Slurry Speech in Parkinson’s Disease

Slurry Speech is among common symptoms of Parkinson’s disease (PD), observed along with motor symptoms. Apart from affecting movement in other parts of the body, the disease also disturbs the muscles that are used in speaking, resulting in slurry speech. A bradykinesia-led symptom of ‘masked face’ can make it harder for the patient to communicate the emotions. Other communication impairments such as poor precision-strength of pronunciation and reductions in expressive language complexity can enhance the problem. This can be misinterpreted as an individual’s lack of interest in the conversation. In few Parkinson’s cases, the patient is seen struggling to recall words, which forces him to speak slowly.

Since the neuromuscular deficits in Parkinson’s also affect the swallowing muscles, patients may experience Esophageal Motility Disorders, difficulty in chewing certain foods properly and choking on liquids. Sometimes, such swallowing difficulties (if observed before slurry speech) can severely limit a Parkinson’s fighter’s ability to speak clearly.

Speech disorders, including slurry speech are common among people with moderate to severe Parkinson’s. In fact, in many cases, the first sign of significant Parkinson’s is reduced voice power and increased rate of utterance.

Options to treat Slurry Speech in Parkinson’s disease

While Deep Brain Stimulation (DBS) is rarely used to relieve the symptom, Speech Therapy (ST) is primarily used to resolve slurry speech. Since, the possible reduction in mental functioning in PD fighters lead to cognitive challenges such as slowing word retrieval, time and reduction in expressive language complexity, Slurry Speech should be primarily addressed by ST. Music Therapy (making or listening to music) is also gaining popularity as an alternative treatment option.

1. Speech-Language Therapy

Poor breath support and Dysphagia (swallowing difficulty) can severely limit the Parkinson’s fighter’s ability to speak clearly. With the help of speech and language therapists, some Parkinson’s patients are able to resolve communication problems such as difficulty in putting thoughts into words.

Vocal cord exercises that focus on sustained single syllables are helpful in improving speech competency. The therapy includes intensive exercises such as repeating certain words, reading-writing exercises and conversational rehearsal.

As people with Parkinson’s often experience slow mental functioning and memory loss, their language formulation and expression are also impacted. They may also develop Aphasia, Dysarthria and Apraxia, which is why an initial assessment should be conducted to address difficulty finding the right words, difficulty speaking in single words, short sentences, difficulty putting words in the right order and mixing up words.

2. Music Therapy

Music can excite the production of neurotransmitters in certain patients, enhancing connections between the auditory and motor systems. This, in turn, can help relax muscles and improve the Parkinson’s fighter’s speech competency.

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Because of poor breath support and difficulties with the motor aspects of speech, Parkinson’s fighters may have problems with articulation. Through Music Therapy, the participant is encouraged to sing and sustain single syllables to promote greater breath support, which ultimately aids in the throat muscle coordination and better speech clarity.

3. Surgery

Through DBS method, a medical device is inserted into a targeted area of the brain that control movement.  The device, known as Neurostimulator, delivers electrical stimulation in Parkinson’s-affected areas of the brain and blocks the abnormal nerve signals that cause speech changes. The procedure involves a minor risk of stroke, brain bleeding or seizures and is rarely used to improve slurry speech in Parkinson’s.

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