Journal articles: 'Hypophonia'

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Sekar, Murali Krishnan, Jon Arcelus, and Robert L. Palmer. "Micrographia and hypophonia in anorexia nervosa." International Journal of Eating Disorders 43, no. 8 (November 2, 2009): 762–65. http://dx.doi.org/10.1002/eat.20768.

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Kim, Soo H., James J. Kearney, and Joseph P. Atkins. "Percutaneous Laryngeal Collagen Augmentation for Treatment of Parkinsonian Hypophonia." Otolaryngology–Head and Neck Surgery 126, no. 6 (June 2002): 653–56. http://dx.doi.org/10.1067/mhn.2002.125756.

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OBJECTIVE: Our goal was to determine whether percutaneous laryngeal collagen augmentation improves hypophonia in parkinsonian patients. STUDY DESIGN AND SETTING: A retrospective review of 18 patients was performed. Patients and/or caretakers were called on the telephone and asked about their response to the procedure, if any. Videostroboscopic examinations for all patients were reviewed. RESULTS: Of 18 patients, 11 (61%) reported improvement in their hypophonia for a period of at least 2 months. Five of 7 patients without improvement were relatively aphonic both before and after the procedure. Five of 7 patients without improvement had severe dysphagia, which in 3 necessitated gastrostomy tube placement. Four of 7 patients without improvement were not ambulatory at the time of the procedure. CONCLUSIONS: Percutaneous laryngeal collagen augmentation is an effective treatment for parkinsonian hypophonia in a majority of patients. Patients with advanced neurologic disease with aphonia, difficulty with speech initiation, dysphagia, or ambulatory difficulty are less likely to respond to this procedure and should be so informed.

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Prabhakar, AppaswamyT, AtifI Shaikh, Ashish Vijayaraghavan, and Gideon Rynjah. "Thalamic hypophonia and the neural control of phonation." Neurology India 66, no. 6 (2018): 1815. http://dx.doi.org/10.4103/0028-3886.246247.

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Berke, Gerald S., Bruce Gerratt, Jody Kreiman, and Katherine Jackson. "Treatment of Parkinson Hypophonia With Percutaneous Collagen Augmentation." Laryngoscope 109, no. 8 (August 1999): 1295–99. http://dx.doi.org/10.1097/00005537-199908000-00020.

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Yoon, Ji Hye, Yisuh Ahn, Sook Hui Kim, Juhee Chin, Seongbeom Park, and Duk L. Na. "Neuroanatomical Correlates of Hypophonia in Subcortical Vascular Cognitive Impairment." European Neurology 78, no. 1-2 (2017): 93–104. http://dx.doi.org/10.1159/000479023.

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Rodríguez-López, Claudia, Blanca Ayuso García, and Sara Moreno García. "Hypophonia as a sign of thalamus lesion: a case report." International Journal of Neuroscience 128, no. 1 (August 6, 2017): 100–101. http://dx.doi.org/10.1080/00207454.2017.1358716.

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Murray, B. J., R. Llinas, L. R. Caplan, T. Scammell, and A. Pascual-Leone. "Cerebral deep venous thrombosis presenting as acute micrographia and hypophonia." Neurology 54, no. 3 (February 8, 2000): 751. http://dx.doi.org/10.1212/wnl.54.3.751.

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Zenon, Alexandre, and Etienne Olivier. "Contribution of the basal ganglia to spoken language: Is speech production like the other motor skills?" Behavioral and Brain Sciences 37, no. 6 (December 2014): 576. http://dx.doi.org/10.1017/s0140525x13004238.

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AbstractTwo of the roles assigned to the basal ganglia in spoken language parallel very well their contribution to motor behaviour: (1) their role in sequence processing, resulting in syntax deficits, and (2) their role in movement “vigor,” leading to “hypokinetic dysarthria” or “hypophonia.” This is an additional example of how the motor system has served the emergence of high-level cognitive functions, such as language.

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Knowles, Thea, Scott G. Adams, Allyson Page, Daryn Cushnie-Sparrow, and Mandar Jog. "A Comparison of Speech Amplification and Personal Communication Devices for Hypophonia." Journal of Speech, Language, and Hearing Research 63, no. 8 (August 10, 2020): 2695–712. http://dx.doi.org/10.1044/2020_jslhr-20-00085.

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Purpose This study compared the performance of three amplification devices hypothesized to improve speech communication in individuals with hypophonia (HP), as well as to identify individuals' device preferences. Method Twenty-two individuals with HP and their primary communication partners participated in a cross-over design study comparing three different speech amplification devices: a wired portable amplifier (Device A), a wireless stationary amplifier (Device B), and a one-way personal communication system (Device C). Participants attended one laboratory visit followed by 1-week trial periods with each device. At the first visit, HP participants completed speech tasks with and without the devices, in quiet and in noise. Following the in-laboratory test period, participants trialed each device at home for approximately 1 week per device. Following completion of the study, participants indicated whether or not they would like to continue using a device. Results Overall, in the presence of noise, all three devices demonstrated significant improvements in speech-to-noise levels and speech intelligibility compared to no device. A clear device hierarchy emerged such that the personal communication device (Device C) was associated with significantly better speech outcomes compared to the other two devices. The majority of participants elected to continue using a device at the completion of the study. Device preferences, however, did not clearly reflect the objective device hierarchy that was found for the objective speech measures. Each of the three devices was selected as a preferred device by at least three participants at the completion of the study. Conclusion Results from this study demonstrated clear differences in device performance in three distinct forms of amplification devices for individuals with HP. Findings suggest that amplification device use may be beneficial for this clinical population and underscore the potential to improve device availability and device selection criteria in future research. Supplemental Material https://doi.org/10.23641/asha.12735875

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Baker, K. K., L. O. Ramig, E. S. Luschei, and M. E. Smith. "Thyroarytenoid muscle activity associated with hypophonia in Parkinson disease and aging." Neurology 51, no. 6 (December 1, 1998): 1592–98. http://dx.doi.org/10.1212/wnl.51.6.1592.

