Speech Difficulties Among OAs With PD Help Determine Rate of Cognitive Decline

According to study findings published online in Parkinsonism & Related Disorders, speech difficulties among older adults Parkinson Disease (PD) are often associated with autonomic dysfunction, sleep disturbances and striatal dopaminergic deficit, and can help predict faster cognitive decline in early PD.  

“Speech difficulties are a common debilitating feature of Parkinson's disease and we aimed to investigate whether speech difficulties are associated with striatal dopaminergic deficits and faster disease progression,” said Sotirios Polychronic, MSc, BSc, and colleagues.  

For the study, the study researchers used the Parkinson’s Progression Markers Initiative database. The team identified 142 early de novo PD patients with speech difficulties and matched them 1:1 with 143 PD patients without speech difficulties for age, disease duration, and motor symptom severity.  

“We investigated differences in clinical features and striatal [¹²³I]FP-CIT single photon emission computed tomography (SPECT) uptake in Parkinson's disease patients with and without speech difficulties,” they explained. “Cox proportional hazards analysis was carried out to investigate whether speech difficulties were predictive of a faster motor progression and cognitive decline.” 

According to the findings, speech difficulties were more common among patients with an akinetic-rigid motor phenotype compared to those with a tremor-dominant phenotype. Compared to patients without speech difficulties, the research team found PD patients with speech difficulties had:

• Lower resting tremor;
• Higher autonomic dysfunction;
• Increased daytime sleepiness;
• A higher prevalence of REM sleep behavior disease symptoms;
• Lower [¹²³I]FP-CIT uptake in the striatum;
• Caudate; and,
• Putamen.

Finally, the researchers found that the presence of speech difficulties was a predictor of cognitive decline but it had no influence on motor progression.  

“Speech difficulties are associated with greater autonomic dysfunction, sleep disturbances and striatal dopaminergic deficit, and can serve as a predictor of faster cognitive decline in early Parkinson's disease,” research authors concluded. 

—Julie Gould  

Reference:

Polychronic S, Niccolini F, Pagano G, Yousaf T, Politis M. Speech difficulties in early de novo patients with Parkinson's disease [published online May 6, 2019]. Parkinsonism Relat Disord. DOI: https://doi.org/10.1016/j.parkreldis.2019.04.026