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