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Amari, A., K. J. Slifer, R. C. Sevier, J. Spezio, and C. L. Tucker. "Using differential reinforcement to treat functional hypophonia in a paediatric rehabilitation patient." Pediatric Rehabilitation 2, no. 2 (January 1998): 89–94. http://dx.doi.org/10.3109/17518429809068160.

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Hill, Amy N., Joseph Jankovic, Kevin D. A. T. Vuong, and Don Donovan. "Treatment of hypophonia with collagen vocal cord augmentation in patients with parkinsonism." Movement Disorders 18, no. 10 (October 2003): 1190–92. http://dx.doi.org/10.1002/mds.10554.

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Liotti, M., L. O. Ramig, D. Vogel, P. New, C. I. Cook, R. J. Ingham, J. C. Ingham, and P. T. Fox. "Hypophonia in Parkinson's disease: Neural correlates of voice treatment revealed by PET." Neurology 60, no. 3 (February 11, 2003): 432–40. http://dx.doi.org/10.1212/wnl.60.3.432.

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Zauber, S. Elizabeth, Nidhi Watson, Cynthia L. Comella, Roy A. E. Bakay, and Leo Verhagen Metman. "Stimulation-induced parkinsonism after posteroventral deep brain stimulation of the globus pallidus internus for craniocervical dystonia." Journal of Neurosurgery 110, no. 2 (February 2009): 229–33. http://dx.doi.org/10.3171/2008.6.17621.

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The authors report on a patient with craniocervical dystonia who was treated with bilateral GPi stimulation, with excellent improvement in dystonia but at the cost of stimulation-induced, reversible parkinsonism. Stimulation through ventral contacts resulted in maximal relief of craniocervical dystonia but induced considerable hypophonia, bradykinesia, rigidity, freezing, and impaired postural reflexes. Stimulation through dorsal contacts alleviated parkinsonism, but resulted in the return of dystonia. No stimulation parameters could alleviate the dystonia without inducing parkinsonism over the course of his 4-year follow-up.

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Adams, Scott, Niraj Kumar, Philippe Rizek, Angeline Hong, Jenny Zhang, Anita Senthinathan, Cynthia Mancinelli, Thea Knowles, and Mandar Jog. "Efficacy and Acceptance of a Lombard-response Device for Hypophonia in Parkinson’s Disease." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 47, no. 5 (May 11, 2020): 634–41. http://dx.doi.org/10.1017/cjn.2020.90.

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ABSTRACT:Objective:The purpose of this study was to examine the effectiveness, satisfaction, and acceptance of a low-cost Lombard-response (LR) device in a group of individuals with Parkinson’s disease (IWPD) and their communication partners (CPs).Method:Sixteen IWPD and hypophonia and their CPs participated in the study. The IWPD wore a LR device that included a small MP3 player (Sony Walkman) and headphones playing a multi-talker noise audio file at 80 dB during lab-based speech tasks and during their daily conversational speech over a 2-week device trial period. Outcome measures included average conversational speech intensity and scores on a questionnaire related to speech impairment, communication effectiveness, and device satisfaction.Results:Conversational speech intensity of the IWPD is increased by 7 to 10 dB with the LR device. Following a 2-week trial period, eight of the IWPD (50%) gave the LR device moderate-to-high satisfaction and effectiveness ratings and decided to purchase the device for long-term daily use. At the 4-month follow-up, none of the IWPDs were still using the LR device. Device rejection was related to discomfort (loudness), headaches, interference with cognition, and difficulty controlling device.Conclusion:Short-term acceptance and satisfaction with the LR device was moderate, but long-term acceptance, beyond 4 months, was absent. Future studies are required to determine if other types of low-cost LR devices can be developed that improve long-term efficacy and device acceptance in IWPD and hypophonia.

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Paolini Paoletti, Federico, Maria Di Gregorio, Paolo Calabresi, and Lucilla Parnetti. "Drug-induced Creutzfeldt-Jakob disease-like syndrome: early CSF analysis as useful tool for differential diagnosis." BMJ Case Reports 11, no. 1 (December 2018): e224314. http://dx.doi.org/10.1136/bcr-2018-224314.

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We report the case of a 78-year-old man who showed a subacute onset of severe cognitive impairment, ataxia, tremor, stimulus sensitive myoclonus and hypophonia. Since a few weeks, he received a treatment with a combination of tricyclic antidepressants for mood disorder. The clinical picture mimicked Creutzfeldt-Jakob disease (CJD), but we could rule out this diagnosis by means of cerebrospinal fluid (CSF) analysis, which showed normal level of tau protein and Aβ1-42, being also negative for CSF 14-3-3 protein. A complete clinical recovery was observed after the discontinuation of antidepressants. So far, some cases of drug-induced CJD-like syndrome have been described. In our experience, early CSF analysis shows high diagnostic usefulness in order to exclude CJD.

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Blacker, David J. "Softly spoken strokes: two patients with marked hypophonia as a feature of strokes involving the anterior thalamus." Journal of Clinical Neuroscience 10, no. 2 (March 2003): 243–45. http://dx.doi.org/10.1016/s0967-5868(02)00114-5.

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Dykstra, Allyson D., Scott G. Adams, and Mandar Jog. "Examining the relationship between speech intensity and self-rated communicative effectiveness in individuals with Parkinson's disease and hypophonia." Journal of Communication Disorders 56 (July 2015): 103–12. http://dx.doi.org/10.1016/j.jcomdis.2015.06.012.

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Le, Andrew Q., Brian P. Walcott, Navid Redjal, and Jean-Valery Coumans. "Cervical osteophyte resulting in compression of the jugular foramen." Journal of Neurosurgery: Spine 21, no. 4 (October 2014): 565–67. http://dx.doi.org/10.3171/2014.6.spine13908.

