Objective: To examine possible correlations between axial motor features, disease severity and speech parameters in advanced Parkinson’s Disease (PD) patients and to evaluate chronic dopaminergic treatment effect on speech disturbances.

Background: Speech disturbances are very common in PD. However, the relationship between speech parameters, axial motor symptoms and disease severity is still unclear. Moreover, the effect of stable dopaminergic treatment on speech parameters is controversial.

Method: We retrospectively analyzed data from 50 advanced PD patients in OFF- and ON-conditions. Perceptual and acoustic analysis of spontaneous monologue and sustained phonation, including quantitative parameters and speech intelligibility rate, were evaluated in OFF- and ON-states. In both these conditions, UPDRS part III score and subscores (Postural Instability Gait Disorder (PIGD) composite subscore) and Hoen and Yahr scale (H&Y) were measured. Statistical analysis was performed using Spearman correlation coefficient and Mann-Whitney test to compare groups.

Results: In the ON-state PIGD subscore correlated positively with dysfluency score (p=0.04) and negatively with speech intelligibility rate (p=0.00). Furthermore, patients presenting freezing of gait (FOG) had lower speech intelligibility rate compared to patients without FOG (p=0.05). This means that patients with higher axial impairment after levodopa intake were more disfluent and less intelligible. As regards disease severity, in the OFF-state H&Y score correlated negatively with maximum phonation time (MPT) of sustained phonation and speech intelligibility rate (p=0.01 and p=0.04 respectively), meaning that more severe PD patients had poorer speech quality. In the OFF- and ON-conditions, patients with speech dysfluencies had longer levodopa treatment duration than patient without speech dysfluencies (OFF: p=0.03; ON: p=0.04), regardless of levodopa equivalent dose (LED) and disease duration.

Conclusion: Our results confirm the possible correlation between speech and axial symptoms in advanced PD. MPT and speech intelligibility rate correlated with disease severity, suggesting their possible role as markers of disease severity. Finally, patients with speech disfluencies had longer history of dopaminergic treatment, but not necessarily longer disease duration or higher LED compared to patients without disfluencies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-disorders-and-axial-motor-impairment-in-advanced-parkinsons-disease-two-sides-of-the-same-coin/