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Friday, March 18, 2016

Have we been treating Parkinson's all wrong?

Patients struggle to speak because they can't keep up with conversation - NOT because of muscle decline


  • Disease is a progressive neurological condition which destroys brain cells
  • 70% of sufferers have problems with their speech and communication
  • There is no cure with treatment focused on treating the symptoms
  • Speech problems now found to be due to a decline in cognitive function 

The discovery leads to hope for new treatments of people with the condition, such as boxer Muhammad who has the condition

Parkinson's patients struggle to speak because they cannot keep up with conversation - not because of physical problems as doctors previously thought.
The discovery, made by scientists at the University of East Anglia and the University of Aberdeen, promises to change the way therapists treat the condition.
Around 127,000 people in the UK are believed to have Parkinson’s disease, which causes tremors, muscle rigidity and slowed movement.
Many patients also struggle to speak clearly, which doctors have assumed was due to the physical difficulty they have controlling their facial muscles.
But now experts have found that speech problems are actually due to a decline in cognitive function - rather than physical issues.
The team, whose work is published in the Journal of Parkinson’s Disease, called for a change in the way the condition is treated.
They said that most speech therapy focuses on motor control - rather than on working on new ways for patients to keep up with conversation.
Study leader Dr Maxwell Barnish, of Aberdeen University, said: ‘Around 70 per cent of people with Parkinson’s have problems with speech and communication, which can really impact their quality of life.
‘Researchers and clinicians have in the past focused on the physical problems patients have with making their speech clear.
‘But patients themselves say the problems are more complex and are more to do with cognitive impairment – for example not being able to think quickly enough to keep up with conversations or not being able to find the right words.

 ‘They say that this that this has the biggest impact on their ability to communicate in everyday life.
‘We wanted to really prioritise the problems that patients experience – and to find out whether it is clarity of speech, or these more cognitive issues, that have the most impact on everyday communication.’
Parkinson’s is a progressive neurological condition that destroys the brain cells producing the chemical messenger dopamine, in the part of the brain that controls movement.
Scientists have so far struggled to make any significant advances in the pursuit of a cure, and treatments are limited to drugs which control symptoms.
The research team undertook the first systematic review to look at whether cognitive issues or physical speech problems create the biggest barriers to communication.

Parkinson's patients struggle to speak because they cannot keep up with conversation - not because of physical problems as doctors previously thought.
The discovery, made by scientists at the University of East Anglia and the University of Aberdeen, promises to change the way therapists treat the condition.
Around 127,000 people in the UK are believed to have Parkinson’s disease, which causes tremors, muscle rigidity and slowed movement.
Many patients also struggle to speak clearly, which doctors have assumed was due to the physical difficulty they have controlling their facial muscles.
But now experts have found that speech problems are actually due to a decline in cognitive function - rather than physical issues.
The team, whose work is published in the Journal of Parkinson’s Disease, called for a change in the way the condition is treated.
They said that most speech therapy focuses on motor control - rather than on working on new ways for patients to keep up with conversation.
Study leader Dr Maxwell Barnish, of Aberdeen University, said: ‘Around 70 per cent of people with Parkinson’s have problems with speech and communication, which can really impact their quality of life.
‘Researchers and clinicians have in the past focused on the physical problems patients have with making their speech clear.
‘But patients themselves say the problems are more complex and are more to do with cognitive impairment – for example not being able to think quickly enough to keep up with conversations or not being able to find the right words.

They say that this that this has the biggest impact on their ability to communicate in everyday life.
‘We wanted to really prioritise the problems that patients experience – and to find out whether it is clarity of speech, or these more cognitive issues, that have the most impact on everyday communication.’
Parkinson’s is a progressive neurological condition that destroys the brain cells producing the chemical messenger dopamine, in the part of the brain that controls movement.
Scientists have so far struggled to make any significant advances in the pursuit of a cure, and treatments are limited to drugs which control symptoms.
The research team undertook the first systematic review to look at whether cognitive issues or physical speech problems create the biggest barriers to communication.
Actor Michael J Fox is a famous sufferer of Parkinson's, a progressive neurological condition that destroys the brain cells producing the chemical messenger dopamine, in the part of the brain that controls movement

They sifted through nearly 5,000 studies in search of helpful data, and found 12 relevant studies involving 222 patients.
The team wrote: ‘Established paradigms in the conceptualisation and treatment of communicative difficulties in Parkinson’s disease have focused predominantly on impairment-level motoric alterations in speech.’
They said the findings would ‘present a challenge to prevailing assessment and treatment practices’.
Dr Katherine Deane, from UEA’s school of Health Sciences, said: ‘What this research tells us is that speech and language therapists need to assess the cognitive problems of people with Parkinson’s as well as their speech clarity when trying to improve everyday communication.
‘It may be that patients who are struggling with thinking quickly need different communication strategies to help them in everyday life.’
Daiga Heisters of the Parkinson’s UK charity said: ‘We know how important it is that speech and language therapy for people with Parkinson’s takes account of cognitive issues alongside physical speech problems.
‘This is why it is essential that people with Parkinson’s are able to see a speech and language therapist with an understanding of the condition who is able to focus on the specific needs of the individual.’
Dr Katherine Deane said: ‘We need speech therapists working with people with Parkinson's to change the focus of their attention from just trying to improve the clarity of speech to teaching them cognitive strategies to help them be more involved in everyday communication.
‘These could include letting their friends know so they are less stressed if they lose track of the conversation, and feel they can ask to be caught up on what is being discussed.’ 

http://www.dailymail.co.uk/health/article-3497277/Have-treating-Parkinson-s-wrong-Patients-struggle-speak-t-conversation-NOT-muscle-decline.html?ITO=1490&ns_mchannel=rss&ns_campaign=1490

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