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Jugular foramen syndrome is a condition characterized by unilateral paresis of cranial nerves IX, X, and XI in the setting of extrinsic compression. Here, the authors describe the case of a giant cervical osteophyte resulting in compression of the jugular foramen. A 74-year-old man who presented with progressive dysphagia and dysarthria was found to have right-sided tongue deviation, left palatal droop, and hypophonia. His dysphagia had progressed to the point that he had lost 25 kg over a 4-month period, necessitating a gastrostomy to maintain adequate nutrition. He underwent extensive workup for his dysphagia with several normal radiographic studies. Ultimately, CT scanning and postcontrast MRI revealed a posterior osteophyte arising from the C1–2 joint space and projecting into the right jugular foramen. This resulted in a jugular foramen syndrome in addition to delayed filling of the patient's right internal jugular vein distal to the osteophyte. Although rare, a posterior cervical osteophyte should be considered in cases of jugular foramen syndrome.

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Cnop, Katia, Boris Martinez, and Kirsten E. Austad. "Resistant dermatomyositis in a rural indigenous Maya woman." BMJ Case Reports 12, no. 2 (February 2019): e223886. http://dx.doi.org/10.1136/bcr-2017-223886.

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A 28-year-old indigenous Guatemalan woman presented with 7 months of progressive weakness and numerous dermatological findings. She initially sought care within the free government-run health system and was treated with oral steroids for presumed dermatomyositis. Her symptoms progressed, including severe dysphagia, hypophonia and weakness preventing sitting. She was lost to follow-up in the public system due to financial and cultural barriers. A non-governmental organisation tailored to the needs of Maya patients provided home intravenous pulse dose methylprednisolone in the absence of first-line biologicals. With longitudinal home-based care, she achieved symptom free recovery. The rising burden of chronic non-communicable diseases highlights shortcomings in health systems evident in this case, including lack of provider capacity, limited infrastructure to test for and treat rare diseases and poor continuity of care. We provide potential solutions to help care delivery in low-resource settings adapt to the demans of chronic disease control with particular attention to social determinants of health.

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Patel, Kishan, Eliezer Nussbaum, Jason Sico, and Naseema Merchant. "Atypical case of Miller-Fisher syndrome presenting with severe dysphagia and weight loss." BMJ Case Reports 13, no. 5 (May 2020): e234316. http://dx.doi.org/10.1136/bcr-2020-234316.

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A 71-year-old man developed dysphagia, bilateral lower extremity muscle weakness and weight loss. He was admitted to the hospital after a failed formal swallow evaluation, nearly 3 weeks after symptom onset. In addition to dysphagia and weakness, physical examination was notable for hypophonia, dysarthria, diplopia, horizontal ophthalmoparesis, ptosis, ataxia and hyporeflexia. Cerebrospinal fluid was notable for albuminocytological dissociation and serum anti-GQ1b antibody titre was elevated (1:200). A diagnosis of Miller-Fisher syndrome (MFS) was made, and the patient was treated with intravenous immunoglobulin (0.4 g/kg/day) for 5 days, which resulted in resolution of symptoms. This is an atypical case of MFS, in that the presenting symptom was progressive dysphagia rather than the ophthalmoplegia and ataxia that are normally seen in MFS. Patients who present with dysphagia should receive a thorough neurological examination, with particular attention to extraocular movements, reflexes and gait stability, to rule out MFS as a potential cause.

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Koutsouraki, Ephrosyni, Georgia Xiromerisiou, Vassiliki Costa, and Stavros Baloyannis. "Acute bilateral thalamic infarction as a cause of acute dementia and hypophonia after occlusion of the artery of Percheron." Journal of the Neurological Sciences 283, no. 1-2 (August 2009): 175–77. http://dx.doi.org/10.1016/j.jns.2009.02.369.

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Matheron, Deborah, Elaine T. Stathopoulos, Jessica E. Huber, and Joan E. Sussman. "Laryngeal Aerodynamics in Healthy Older Adults and Adults With Parkinson's Disease." Journal of Speech, Language, and Hearing Research 60, no. 3 (March 2017): 507–24. http://dx.doi.org/10.1044/2016_jslhr-s-14-0314.

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Purpose The present study compared laryngeal aerodynamic function of healthy older adults (HOA) to adults with Parkinson's disease (PD) while speaking at a comfortable and increased vocal intensity. Method Laryngeal aerodynamic measures (subglottal pressure, peak-to-peak flow, minimum flow, and open quotient [OQ]) were compared between HOAs and individuals with PD who had a diagnosis of hypophonia. Increased vocal intensity was elicited via monaurally presented multitalker background noise. Results At a comfortable speaking intensity, HOAs and individuals with PD produced comparable vocal intensity, rates of vocal fold closure, and minimum flow. HOAs used smaller OQs, higher subglottal pressure, and lower peak-to-peak flow than individuals with PD. Both groups increased speaking intensity when speaking in noise to the same degree. However, HOAs produced increased intensity with greater driving pressure, faster vocal fold closure rates, and smaller OQs than individuals with PD. Conclusions Monaural background noise elicited equivalent vocal intensity increases in HOAs and individuals with PD. Although both groups used laryngeal mechanisms as expected to increase sound pressure level, they used these mechanisms to different degrees. The HOAs appeared to have better control of the laryngeal mechanism to make changes to their vocal intensity.

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Solomon, Nancy Pearl, Amy S. McKee, Katherine J. Larson, Michael D. Nawrocki, Paul J. Tuite, Sharon Eriksen, Walter C. Low, and Robert E. Maxwell. "Effects of Pallidal Stimulation on Speech in Three Men With Severe Parkinson’s Disease." American Journal of Speech-Language Pathology 9, no. 3 (August 2000): 241–56. http://dx.doi.org/10.1044/1058-0360.0903.241.

