Several faculty within the Center for Movement Disorders and Neurorestoration are focused on investigating speech-language, voice, and cough-swallow outcomes in persons with Parkinson’s disease. As a collaborative unit, Drs Rosenbek, Hegland, and Troche had as their ultimate goal the development of novel, effective, and restorative treatments for speech, swallowing, and cough disorders in neurodegenerative disease.
Following the development of the expiratory muscle strength training (EMST) device by Dr. Sapienza and colleagues, we recently completed a large randomized study testing the effects of EMST on cough, speech, swallowing and breathing outcomes in persons with PD. The results (published in Neurology, 2010) revealed improvements in cough and swallowing functioning following four weeks of training. These exciting findings have served as impetus for exploring EMST as a treatment option in other neurodegenerative diseases (i.e. multiple sclerosis, progressive supranuclear palsy). Additionally, we continue to search for ways to improve the treatment paradigm and simplify its use for patients and clinicians. More trials are currently underway.
Relationship between Cough and Swallowing
We have also become very interested in the relationship between cough and swallowing function in neurodegenerative disease. Recent work out of our labs has begun to explore the predictive nature of cough for identification of swallowing dysfunction. Studies being completed by our group continue to explore this relationship and we are working to find ways to be identify and treat coughing dysfunction. We have several active and ongoing projects studying the effects of PD and DBS on swallowing and cough function.
Language functioning in Parkinson’s Disease
Where as much research focus has been placed on changes to motor speech function secondary to PD, less is known about the effects of PD on language functioning. Recent research conducted by our group identified subtle language disturbance in persons with PD and trials are now underway to further understand these mechanisms and identify appropriate therapeutic targets.
Speech production in Neurodegenerative disease
Spearheaded by Drs. Shrivastav and Rosenbek we continue to try to understand the deviant components of speech production in movement disorders populations, but most importantly are striving to identify more quantitative techniques for the classification and evaluation of speech dysfunction.