Efficacy and Acceptance of a Lombard-response Device for Hypophonia in Parkinson’s Disease

ABSTRACT:Objective:The purpose of this study was to examine the effectiveness, satisfaction, and acceptance of a low-cost Lombard-response (LR) device in a group of individuals with Parkinson’s disease (IWPD) and their communication partners (CPs).Method:Sixteen IWPD and hypophonia and their CPs participated in the study. The IWPD wore a LR device that included a small MP3 player (Sony Walkman) and headphones playing a multi-talker noise audio file at 80 dB during lab-based speech tasks and during their daily conversational speech over a 2-week device trial period. Outcome measures included average conversational speech intensity and scores on a questionnaire related to speech impairment, communication effectiveness, and device satisfaction.Results:Conversational speech intensity of the IWPD is increased by 7 to 10 dB with the LR device. Following a 2-week trial period, eight of the IWPD (50%) gave the LR device moderate-to-high satisfaction and effectiveness ratings and decided to purchase the device for long-term daily use. At the 4-month follow-up, none of the IWPDs were still using the LR device. Device rejection was related to discomfort (loudness), headaches, interference with cognition, and difficulty controlling device.Conclusion:Short-term acceptance and satisfaction with the LR device was moderate, but long-term acceptance, beyond 4 months, was absent. Future studies are required to determine if other types of low-cost LR devices can be developed that improve long-term efficacy and device acceptance in IWPD and hypophonia.

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Speech Impairment in a Large Sample of Patients with Parkinson’s Disease

Behavioural Neurology ◽

10.1155/1999/327643 ◽

1999 ◽

Vol 11 (3) ◽

pp. 131-137 ◽

Cited By ~ 259

Author(s):

Aileen K. Ho ◽

Robert Iansek ◽

Caterina Marigliani ◽

John L. Bradshaw ◽

Sandra Gates

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Control ◽

Speech Motor Control ◽

Conversational Speech ◽

Speech Impairment ◽

Point Scale ◽

Severe Stage ◽

Motor Set ◽

Speech Motor

This study classified speech impairment in 200 patients with Parkinson’s disease (PD) into five levels of overall severity and described the corresponding type (voice, articulation, fluency) and extent (rated on a five-point scale) of impairment for each level. From two-minute conversational speech samples, parameters of voice, fluency and articulation were assessed by two trained-raters. Voice was found to be the leading deficit, most frequently affected and impaired to a greater extent than other features in the initial stages. Articulatory and fluency deficits manifested later, articulatory impairment matching voice impairment in frequency and extent at the ‘Severe’ stage. At the final stage of `Profound' impairment, articulation was the most frequently impaired feature at the lowest level of performance. This study illustrates the prominence of voice and articulatory speech motor control deficits, and draws parallels with deficits of motor set and motor set instability in skeletal controls of gait and handwriting.

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Faculty Opinions recommendation of Long-term follow-up of a randomized AAV2-GAD gene therapy trial for Parkinson's disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.727492597.793530605 ◽

2017 ◽

Author(s):

Laurent Villard

Keyword(s):

Parkinson’S Disease ◽

Gene Therapy ◽

Parkinson's Disease ◽

Gene Therapy Trial ◽

Long Term Follow Up ◽

Therapy Trial

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Neurobehavioral Consequences Associated with Long Term Tramadol Utilization and Pathological Mechanisms

CNS & Neurological Disorders - Drug Targets ◽

10.2174/1871527318666191112124435 ◽

2020 ◽

Vol 18 (10) ◽

pp. 758-768 ◽

Cited By ~ 2

Author(s):

Khadga Raj ◽

Pooja Chawla ◽

Shamsher Singh

Keyword(s):

Alzheimer’S Disease ◽

Parkinson’S Disease ◽

Alzheimer's Disease ◽

Parkinson's Disease ◽

Serotonin Reuptake ◽

Selective Serotonin Reuptake Inhibitors ◽

Serotonin Syndrome ◽

Dopamine Synthesis ◽

Synthetic Analog

: Tramadol is a synthetic analog of codeine used to treat pain of moderate to severe intensity and is reported to have neurotoxic potential. At therapeutic dose, tramadol does not cause major side effects in comparison to other opioid analgesics, and is useful for the management of neurological problems like anxiety and depression. Long term utilization of tramadol is associated with various neurological disorders like seizures, serotonin syndrome, Alzheimer’s disease and Parkinson’s disease. Tramadol produces seizures through inhibition of nitric oxide, serotonin reuptake and inhibitory effects on GABA receptors. Extensive tramadol intake alters redox balance through elevating lipid peroxidation and free radical leading to neurotoxicity and produces neurobehavioral deficits. During Alzheimer’s disease progression, low level of intracellular signalling molecules like cGMP, cAMP, PKC and PKA affect both learning and memory. Pharmacologically tramadol produces actions similar to Selective Serotonin Reuptake Inhibitors (SSRIs), increasing the concentration of serotonin, which causes serotonin syndrome. In addition, tramadol also inhibits GABAA receptors in the CNS has been evidenced to interfere with dopamine synthesis and release, responsible for motor symptoms. The reduced level of dopamine may produce bradykinesia and tremors which are chief motor abnormalities in Parkinson’s Disease (PD).