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This project examined the effects of pallidal stimulation and medication on speech in three men with severe Parkinson’s disease. Two participants had bilateral pallidal stimulation and one had unilateral stimulation contralateral to a prior pallidotomy. Measures included general motor function, auditory perceptual characteristics of speech, intelligibility, inter-pause speech rate, and speech aerodynamics. All three participants had improved motor function (better mobility, reduced tremor and dyskinesia), but responses for speech varied widely. The participant with a prior unilateral pallidotomy and contralateral pallidal stimulation had alleviation of painful facial-mandibular dystonia so that he was more willing and better able to talk. One participant developed marked hypophonia postoperatively from a presumed pallidotomy or chronic stimulation effect as this result was not altered by deactivating the bilateral stimulators. The third participant dεmonstrated improved overall speech characterized by reduced vocal strain and tremulousness in the medication-on condition when the stimulators were activated. In the medication-of condition, he developed abnormal speech dysfluencies with bilateral pallidal stimulation, but this impairment was eliminated with medication or when the stimulators were deactivated. Careful exploration of speech sequelae after pallidal stimulation is essential to develop risk/benefit data for future neurosurgical candidates.

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Andreetta, Monika D., Scott G. Adams, Allyson D. Dykstra, and Mandar Jog. "Evaluation of Speech Amplification Devices in Parkinson's Disease." American Journal of Speech-Language Pathology 25, no. 1 (February 2016): 29–45. http://dx.doi.org/10.1044/2015_ajslp-15-0008.

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Purpose The purpose of this study was to evaluate the efficacy of selected speech amplification devices in individuals with hypophonia and idiopathic Parkinson's disease (PD). Method This study compared the effectiveness of seven devices (ADDvox, BoomVox, ChatterVox, Oticon Amigo, SoniVox, Spokeman, and Voicette) to unamplified speech for 11 participants with PD during conversation in 65-dB SPL multitalker noise, using experience ratings collected from participant questionnaires and speech performance measures (i.e., speech-to-noise ratio [SNR], speech intensity, and intelligibility) obtained from audio recordings. Results Compared with unamplified speech, device use increased SNR by 1.07–4.73 dB SPL and speech intensity by 1.1–5.1 dB SPL, and it significantly increased transcribed intelligibility from 13.8% to 58.9%. In addition, the type of device used significantly affected speech performance measures (e.g., BoomVox was significantly higher than most of the other devices for SNR, speech intensity, and intelligibility). However, experience ratings did not always correspond to performance measures. Conclusions This study found preliminary evidence of improved speech performance with device use for individuals with PD. A tentative hierarchy is suggested for device recommendations. Future research is needed to determine which measures will predict long-term device acceptance in PD.

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Maxwell, Alice, Hilary Archer, Nicki Cohen, Seth Love, and David Cottrell. "PROGRESSIVE MULTIFOCAL LEUCOENCEPHALOPATHY: AN ATYPICAL CASE." Journal of Neurology, Neurosurgery & Psychiatry 86, no. 11 (October 14, 2015): e4.185-e4. http://dx.doi.org/10.1136/jnnp-2015-312379.90.

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Case reportA 71 year old man presented with a three month history of gradual arm and leg weakness, followed by neck stiffness, dysphagia, dysarthria and hypophonia. Past Medical History included Burkitt's lymphoma of the jaw 14 years previously, treated with chemotherapy and radiotherapy.Examination demonstrated a restriction of upgaze and dysphonia. Tone was markedly increased, and power reduced globally at a grading of 4/5. Reflexes were brisk with an upgoing left plantar.Investigations revealed, longstanding idiopathic lymphopenia for 10 years, CT chest/abdominal/pelvis was normal, serial MRI of the brain demonstrated changes in the subcortical white matter, frontal and parietal lobes. JC virus PCR was negative, however, brain biopsy was consistent with Progressive Multifocal Leucoencephalopathy (PML).DiscussionPML is caused by reactivation of the polyomavirus JC in the CNS. Reactivation typically occurs following immunosuppression e.g. HIV, haematological malignancies and drugs. Gold standard for diagnosis is brain biopsy as JC virus PCR has a sensitivity of only 80%. Treatment is through removal of the immunosuppressive agent, and immune reconstitution.PML should be considered in all patients with a suggestive clinical and radiological presentation where there is current or historical immunosuppression, should JC virus PCR be negative a tissue biopsy should be sought.

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Dias, Alice Estevo, Hsin Fen Chien, and Egberto Reis Barbosa. "O método Lee Silverman para reabilitação da fala na doença de Parkinson." Revista Neurociências 19, no. 3 (March 31, 2001): 551–57. http://dx.doi.org/10.34024/rnc.2011.v19.8356.

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As alterações da fala (disfonia e disartria) frequentemente acompanham a evolução da doença de Parkinson (DP). Objetivo. Este estudo revisa o Método Lee Silverman, considerado o mais eficiente para a reabilitação das alterações da fala na DP e atualiza os avanços na sua aplicação. Método. Foi realizada uma pesquisa nas bases de dados MEDLINE, Pubmed e Bireme dos artigos indexados publicados de 1990 a 2010, com as seguintes palavras-chave: Parkinson’s disease, PD, Lee Silverman Voice Treatment, LSVT, LSVT LOUD, LSVT parkinson, voice treatment and PD, voice therapy and PD, communication and PD, dysarthria and PD, dysphonia and PD, speech disorders and PD, voice disorders and PD, hypophonia and PD, speech motor system and PD. Resultados. Na literatura, existe ampla descrição dos resultados de estudos do método Lee Silverman na DP. Os artigos encontrados evidenciam melhora da prosódia, articulação, ressonância, respiração, inteligibilidade, intensidade e qualidade da voz, assim como da deglutição e da expressividade facial. Conclusões. Para a reabilitação da fala dispõe-se de eficientes técnicas fonoaudiológicas. Contudo, conforme a literatura científica, o emprego do Método Lee Silverman é opção vantajosa, pois foi desenvolvido especificamente para a DP. Há inúmeras evidências de sua eficácia e vem sendo continuamente avaliado, ampliando sua aplicabilidade.

