Document Detail


Speech disorders of Parkinsonism: a review.
MedLine Citation:
PMID:  7031185     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E M Critchley
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of neurology, neurosurgery, and psychiatry     Volume:  44     ISSN:  0022-3050     ISO Abbreviation:  J. Neurol. Neurosurg. Psychiatr.     Publication Date:  1981 Sep 
Date Detail:
Created Date:  1982-02-22     Completed Date:  1982-02-22     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  2985191R     Medline TA:  J Neurol Neurosurg Psychiatry     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  751-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Humans
Levodopa / therapeutic use
Parkinson Disease / complications,  drug therapy,  physiopathology*,  surgery
Respiration
Speech / physiology
Speech Disorders / drug therapy,  etiology,  physiopathology*
Stereotaxic Techniques
Thalamus / physiology
Chemical
Reg. No./Substance:
0/Levodopa
Comments/Corrections

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