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Parkinson's Effect on Speech Fosters Isolation

Wednesday June 19, 2013

Ed Susman

MedPage Today - A new study demonstrated that subtle changes in speech can impact the ability of Parkinson's patients to communicate and may result in further isolation from the community, researchers said here.

Patients participating in the Factors Affecting the Speech of People with Parkinson's Disease Study scored an average 14.8 percentage points lower in their ability to communicate intended emotions compared with controls (P=0.02), Maxwell Barnish, a PhD candidate at University of East Anglia in Norwich, England, and colleagues found.

In his poster presentation at the International Congress on Parkinson's Disease and Movement Disorders, Barnish noted that the communication and emotional conveyance were both predicted by patients' cognitive status as measured by the Montreal Cognitive Assessment.

"Cognitive impairment significantly affects speech and communication in Parkinson's disease," he said. "This leads to reduced communicative participation."

Parkinson's patients were stratified by the median score on the test, and those who scored lower than or equal to 23 also measured 16.7 percentage points lower, on average, in their ability to convey emotion, he told MedPage Today. Cognitive status predicted 19% of the variance in communicative participation, which was statistically significant (P<0.05), he said.

For the study, the researchers recruited 45 people with Parkinson's disease and 29 people who were friends or relatives of the patients. All were from various areas of the U.K. and all were white. The patients were about 70 years of age, and ranged from 48 to 93 years.

The group was not gender-balanced, with a predominance of men in the patients and a predominance of women among the controls. The difference was controlled for in the analysis, Barnish said.

"The majority of Parkinson's patients in this study had mild speech impairments, but this impairment had a substantial impact on everyday communication tasks," Barnish explained. "The qualitative analysis we performed indicated that patients were anxious about their speech and that voices sounded different."

Barnish suggested that their anxiety and perceived voice change might lead to them become less outgoing.

Previous research had not focused on the relationship between cognitive status and everyday communication, hence Barnish attempted to define these relationships.

"Further research is required to determine how these findings can be applied in speech and language therapy for Parkinson's disease," he added.

Alison Yarnall, MD, of the University of Newcastle in England, told MedPage Today, "This is an interesting area of study. Obviously speech and communication are important aspects of daily living that can be interrupted by Parkinson's disease."

"Drugs in Parkinson's disease are well studied with big randomized clinical trials, but things like speech therapy and physical therapy, which can make a massive difference to patients, are often not well studied," she said. Yarnall said she was interested in seeing how further research in the field could impact treatment decisions and resource implementation.

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