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Liu, Zhiguang, Guanqun Zhang, Liang Zhu, Jiangbo Wang, Dongbo Liu, Lifei Lian, Jianlin Liu, Tianbao Lai, and Xiaorong Zhuang. "Retrospective Analysis of Bevacizumab in Combination with Fotemustine in Chinese Patients with Recurrent Glioblastoma Multiforme." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/723612.

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The aim of this study was to assess the activity and safety of bevacizumab (BEV) and fotemustine (FTM) for the treatment of recurrent glioblastoma multiforme (GBM) patients and explore the potential prognostic parameters on survival. This study retrospectively analyzed all patients with GBM who were treated with at least one cycle of BEV and FTM from July 2010 to October 2012. A total of 176 patients with recurrent GBM were enrolled. The response rate and disease control rate were 46.6% and 90.9%, respectively. A 6-month PFS rate of 33.3% (95% CI: 26.5%–40.3%) and a median PFS of 5.0 (95% CI: 2.4–7.5) months were observed. The median OS was 8.0 (95% CI: 6.7–9.2) months. Multivariate analysis showed that risk factors with a significant influence on the PFS of all patients were Karnofsky Performance Status (KPS) (≥70 versus <70,HR=0.53, 95% CI: 0.39–0.73, andP=0.01) and MGMT status (methylated versus unmethylated,HR=0.69, 95% CI: 0.52–0.97, andP=0.04). The most common treatment-related adverse events were fatigue, proteinuria, hypophonia, hypertension, thrombocytopenia, anemia, and neutropenia. In conclusion, combination of BEV with FTM is well tolerated and may derive some clinical benefits in recurrent GBM patients. Higher KPS and MGMT promoter hypermethylation were suggested to be associated with prolonged survival.

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Nmezi, Bruce, Elisa Giorgio, Raili Raininko, Anna Lehman, Malte Spielmann, Mary Kay Koenig, Rahmat Adejumo, et al. "Genomic deletions upstream of lamin B1 lead to atypical autosomal dominant leukodystrophy." Neurology Genetics 5, no. 1 (January 24, 2019): e305. http://dx.doi.org/10.1212/nxg.0000000000000305.

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ObjectiveClinical, radiologic, and molecular analysis of patients with genomic deletions upstream of the LMNB1 gene.MethodsDetailed neurologic, MRI examinations, custom array comparative genomic hybridization (aCGH) analysis, and expression analysis were performed in patients at different clinical centers. All procedures were approved by institutional review boards of the respective institutions.ResultsFive patients from 3 independent families presented at ages ranging from 32 to 52 years with neurologic symptoms that included progressive hypophonia, upper and lower limb weakness and spasticity, and cerebellar dysfunction and MRIs characterized by widespread white matter alterations. Patients had unique nonrecurrent deletions upstream of the LMNB1, varying in size from 250 kb to 670 kb. Deletion junctions were embedded in repetitive elements. Expression analysis revealed increased LMNB1 expression in patient cells.ConclusionsOur findings confirmed the association between LMNB1 upstream deletions and leukodystrophy previously reported in a single family, expanding the phenotypic and molecular description of this condition. Although clinical and radiologic features overlapped with those of autosomal dominant leukodystrophy because of LMNB1 duplications, patients with deletions upstream of LMNB1 had an earlier age at symptom onset, lacked early dysautonomia, and appeared to have lesser involvement of the cerebellum and sparing of the spinal cord diameter on MRI. aCGH analysis defined a smaller minimal critical region required for disease causation and revealed that deletions occur at repetitive DNA genomic elements. Search for LMNB1 structural variants (duplications and upstream deletions) should be an integral part of the investigation of patients with autosomal dominant adult-onset leukodystrophy.

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Feng, Xin, Victor M. Henriquez, Judith R. Walters, and Christy L. Ludlow. "Effects of Dopamine D1 and D2 Receptor Antagonists on Laryngeal Neurophysiology in the Rat." Journal of Neurophysiology 102, no. 2 (August 2009): 1193–205. http://dx.doi.org/10.1152/jn.00121.2009.

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Hypophonia is an early symptom in Parkinson's disease (PD) that involves an increase in laryngeal muscle activity, interfering with voice production. Our aim was to use an animal model to better understand the role of different dopamine receptor subtypes in the control of laryngeal neurophysiology. First, we evaluated the combined effects of SCH23390—a D1 receptor antagonist with a D2 receptor antagonist (eticlopride) on laryngeal neurophysiology, and then tested the separate effects of selective receptor antagonists. Thyroarytenoid (TA) and gastrocnemius (GN) muscle activity was measured at rest and while stimulating the internal branch of superior laryngeal nerve to elicit the laryngeal adductor response (LAR) in alpha-chloralose–anesthetized rats. Paired stimuli at different interstimulus intervals between 250 and 5,000 ms measured central conditioning of the LAR. Changes in resting muscle activity, response latency, amplitude, and LAR conditioning after each drug were compared with the saline control. SCH23390 alone increased the resting TA muscle activity ( P < 0.05). With the combined SCH23390 + eticlopride or SCH23390 alone, response latency decreased ( P < 0.01), amplitude increased ( P < 0.01), and the test LAR was reduced at 2,000-ms ISI ( P < 0.01). No LAR changes occurred when eticlopride was administered alone at a low dose and only a tendency to suppress responses was found at a high dose. No changes in GN muscle activity occurred in any of the groups. The results suggest that a loss of stimulation of D1 receptors plays a significant role in laryngeal pathophysiology in PD.

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Senthinathan, Anita, Scott Adams, Allyson D. Page, and Mandar Jog. "Speech Intensity Response to Altered Intensity Feedback in Individuals With Parkinson's Disease." Journal of Speech, Language, and Hearing Research 64, no. 6S (June 18, 2021): 2261–75. http://dx.doi.org/10.1044/2021_jslhr-20-00278.

