Dysarthria in Parkinson's Disease: Clinical Presentation, Pathophysiological and Diagnostic Aspects

Hypokinetic dysarthria of Parkinson's disease is a multidimensional impairment associated with considerable communication deficits with great impact on quality of life in the majority of - patients. The typical pattern of Parkinsonian - dysarthria includes a reduction in loudness and intonation variability ("monopitch and monoloudness") often combined with impaired speech respiration, phonation, articulation and temporal aspects of speech such as speech rate and rhythm. Pattern and degree of dysarthria can differ to some extent from individual to individual and show progressive deterioration over the course of disease progression. The underlying pathophysiology is still not fully understood; however, it cannot be explained by dopaminergic deficits alone. Speech/language therapy is the treatment of choice for Parkinsonian dysarthria. The diagnostic approach is based on perceptual analysis of speech in the clinical setting, but can be complemented by acoustic analyses, physiologic measures and functional neuro-imaging.