speech impairment in parkinson’s disease is improved by transcranial application of...

Speech Impairment in Parkinson’s Disease is Improved

by Transcranial Application of Electromagnetic Fields

By: Reuven Sandyk

Parkinson’s Disease

• Frequently associated with speech disturbance

• Affects 50-70% of patients

• An even greater percentage in advanced stages of disease

Parkinsonian Speech Impairment

• Monotonous pitch

• Slow rate

• Decrease in volume (hypophonia)

• Symptoms generally worse when patient is tired or anxious

• In mid to advanced stages– Phonemes are less articulated

• Produces a hypokinetic dysarthria (stuttering)

– Festinating speech

• Dysfluency may become worse as disease progresses

Hypothesis

• Treatment with weak electromagnetic fields (EMFs) applied transcranially

Case Report

• 52 year old radiologist • Freezing of gate, increased difficulties with

hypophonia and with articulation• Mental depression, chronic insomnia• Anxiety and autonomic symptoms• Hyperkinetic dysarthria-particulaly severe

during periods of mental stress• Started on serotonergic medication one

month before treatment started

Treatment

• Four years, one treatment session each week

• Treatment session

• Patient continued to take serotonergic and antiParkinsonian medications

Results

• 80-90% improvement in speech • Impact of treatment is best the day after• Effect of treatment lasts 5-6 days• Continues to experience “on-off”

fluctuations• Dramatic improvement in cognitive

functions• Speech impairment was one of first

symptoms to reappear

Discussion

• Stuttering observed in young children• Acquired stuttering is rarely observed in

adults• Transient stuttering-left hemispheric

lesions• Acquired stuttering-bilateral cerebral

lesions • Prefrontal lobe, caudate-putamen, limbic

system

• Many symptoms associated with decreased levels of serotonin

• SSRIs may improve speech impairment

• Mechanisms by which EMFs improved speech impairment – Synaptic level– Synergistic interaction

Conclusion

Transcranial applications of EMFs may provide a novel, nonpharmacologic approach to the management of speech impairment associated with Parkinsonism