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Purpose Hypophonia (low speech intensity) is the most common speech symptom experienced by individuals with Parkinson's disease (IWPD). Previous research suggests that, in IWPD, there may be abnormal integration of sensory information for motor production of speech intensity. In the current study, intensity of auditory feedback was systematically manipulated (altered in both positive and negative directions) during sensorimotor conditions that are known to modulate speech intensity in everyday contexts in order to better understand the role of auditory feedback for speech intensity regulation. Method Twenty-six IWPD and 24 neurologically healthy controls were asked to complete the following tasks: converse with the experimenter, start vowel production, and read sentences at a comfortable loudness, while hearing their own speech intensity randomly altered. Altered intensity feedback conditions included 5-, 10-, and 15-dB reductions and increases in the feedback intensity. Speech tasks were completed in no noise and in background noise. Results IWPD displayed a reduced response to the altered intensity feedback compared to control participants. This reduced response was most apparent when participants were speaking in background noise. Specific task-based differences in responses were observed such that the reduced response by IWPD was most pronounced during the conversation task. Conclusions The current study suggests that IWPD have abnormal processing of auditory information for speech intensity regulation, and this disruption particularly impacts their ability to regulate speech intensity in the context of speech tasks with clear communicative goals (i.e., conversational speech) and speaking in background noise.

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Figueira, Helena Dutra. "Pneumocephalus Following Unidentified Dural Puncture: A Case Report with an Unusual Neurological Presentation." Pain Physician 2, no. 20;2 (February 14, 2017): E329—E334. http://dx.doi.org/10.36076/ppj.2017.e334.

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Pneumocephalus is a rare consequence of epidural anesthesia, which may occur following inadvertent or unidentified dural puncture when the loss of resistance to air technique is applied to identify the epidural space. Headache is the most common symptom presented in this condition, usually with sudden onset. This case report describes an unusual presentation of diffuse pneumocephalus after an unidentified dural puncture. The patient (male, 67 years old) was submitted to epidural catheter placement for the treatment of acute exacerbation of ischemic chronic pain using loss of resistance to air technique. No cerebrospinal fluid or blood flashback was observed after needle withdrawal. Shortly after the intervention, the patient presented symptoms of lethargy, apathy, and hypophonia, which are not commonly associated with pneumocephalus. No motor or sensory deficits were detected. Cranial computed tomography showed air in the frontal horn of the left ventricle, subarachnoid space at interhemispheric fissure and basal cisterns, confirming the diagnosis of diffuse pneumocephalus. The patient remained under vigilance with oxygen therapy and the epidural catheter left in place. After 24 hours, cranial computed tomography showed air in the temporal and frontal horns of the left ventricle, with no air in the subarachnoid space. The patient presented no neurological signs or symptoms at this time. Although headache is the most common symptom presented in reported cases of pneumocephalus, this case shows the need for the clinician to be aware of other signs and symptoms that may be indicative of this condition, in order to properly diagnose and treat these patients. Key words: Pneumocephalus, continuous epidural analgesia, ischemic chronic pain, lossof-resistance to air technique, dural puncture, headache, unusual presentation

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Roy, Priyanka, and Praveen Kumar. "P.2.27 Manganese exposure in steel and allied factory: cause of secondary parkinsonism." Occupational and Environmental Medicine 76, Suppl 1 (April 2019): A94.2—A94. http://dx.doi.org/10.1136/oem-2019-epi.257.

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Case presentationA 43 year old male presented with 6 months history of gradual onset and progressive bradykinesia, tremors of upper limbs and walking difficulty in the form of imbalance and short shuffling gait, slurring of speech with hypophonia. Neurological examination revealed slow broken saccades, rigidity with cogwheeling, bradykinesia and short shuffling, festinant gait. He had action and postural tremors of upper limbs. Pull test was positive. Thus a diagnosis of young onset Parkinsonism was considered. But, occupational history revealed that he worked in blast furnace of a steel and allied factory for past 14 years where manganese ore has been using for the strengthening of the stainless steel. He was evaluated with MRI Brain which showed symmetrical hyperintensities involving basal ganglia and subcortical white matter in T2 weighted images. T1 weighted images showed evidence of basal ganglia hyperintensities probably related to mineral deposition. Renal function, thyroid function tests including anti thyroid antibodies, KF Ring, S. Ceruloplasmin, Liver function tests, CSF, ultrasound abdomen- all were normal. Two consecutive serum manganese level tests in six months interval showed initial rise (two times) with the history of exposure and followed by normal level without the exposure. Patient was started on symptomatic medications like levodopa and trihexiphenidyl but after 8 months of medication (March- October, 2018) he had not showed any significant improvement. The written consent was taken from patient for this study.ConclusionIn view of strong occupational history of manganese exposure, the clinical features and non responsiveness of treatment with levodopa, a possibility of manganese toxicity was strongly considered for this rare case of secondary parkinsonism. Also non adherence with the legal mandate of periodical medical examination of workers exposed to toxic metals with long term consequence is very important factor to be corrected in the developing country like India.

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Dal, Shoaib, and Scott Whyte. "035 Valproate-induced parkinsonism ‘an early warning’: case reports and review of literature." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A12.2—A12. http://dx.doi.org/10.1136/jnnp-2019-anzan.32.

