RESEARCH PAPER
Speech disorders in Multiple System Atrophy of Parkinson Type
More details
Hide details
1
Department of Neurodegenerative Diseases, Institute of Agricultural Medicine, Lublin, Poland ; 2. Memory and Cognition Center, Department of Neurology, Case Western Reserve University, Cleveland, OH, USA
2
Department of English, Phonetics and Phonology Section, UMCS, Lublin, Poland
Corresponding author
Katarzyna Gustaw
Department of
Neurodegenerative Diseases, Institute of Agricultural Medicine, Jaczewskiego
2, 20-090 Lublin, Poland.
J Pre Clin Clin Res. 2007;1(2):185-188
KEYWORDS
ABSTRACT
Multiple system atrophy (MSA) is characterized clinically by the combination of Parkinsonian, pyramidal, cerebellar, and autonomic symptoms. If parkinsonism predominates in the clinical picture of the disease, the condition is named striatonigral degeneration or MSA type P (P stands for parkinsonism). A 67 years’ old woman with a previous clinical diagnosis of striatonigral degeneration and a five year history of the symptoms had initially been misdiagnosed as suffering from Parkinson’s disease. However, she did not respond well to levodopa and soon developed severe dysarthria. The neurological features, helpful in differentiating MSA type P from other extrapiramidal disorders, included falling, dysarthria and dysphonia, respiratory stridor, hyperreflexia and ataxia. Cerebellar signs were well manifested, whereas autonomic symptoms were less severe. Besides neurological and imaging study, a specially designed Speech Efficiency Test for dysarthria was performed. It revealed numerous speech deficiencies: a flat Fo contour, slow speech pace and a tendency to divide words into syllables. Vowels were centralized and reduced, obstruents articulated with impeded precision, and nasals produced with irregular soft palate timing. Glottal activity was characterized by lowered Fo and breathy phonation.
REFERENCES (11)
1.
Graham JG, Oppenheimer DR: Orthostatic hypotension and nicotinic sensitivity in a case of multiple system atrophy. J Neurol Neurosurg Psychiatry 1969, 32, 28-32.
2.
Quinn N: Multiple system atrophy; in Marsden CD, Fahn S (eds): Movement Disorders. London. Butterworths 2002.
3.
Fearnley JM, Lees AJ: Striatonigral degeneration. Brain 1990, 113, 1823.
4.
O’Brien C, Sung JH, McGeachie RE, Lee MC: 5triatonigral degeneration: Clinical, MRI, and pathologic correlation. Neurology 1990, 40, 710.
5.
Goto S, Hirano A, Matsumoto S: Met-enkephalin immunoreactivity in the basal ganglia in Parkinson’s disease and striatonigral degeneration. Neurology 1990, 40, 1051.
6.
Malessa S, Hirsch EC, Cervera P, et al.: Catecholamingeric systems in the medulla oblongata in parkinsonian syndromes. Neurology 1990, 40, 1739-1745.
7.
Drayer BP, Olanow W, Burger P, et al.: Parkinson plus syndrome: Diagnosis using high field MR imaging of brain iron. Radiology 1989, 159, 483.
8.
Brooks DJ, Salmon EP, Mathias CJ, et al.: The relationship between locomotor disability, autonomic dysfunction, and integrity of the striatonigral dopaminergic system in patients with multiple system atrophy, pure autonomic failure and Parkinson’s disease, studied with PET. Brain 1990, 113(1), 539.
9.
Muller J, Wenning GK, Verny M, McKee A, Chaudhuri KR, Jellinger K, Poewe W, Litvan I: Progression of dysarthria and dysphagia in postmortem-confirmed parkinsonian disorders. Arch Neurol 2001, 58(9), 1499-500.
10.
Knopp DB, Barsottini OG, Ferraz HB: Multiple system atrophy speech assessment: study of five cases. Arq Neuropsiquiatr 2002, 60, 619- 623.
11.
Klunin KJ, Gilman S, Lohman M, Junck L: Characteristics of the dysarthria of multiple system atrophy. Arch Neurol 1996, 53(6), 545- 548.