerate and die off. This cell death causes a number of motor and non-motor symptoms. The main motor symptoms that occur are difficulty initiating movement, slow movement, resting tremor and muscle rigidity. Non-motor symptoms include cognitive impairment, sensory disturbances and mood disorders.
Voice and speech disorder is common in people who have Parkinson Disease. Frequently reported problems are weak voice, reduced loudness, hoarseness, monotonous voice, breathy quality, imprecise articulation, short rushes of speech, inappropriate silences and difficulty getting the voice started. Most people with Parkinson Disease also lose their ability to accurately perceive the volume of their voice and may be unaware of the voice disorder severity. This is often exemplified by comments such as “I feel like I’m shouting” when asked to increase the volume of their voice.
Voice and speech difficulties in Parkinson Disease have lifelong consequences for communication which in turn has a negative impact on psycho-social well-being and quality of life. Examples of adverse experiences of people with Parkinson Disease as a result of voice changes include:
Feeling embarrassed and demoralised at the sound of their voice and at other people’s reactions to their voice
Being apprehensive and anxious about starting a sentence because it might not come out as planned or it may stop suddenly
Irritation at people talking for them or over them during conversation
Feeling ignored and neglected by others because they are unable to initiate conversation or hold their place in conversation
Frustration and depression from not being able to make their needs and wants known
Treatment
Voice therapy is the most effective treatment for the voice and speech disturbances associated with Parkinson Disease. A particular approach to voice therapy called the Lee Silverman Voice Treatment (LSVT) is often recommended based on the research evidence supporting is effectiveness and efficacy. Only Speech Pathologists who have trained and received certification are qualified to deliver this method of treatment.
For more information on LSVT please visit the LSVT global website https://www.lsvtglobal.com/. Speech Pathologist Clare Eastwood at Southern Sydney Voice Therapy is LSVT qualified. Please contact us to book an appointment.