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IntroductionWe describe two cases of valproate-induced parkinsonism, where the parkinsonian features develop after commencing valproate (VPA), in a time frame and manner well described by previous publications.1 In contrast to the published literature, that has short duration of follow-up, we have had a prolonged follow-up of these two cases, who initially improved on ceasing valproate, but then after a period progressed again, with the development of levodopa-responsive asymmetrical Parkinson’s disease.2Cases67 years old man, on VPA 500 mg twice a day for seizures since 2008, developed new rest, re-emergent left hand tremor and hypomimia in 2012. Within months, the parkinsonism progressed to decremental bradykinesia, cog-wheel rigidity and hypophonia. The symptoms initially improved with changing VPA to levetiracetam; however, the disease reappeared after 6 months and although levodopa-responsive, it has been progressive since then.88 years old man, on VPA 700 mg twice a day for seizures since 2010, developed upper limb decremental bradykinesia, cog-wheel rigidity, camptocormia and rest, re-emergent tremor in hands in 2011. The parkinsonism improved significantly with cessation of VPA; however, the disease re-emerged after 2 years and has been progressive since then.ConclusionVPA may be responsible for unmasking underlying subclinical parkinsonism and these patients represent an earlier onset of Parkinson’s disease related to VPA exposure, rather than a purely drug related parkinsonian dysfunction. These cases also highlight the importance of long-term follow up in VPA-induced parkinsonism. These observations are an important consideration for clinicians treating patients with parkinsonian features secondary to VPA exposure.ReferencesBrugger F, Bhatia KP, Besag FM. Valproate-associated parkinsonism: a critical review of the literature. CNS Drugs 2016;30(6):527–540.Mahmoud F, Tampi RR. Valproic acid-induced parkinsonism in the elderly: a comprehensive review of the literature. Am J Geriatr Pharmacother 2011;9(6):405–412.

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Horisawa, Shiro, Atsushi Fukui, Hayato Yamahata, Yukiko Tanaka, Atsushi Kuwano, Oji Momosaki, Mutsumi Iijima, Magi Nanke, Takakazu Kawamata, and Takaomi Taira. "Unilateral pallidothalamic tractotomy for akinetic-rigid Parkinson’s disease: a prospective open-label study." Journal of Neurosurgery 135, no. 3 (September 2021): 799–805. http://dx.doi.org/10.3171/2020.7.jns201547.

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OBJECTIVE Neurosurgical ablation is an effective treatment for medically refractory motor symptoms of Parkinson’s disease (PD). A limited number of studies have reported the effect of ablation of the pallidothalamic tract for PD. In this study, the authors evaluated the safety and efficacy of unilateral pallidothalamic tractotomy for akinetic-rigid (AR)–PD. METHODS Fourteen AR-PD patients, who were enrolled in this prospective open-label study, underwent unilateral pallidothalamic tractotomy. The Movement Disorder Society–Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III and Part IV (dyskinesia and dystonia) scores and levodopa equivalent daily dose (LEDD) were evaluated at baseline and at 3 and 12 months postoperatively. RESULTS Of the 14 patients enrolled in the study, 4 were lost to follow-up and 10 were analyzed. The total MDS-UPDRS Part III score significantly improved from 45 ± 4.6 at baseline to 32.9 ± 4.8 at 12 months postoperatively (p = 0.005). Contralateral side rigidity and bradykinesia significantly improved from 4.4 ± 0.5 and 10.4 ± 1.5 at baseline to 1.7 ± 0.4 (p = 0.005) and 5.2 ± 1.4 (p = 0.011) at 12 months, respectively. While posture significantly improved with a 20% reduction in scores (p = 0.038), no significant improvement was found in gait (p = 0.066). Dyskinesia and dystonia were improved with a 79.2% (p = 0.0012) and 91.7% (p = 0.041) reduction in scores, respectively. No significant change was found in the LEDD. Hypophonia was noted in 2 patients, eyelid apraxia was noted in 1 patient, and a reduced response to levodopa, which resulted in an increase in the daily dose of levodopa, was noted in 3 patients. No serious permanent neurological deficits were observed. CONCLUSIONS Unilateral pallidothalamic tractotomy improved contralateral side rigidity and bradykinesia, dyskinesia, and dystonia in patients with AR-PD. Clinical trial registration no.: UMIN000031138 (umin.ac.jp)

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Maremmani, Angelo, Matteo Pacini, and Icro Maremmani. "What we have learned from the Methadone Maintenance Treatment of Dual Disorder Heroin Use Disorder patients." International Journal of Environmental Research and Public Health 16, no. 3 (February 3, 2019): 447. http://dx.doi.org/10.3390/ijerph16030447.

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Mental Disorders and Heroin Use Disorder (HUD) often co-occur and constitute correlated risk factors that the authors believe are best considered from a unitary perspective. In this article we review and discuss data collected by the V.P. Dole Research Group in Dual Disorder (V.P. Dole DD-RG) patients according to the following six discussion points: (1) Treatment of personality disorders during Methadone Maintenance Treatment (MMT); (2) Treatment of Mood Disorders during MMT; (3) Treatment of Anxiety Disorders during MMT; (4) Treatment of Psychotic Disorders during MMT; (5) Treatment of violence during MMT; (6) Treatment of Alcohol Use Disorder (AUD) during MMT. In treating Mood Disorder in HUD patients, we must bear in mind the interactions (potentiation and side effects) between psychopharmacology, used substances and agonist opioid medications; the use of psychiatric medications as an anti-craving drug, and the possible use of agonist and antagonist opioid medications in treating the other mental disorders. In treating chronic psychosis in HUD patients, we must consider the potentiation and side effects of antipsychotic drugs consequent on HUD treatment, worsening addiction hypophoria and inducing a more severe reward deficiency syndrome (RDS) in hypophoric patients. Violence and AUD during MMT can benefit from adequate dosages of methadone and co-medication with Sodium gamma-hydroxybutyrate (GHB). The experience of our V.P. Dole DD-RG suggests the following: (a) DD is the new paradigm in neuroscience in deepening our understanding of mental health; (b) To successfully treat DD patients a double competence is needed; (c) In managing DD patients priority must be given to Substance Use Disorder (SUD) treatment (stabilizing patients); (d) Antidepressant use is ancillary to SUD treatment; antipsychotic use must be restricted to acute phases; mood stabilizers must be preferred; any use of Benzodiazepines (BDZs) must be avoided.

