Transcript Speech Impairment in Parkinson`s Disease is Improved by

Speech Impairment in
Parkinson’s Disease is Improved
by Transcranial Application of
Electromagnetic Fields
By: Reuven Sandyk
Parkinson’s Disease
• Frequently associated with speech
disturbance
• Affects 50-70% of patients
• An even greater percentage in advanced
stages of disease
Parkinsonian Speech Impairment
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Monotonous pitch
Slow rate
Decrease in volume (hypophonia)
Symptoms generally worse when patient is
tired or anxious
• In mid to advanced stages
– Phonemes are less articulated
• Produces a hypokinetic dysarthria (stuttering)
– Festinating speech
• Dysfluency may become worse as disease
progresses
Hypothesis
• Treatment with weak electromagnetic
fields (EMFs) applied transcranially
Case Report
• 52 year old radiologist
• Freezing of gate, increased difficulties with
hypophonia and with articulation
• Mental depression, chronic insomnia
• Anxiety and autonomic symptoms
• Hyperkinetic dysarthria-particulaly severe
during periods of mental stress
• Started on serotonergic medication one
month before treatment started
Treatment
• Four years, one treatment session each
week
• Treatment session
• Patient continued to take serotonergic and
antiParkinsonian medications
Results
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80-90% improvement in speech
Impact of treatment is best the day after
Effect of treatment lasts 5-6 days
Continues to experience “on-off”
fluctuations
• Dramatic improvement in cognitive
functions
• Speech impairment was one of first
symptoms to reappear
Discussion
• Stuttering observed in young children
• Acquired stuttering is rarely observed in
adults
• Transient stuttering-left hemispheric
lesions
• Acquired stuttering-bilateral cerebral
lesions
• Prefrontal lobe, caudate-putamen, limbic
system
• Many symptoms associated with
decreased levels of serotonin
• SSRIs may improve speech impairment
• Mechanisms by which EMFs improved
speech impairment
– Synaptic level
– Synergistic interaction
Conclusion
Transcranial applications of EMFs may
provide a novel, nonpharmacologic
approach to the management of speech
impairment associated with Parkinsonism