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Speech and voice response to a Levodopa challenge in late-stage Parkinson’s Disease

dc.contributor.authorFabbri, Margherita
dc.contributor.authorGuimarães, Isabel
dc.contributor.authorCardoso, Rita
dc.contributor.authorCoelho, Miguel
dc.contributor.authorGuedes, Leonor Correia
dc.contributor.authorRosa, Maria M.
dc.contributor.authorGodinho, Catarina
dc.contributor.authorAbreu, Daisy
dc.contributor.authorGonçalves, Nilza
dc.contributor.authorAntonini, Angelo
dc.contributor.authorFerreira, Joaquim J.
dc.date.accessioned2019-10-10T13:30:17Z
dc.date.available2019-10-10T13:30:17Z
dc.date.issued2017-08
dc.descriptionThis is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.pt_PT
dc.description.abstract"Background: Parkinson’s disease (PD) patients are affected by hypokinetic dysarthria, characterized by hypophonia and dysprosody, which worsens with disease progression. Levodopa’s (l-dopa) effect on quality of speech is inconclusive; no data are currently available for late-stage PD (LSPD). Objective: To assess the modifications of speech and voice in LSPD following an acute l-dopa challenge. Method: LSPD patients [Schwab and England score <50/Hoehn and Yahr stage >3 (MED ON)] performed several vocal tasks before and after an acute l-dopa challenge. The following was assessed: respiratory support for speech, voice quality, stability and variability, speech rate, and motor performance (MDS-UPDRS-III). All voice samples were recorded and analyzed by a speech and language therapist blinded to patients’ therapeutic condition using Praat 5.1 software. Results: 24/27 (14 men) LSPD patients succeeded in performing voice tasks. Median age and disease duration of patients were 79 [IQR: 71.5–81.7] and 14.5 [IQR: 11–15.7] years, respectively. In MED OFF, respiratory breath support and pitch break time of LSPD patients were worse than the normative values of non-parkinsonian. A correlation was found between disease duration and voice quality (R = 0.51; p = 0.013) and speech rate (R = −0.55; p = 0.008). l-Dopa significantly improved MDS-UPDRS-III score (20%), with no effect on speech as assessed by clinical rating scales and automated analysis. Conclusion: Speech is severely affected in LSPD. Although l-dopa had some effect on motor performance, including axial signs, speech and voice did not improve. The applicability and efficacy of non-pharmacological treatment for speech impairment should be considered for speech disorder management in PD."pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationFront Neurol. 2017 Aug 22;8:432. doi: 10.3389/fneur.2017.00432pt_PT
dc.identifier.doi10.3389/fneur.2017.00432pt_PT
dc.identifier.issn1664-2295
dc.identifier.urihttp://hdl.handle.net/10400.26/29905
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherFrontiers Mediapt_PT
dc.relation.publisherversionhttps://doi.org/10.3389/fneur.2017.00432pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectParkinson’s diseasept_PT
dc.subjectLate stagept_PT
dc.subjectLevodopapt_PT
dc.subjectSpeechpt_PT
dc.subjectVoicept_PT
dc.titleSpeech and voice response to a Levodopa challenge in late-stage Parkinson’s Diseasept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleFrontiers in Neurologypt_PT
oaire.citation.volume8(432)pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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