Zaburzenia j zyka, mowy i komunikacji w chorobie Parkinsona

Parkinson’s disease (PD) is a neurodegenerative disorder,which mostly afflicts older people, affecting the motor,executive, and neuropsychological functions of anindividual. 89% of the patients suffer from languageand speech disorders and only 3% of them receivetreatment. In general, patients’ speech is quieter, theirvoices are harsh and breathy, the intonation is flat,and the articulation is imprecise, which makes com -munication difficult and significantly affects thepatients’ life. This article discusses language, speech,and communication disorders in PD, including theirarticulatory, respiratory, acoustic, and pragmatic aspects.Among the most common disorders are hypokineticdysarthria, palilalia, phonatory impairment, long pauses,metaphor understanding and contrastive stressproblems, impaired sentence processing, turn-taking,staying on topic and others. Possible ways of treatmentare then presented (pharmacological, stereotactic, andbehavioural therapy), with a special focus on LeeSilverman Voice Treatment (LSVT), a behaviouraltreatment programme in which the goal is to make thepatients speak louder and to re-calibrate their perceptionof loudness. Normally a patient receives 13–16 hours ofindividual therapy during one-hour sessions four timesa week in one month. In an extended version (LSVT-X)the one-hour sessions take place twice a week over twomonths. An increasing body of evidence indicates theefficacy of LSVT. The Polish version of LSVT VirtualTherapist (LSVTVT) has also shown significantimprovement in linguistic functions.