RESUMO
Purpose: To better define the clinical characteristics of idiopathic oromandibular dystonia, we studied voice, speech, and swallowing disorders and their impact on activities of daily living. Method: Fourteen consecutive patients with idiopathic oromandibular dystonia and 14 matched, healthy control subjects were included in the study. Results: Dysarthria was the most common disorder and its characteristics varied from one patient to another. However, we frequently observed a hyperkinetic, dysarthric profile characterized by imprecise consonants, a rough voice, changes in intensity, and hypernasality. Dysphagia appeared to be slightly less frequent and less disabling than dysarthria. Most patients had difficulty swallowing solids, and the oral phase was particularly problematic. Dysarthria and dysphagia affected activities of daily living in general and the psychological/emotional domain in particular. Conclusions: The characteristics of dysarthria in oromandibular dystonia vary significantly from one patient to another due to differences in the set of affected muscles, so each patient should receive a personalized rehabilitation program. Dysarthria was the most prominent symptom, although spasmodic dysphonia was more frequent than expected. Further laboratory-based studies are needed to clarify the mechanisms and consequences of dysphagia in oromandibular dystonia.
Assuntos
Transtornos de Deglutição/fisiopatologia , Disartria/fisiopatologia , Distonia/fisiopatologia , Distúrbios da Voz/fisiopatologia , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Deglutição , Transtornos de Deglutição/etiologia , Disartria/etiologia , Distonia/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Fala , Voz , Distúrbios da Voz/etiologiaRESUMO
BACKGROUND: Parkinsonian dysarthria (as typically characterized by hypophonia, monotony of pitch, and rhythm abnormalities) is often accompanied by gait disturbances. The long-term effect of subthalamic nucleus deep brain stimulation (STN DBS) on dysarthria remains unclear. METHODS: Given STN DBS's known improvement of gait disorders, we analyzed speech intelligibility and aerodynamic and acoustic parameters in 11 advanced PD patients in three double-blind, randomized conditions: "defined Off," 60 Hz STN DBS and 130 Hz STN DBS. RESULTS: An improvement in aerodynamic speech parameters during 60 Hz STN DBS was accompanied by significant clinical benefit. CONCLUSIONS: Chronic treatment with low-frequency STN DBS may have a beneficial impact on dysarthropneumophonia, even in advanced PD patients.