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The mechanistic role of thymoquinone in Parkinson's disease: focus on neuroprotection in pre-clinical studies

Current Molecular Pharmacology ◽

10.2174/1874467214666210105140944 ◽

2021 ◽

Vol 14 ◽

Author(s):

Mohammad Najim Uddin ◽

Mohammad Injamul Hoq ◽

Israt Jahan ◽

Shafayet Ahmed Siddiqui ◽

Chayan Dhar Clinton ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Clinical Studies ◽

Nigella Sativa ◽

Biological Effects ◽

Neuroprotective Activity ◽

Substantia Nigra Pars Compacta ◽

Movement Difficulties

: Thymoquinone (TQ) is one of the leading phytochemicals, which is abundantly found in Nigella sativa L. seeds. TQ exhibited various biological effects such as antioxidant, anti-inflammatory, antimicrobial, and anti-tumoral in several pre-clinical studies. Parkinson's disease (PD) is a long-term neurodegenerative disease with movement difficulties, and the common feature of neurodegeneration in PD patients is caused by dopaminergic neural damage in the substantia nigra pars compacta. The neuroprotective activity of TQ has been studied in various neurological disorders. TQ-mediated neuroprotection against PD yet to be reported in a single frame; therefore, this review is intended to narrate the potentiality of TQ in the therapy of PD. TQ has been shown to protect against neurotoxins via amelioration of neuroinflammation, oxidative stress, apoptosis, thereby protects neurodegeneration in PD models. TQ could be an emerging therapeutic intervention in PD management, but mechanistic studies have been remained to be investigated to clarify its neuroprotective role.

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Focal Subthalamic Atrophy After Long‐Term Deep Brain Stimulation in Parkinson's Disease

Movement Disorders ◽

10.1002/mds.28653 ◽

2021 ◽

Author(s):

Ellen Gelpi ◽

Christine Haberler ◽

Alexander Micko ◽

Andrea Polt ◽

Andreas Amon ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Deep Brain

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Long term mortality of patients with Parkinson’s disease treated with deep brain stimulation in a reference center

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2021.106486 ◽

2021 ◽

Vol 202 ◽

pp. 106486

Author(s):

Ana Luísa Rocha ◽

Ana Oliveira ◽

Cláudia Sousa ◽

Pedro Monteiro ◽

Maria José Rosas ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Reference Center ◽

Deep Brain ◽

Long Term Mortality

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Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

Brain Sciences ◽

10.3390/brainsci11040416 ◽

2021 ◽

Vol 11 (4) ◽

pp. 416

Author(s):

Carla Piano ◽

Francesco Bove ◽

Delia Mulas ◽

Enrico Di Stasio ◽

Alfonso Fasano ◽

...

Keyword(s):

Quality Of Life ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Cortex ◽

Clinical Outcome ◽

Motor Cortex Stimulation ◽

Dopaminergic Therapy

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

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PARKINSON’S DISEASE — LONG-TERM THERAPY WITH LEVODOPA

InPharma ◽

10.1007/bf03287873 ◽

1975 ◽

Vol 10 (1) ◽

pp. 8-8

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Term Therapy ◽

Long Term Therapy

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Evidence for Early and Regular Physical Therapy and Exercise in Parkinson's Disease

Seminars in Neurology ◽

10.1055/s-0041-1725133 ◽

2021 ◽

Author(s):

Terry D. Ellis ◽

Cristina Colón-Semenza ◽

Tamara R. DeAngelis ◽

Cathi A. Thomas ◽

Marie-Hélène Saint Hilaire ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Physical Therapy ◽

Secondary Prevention ◽

Medical Management ◽

Long Term Outcomes ◽

High Prevalence ◽

Growing Body ◽

Prevention Model

AbstractAdvances in medical management of Parkinson's disease (PD) have resulted in living longer with disability. Although disability worsens over the course of the disease, there are signs of disability even in the early stages. Several studies reveal an early decline in gait and balance and a high prevalence of nonmotor signs in the prodromal period that contribute to early disability. There is a growing body of evidence revealing the benefits of physical therapy and exercise to mitigate motor and nonmotor signs while improving physical function and reducing disability. The presence of early disability coupled with the benefits of exercise suggests that physical therapy should be initiated earlier in the disease. In this review, we present the evidence revealing early disability in PD and the effectiveness of physical therapy and exercise, followed by a discussion of a secondary prevention model of rehabilitation to reduce early disability and optimize long-term outcomes.

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