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By: Reuven Sandyk

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.

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By: Reuven Sandyk

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  1. Speech Impairment in Parkinson’s Disease is Improved by Transcranial Application of Electromagnetic Fields By: Reuven Sandyk

  2. Parkinson’s Disease • Frequently associated with speech disturbance • Affects 50-70% of patients • An even greater percentage in advanced stages of disease

  3. Parkinsonian Speech Impairment • Monotonous pitch • Slow rate • Decrease in volume (hypophonia) • Symptoms generally worse when patient is tired or anxious

  4. In mid to advanced stages • Phonemes are less articulated • Produces a hypokinetic dysarthria (stuttering) • Festinating speech • Dysfluency may become worse as disease progresses

  5. Hypothesis • Treatment with weak electromagnetic fields (EMFs) applied transcranially

  6. 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

  7. Treatment • Four years, one treatment session each week • Treatment session • Patient continued to take serotonergic and antiParkinsonian medications

  8. Results • 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

  9. 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

  10. Many symptoms associated with decreased levels of serotonin • SSRIs may improve speech impairment • Mechanisms by which EMFs improved speech impairment • Synaptic level • Synergistic interaction

  11. Conclusion Transcranial applications of EMFs may provide a novel, nonpharmacologic approach to the management of speech impairment associated with Parkinsonism

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