ABSTRACT
BACKGROUND: Vocal impairment is one of the main debilitating symptoms of Parkinson disease (PD). The effect of levodopa on vocal function remains unclear. OBJECTIVE: This study aimed to determine the effect of levodopa on electromyographic patterns of the laryngeal muscle in patients with PD. STUDY DESIGN: This is a prospective interventional trial. METHODS: Nineteen patients with PD-diagnosed by laryngeal electromyography-were enrolled. Cricothyroid and thyroarytenoid (TA) muscle activities were measured at rest and during muscle contraction (phonation), when participants were on and off medication (12 hours after the last levodopa dose). RESULTS: Prevalence of resting hypertonia in the cricothyroid muscle was similar in the off and on states (7 of 19, P = 1.00). Eight patients off medication and four patients on medication had hypertonic TA muscle at rest (P = 0.289). No electromyographic alterations were observed during phonation for either medication states. CONCLUSION: Despite a tendency for increased rest tracings in the TA muscle when participants were on medication, no association was found between laryngeal electromyography findings and levodopa + carbidopa administration.
Subject(s)
Antiparkinson Agents/administration & dosage , Carbidopa/administration & dosage , Electromyography , Laryngeal Muscles/drug effects , Levodopa/administration & dosage , Parkinson Disease/drug therapy , Phonation/drug effects , Voice Quality/drug effects , Aged , Antiparkinson Agents/adverse effects , Brazil , Carbidopa/adverse effects , Drug Administration Schedule , Drug Combinations , Female , Humans , Laryngeal Muscles/physiopathology , Levodopa/adverse effects , Male , Middle Aged , Parkinson Disease/diagnosis , Parkinson Disease/physiopathology , Predictive Value of Tests , Prospective Studies , Time Factors , Treatment OutcomeABSTRACT
UNLABELLED: Parkinson's disease (PD) involves a progressive depletion of dopamine in the basal ganglia leading to motor alterations. Oral communication impairment occurs in 75% to 90% of patients and has been poorly studied. AIM: to asses laryngeal electromyography (LEMG) patterns and correlate them to vocal analysis in patients with Parkinson's disease. MATERIALS AND METHODS: This is a prospective study. Twenty six adults with PD underwent laryngeal electromyography. Rest and phonation potentials were analyzed. VOXMETRIA and GRAM 5.1.6. were used in acoustic analysis. RESULTS: The main electromyographic pattern observed in the PD group was rest hypertonicity meaning that patients with PD presented with spontaneous intrinsic laryngeal muscle activity during voice rest, which occurred in 73% of the individuals. Not a case of laryngeal tremor was detected by electromyography, although vocal tremor was detected by VOXMETRIA in 69.5% of the individuals and in 61% of them by perceptive-auditive analysis. CONCLUSION: Vocal tremor was the main acoustic change in the PD group, with no correlation to LEMG findings.
Subject(s)
Laryngeal Muscles/physiopathology , Parkinson Disease/physiopathology , Voice Disorders/physiopathology , Aged , Aged, 80 and over , Electromyography , Female , Humans , Male , Middle Aged , Parkinson Disease/complications , Prospective Studies , Voice Disorders/etiologyABSTRACT
A doença ou Mal de Parkinson se deve à deficiência dopaminérgica nos núcleos da base que geram alterações motoras. Comprometimento da comunicação verbal ocorre em 70 a 90 por cento dos doentes. Existem poucas referências da aplicação da eletromiografia no estudo dos músculos laríngeos em pacientes com a doença de Parkinson. Objetivos: Definir o padrão contrátil da musculatura intrínseca da laringe e sua correlação com a análise acústica vocal nos parkinsonianos. Casuística e método: Estudo prospectivo onde 26 adultos com o diagnóstico de Mal de Parkinson foram submetidos à eletromiografia laríngea e análise acústica vocal. Foram coletados potenciais de ação, tanto em repouso vocal quanto em fonação. Para a análise acústica da voz foram utilizados os programas VOXMETRIA® e GRAM 5.1.6®. Resultados: O padrão eletromiográfico predominante no grupo estudo foi o de hipercontratibilidade (ou recrutamento aumentado) durante repouso vocal que ocorreu em 73 por cento dos indivíduos, sem que houvesse registro eletromiográfico de tremor. Quanto às características vocais, detectou-se a presença de tremor vocal no traçado do espectrograma (VOXMETRIA E GRAM) e na avaliação perceptivo-auditiva em 69,5 por cento e 61 por cento dos sujeitos, respectivamente. Conclusão: O tremor vocal foi a característica acústica predominante no grupo estudado, sem que houvesse correlação eletromiográfica.
Parkinson's disease (PD) involves a progressive depletion of dopamine in the basal ganglia leading to motor alterations. Oral communication impairment occurs in 75 percent to 90 percent of patients and has been poorly studied. AIM: to asses laryngeal electromyography (LEMG) patterns and correlate them to vocal analysis in patients with Parkinson's disease. Materials and methods: This is a prospective study. Twenty six adults with PD underwent laryngeal electromyography. Rest and phonation potentials were analyzed. VOXMETRIA® and GRAM 5.1.6. ® were used in acoustic analysis. Results: The main electromyographic pattern observed in the PD group was rest hypertonicity meaning that patients with PD presented with spontaneous intrinsic laryngeal muscle activity during voice rest, which occurred in 73 percent of the individuals. Not a case of laryngeal tremor was detected by electromyography, although vocal tremor was detected by VOXMETRIA in 69.5 percent of the individuals and in 61 percent of them by perceptive-auditive analysis. Conclusion: Vocal tremor was the main acoustic change in the PD group, with no correlation to LEMG findings.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Laryngeal Muscles/physiopathology , Parkinson Disease/physiopathology , Voice Disorders/physiopathology , Electromyography , Prospective Studies , Parkinson Disease/complications , Voice Disorders/etiologyABSTRACT
OBJECTIVE: To study the laryngeal electromyography (LEMG) pattern in patients with Parkinson's disease (PD) and vocal complaints. STUDY DESIGN AND SETTING: Twenty-six adults with PD and vocal complaints and 26 controls with presbyphonia underwent videolaryngoscopy (VL) and LEMG. RESULTS: No tremor was found on LEMG of the cricothyroid and thyroarytenoid muscles, even in cases with clinical and VL tremor. LEMG hypertonicity during voice rest was the typical feature observed in 73% of the patients with PD versus 23% of the controls. This difference was statistically significant. The severity of the disease, diagnosis, and the time of treatment did not correlate with LEMG findings. CONCLUSION: This is the first study reporting the use of LEMG in a large series of patients with PD and vocal complaints. Patients with PD presented spontaneous intrinsic laryngeal muscle activity during voice rest. SIGNIFICANCE: The typical patterns in LEMG suggest this to be a valuable diagnostic tool in PD.
