Multiple Factors Are Involved in the Dysarthria Associated With Parkinson's Disease: A Review With Implications for Clinical Practice and Research Purpose Motor speech abnormalities are highly common and debilitating in individuals with idiopathic Parkinson's disease (IPD). These abnormalities, collectively termed hypokinetic dysarthria (HKD), have been traditionally attributed to hypokinesia and bradykinesia secondary to muscle rigidity and dopamine deficits. However, the role of rigidity and dopamine in the development of HKD ... Review
Review  |   August 01, 2014
Multiple Factors Are Involved in the Dysarthria Associated With Parkinson's Disease: A Review With Implications for Clinical Practice and Research
 
Author Affiliations & Notes
  • Shimon Sapir
    University of Haifa, Israel
  • Disclosure: The author has declared that no competing interests existed at the time of publication.
    Disclosure: The author has declared that no competing interests existed at the time of publication.×
  • Correspondence to Shimon Sapir: sapir@research.haifa.ac.il
  • Editor: Jody Kreiman
    Editor: Jody Kreiman×
  • Associate Editor: Julie Liss
    Associate Editor: Julie Liss×
Article Information
Speech, Voice & Prosodic Disorders / Dysarthria / Special Populations / Older Adults & Aging / Speech, Voice & Prosody / Speech / Review
Review   |   August 01, 2014
Multiple Factors Are Involved in the Dysarthria Associated With Parkinson's Disease: A Review With Implications for Clinical Practice and Research
Journal of Speech, Language, and Hearing Research, August 2014, Vol. 57, 1330-1343. doi:10.1044/2014_JSLHR-S-13-0039
History: Received February 18, 2013 , Revised October 15, 2013 , Accepted December 11, 2013
 
Journal of Speech, Language, and Hearing Research, August 2014, Vol. 57, 1330-1343. doi:10.1044/2014_JSLHR-S-13-0039
History: Received February 18, 2013; Revised October 15, 2013; Accepted December 11, 2013
Web of Science® Times Cited: 11

Purpose Motor speech abnormalities are highly common and debilitating in individuals with idiopathic Parkinson's disease (IPD). These abnormalities, collectively termed hypokinetic dysarthria (HKD), have been traditionally attributed to hypokinesia and bradykinesia secondary to muscle rigidity and dopamine deficits. However, the role of rigidity and dopamine in the development of HKD is far from clear. The purpose of the present study was to offer an alternative view of the factors underlying HKD.

Method The authors conducted an extensive, but not exhaustive, review of the literature to examine the evidence for the traditional view versus the alternative view.

Results The review suggests that HKD is a highly complex and variable phenomenon including multiple factors, such as scaling and maintaining movement amplitude and effort; preplanning and initiation of movements; internal cueing; sensory and temporal processing; automaticity; emotive vocalization; and attention to action (vocal vigilance). Although not part of the dysarthria, nonmotor factors, such as depression, aging, and cognitive-linguistic abnormalities, are likely to contribute to the overall speech symptomatology associated with IPD.

Conclusion These findings have important implications for clinical practice and research.

Acknowledgments
The author wishes to thank Joseph R. Duffy for his critical review and insightful comments and suggestions on a previous version of this article.
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