Investigation of the voice handicaps in Parkinson's disease and determination of the clinical correlates

Abstract

Speech impairment is a common and disabling symptom of Parkinson's disease (PD). We aimed to reveal the motor, nonmotor, and other clinical factors that might be associated with voice disturbances in PD. Remarkably, we aimed to present a possible specific clinical phenotype more prone to display speech disturbances. We included all the patients with PD who visited our movement disorders clinic between March 2023 and March 2024 and whose information regarding the clinical features and scale results was fully available. In addition to detailed demographic data, comprehensive clinical assessments were performed. We included 232 PD patients with a mean age of 64.4 ± 10.5 y (F/M = 145/87). The median disease duration was 4 y. The comparative analyses of the patients with and without voice handicaps (VH) revealed that patients with VH had higher disease duration and LED. They got higher scores in all the clinical scales, including MDS-UPDRS 1, 2, 3, 4, FOGQ, FES-I, HAM-A, and HDRS revealing a more severe disease stage However, multiple linear regression models revealed only the MDS-UPDRS 4 score, HAM-A score, and MDS-UPDRS-3 (on) score [- 10,658 + 2297*MDS-UPDRS-4 + 0949*HAI + 0549*MDS-UPDRS-3 (on)] as predictors of VHI. Our results support increasing speech problems with higher motor stage, and motor complication score. Besides, we also draw attention to anxiety, which is associated with speech problems in the general community, but only in an experimental study of PD pathology.

Keywords: Anxiety; Clinical correlates; Motor severity; Parkinson’s disease; Voice handicaps.