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Lombard, Lori E., and Kimberly M. Steinhauer. "A Novel Treatment for Hypophonic Voice: Twang Therapy." Journal of Voice 21, no. 3 (May 2007): 294–99. http://dx.doi.org/10.1016/j.jvoice.2005.12.006.

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Edwards, Leon S., Michel Tchan, Kate M. Crossley, Brendon Yee, and Judith M. Spies. "128 Late-onset pompe disease (LOPD) presenting with fulminant hypercapnic respiratory failure." Journal of Neurology, Neurosurgery & Psychiatry 90, e7 (July 2019): A41.2—A41. http://dx.doi.org/10.1136/jnnp-2019-anzan.113.

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IntroductionWe report a case of LOPD with acute-on-chronic respiratory failure.CaseA 57 year-old retired farmer presented with obtundation requiring intubation. He reported a 4 month history of hypophonia, intermittent diplopia, lethargy and orthopnea.Initial arterial blood gas measurement displayed acute-on-chronic hypercapnic respiratory failure (pH 7.19, pO2 98 mmHg, pCO2 112 mmHg, HCO3 43 mmol/L). Muscle biopsy was suggestive of LOPD with myofibres demonstrating acid phosphatase and periodic acid-schiff positive vacuoles. Diagnosis was confirmed with low α-glucosidase activity on dried blood spot (0.4umol/h/L) and elevated urinary tetrasaccharide level (5 mmol/mol creatinine). Mutation analysis of the GAA gene demonstrated two known pathogenic mutations (c.-32–13T>G and c.1075+1G>T). With improved ventilation, he was able to be extubated. The only respiratory support on discharge was overnight bilevel positive airway pressure ventilation.ConclusionLOPD is a rare autosomal recessive metabolic disorder caused by a deficiency in acid α-glucosidase. This leads to intra-lysomal accumulation of glycogen in tissues. Particularly in the late form, there is significant phenotypic variability.1 Diagnosis remains challenging. Cases have been reported with a range of initial symptoms including stroke,2 syncope3 and chronic respiratory failure.4 Acute on chronic respiratory failure at presentation is rare.Enzyme replacement therapy has been shown to improve both morbidity and mortality in LOPD.5 Earlier treatment is associated with better outcomes.6 Prompt recognition of cases is paramount. Unexplained acute-on-chronic respiratory failure should raise the possibility of this condition. In such cases, management of ventilation is vital.ReferencesChan J, et al. The emerging phenotype of late-onset Pompe disease: A systematic literature review. Mol Genet Metab 2017;120(3):163–172.Hossain MA, et al. A Case of Adult-onset Pompe Disease with Cerebral Stroke and Left Ventricular Hypertrophy. J Stroke Cerebrovasc Dis 2018;27(11):3046–3052.Walczak-Galezewska M, et al, Late-onset Pompe disease in a 54 year-old sportsman with an episode of syncope: a case report. Eur Rev Med Pharmacol Sci 2017;21(16):3665–3667.O’Callaghan C, et al, Adult-onset Pompe disease presenting with insidious hypercapnic respiratory failure. Respirol Case Rep 2016;4(5):e00178.Schoser B, S A, Kanters S, Hamed A, Jansen J, Chan K, Karamouzian M, Toscano A. Survival and long-term outcomes in late-onset Pompe disease following alglucosidase alfa treatment: a systematic review and meta-analysis. J Neurol 2017;264(4):621–630.Chien YH, HW, Lee NC. Pompe disease: early diagnosis and early treatment make a difference. Pediatr Neonatol 2013;54(4):219–227.

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Heidler, Maria-Dorothea. "Thalamische Aphasien." Zeitschrift für Neuropsychologie 20, no. 2 (January 2009): 127–39. http://dx.doi.org/10.1024/1016-264x.20.2.127.

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Primär nach linksseitigen thalamischen Läsionen manifestieren sich zwei sprachpathologische Syndrome, die charakterisiert sind durch eine entweder verminderte oder aber flüssige Spontansprachenproduktion, Wortabrufstörungen infolge mangelhafter semantischer Selektion, Perseverationen, Paraphasien, relativ intakte schriftsprachliche, syntaktische und repetitive Fähigkeiten, moderate auditive und visuelle Sprachverständnisstörungen sowie fakultative sprechmotorische Beeinträchtigungen wie Hypophonie und/oder Dysprosodie. Diese als «thalamische Aphasien» bezeichneten Syndrome zeigen einen im Vergleich zu kortikalen Aphasien distinkten Pathomechanismus, da vor allem kognitive Basisprozesse (wie Aufmerksamkeit, Gedächtnis, Exekutivfunktionen, Antrieb etc.) beeinträchtigt sind, die sekundär zu ineffizienten Sprachverarbeitungsprozessen führen. Zudem führen thalamische Läsionen oft zu Amnesien, Orientierungsstörungen und Anosognosie, die auf sprachlicher Ebene u. a. thematische Instabilität, Fragmentation und Konfabulationen zur Folge haben.

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Möller, Jens Carsten, Alexandra Menig, and Matthias Oechsner. "Neurorehabilitation bei der Parkinson-Krankheit." Praxis 105, no. 7 (March 2016): 377–82. http://dx.doi.org/10.1024/1661-8157/a002306.

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Zusammenfassung. Die Parkinson-Krankheit (PK) ist eine chronische neurodegenerative Krankheit, die durch die Kardinalsymptome Akinese, Rigor, Ruhetremor und posturale Instabilität gekennzeichnet ist. Zudem ist die PK durch eine Vielzahl nicht-motorischer Symptome charakterisiert. Während körperliche Aktivität in allen Stadien der Parkinson-Krankheit empfohlen wird und womöglich sogar den Krankheitsverlauf positiv beeinflusst, werden rehabilitative Behandlungen mit zunehmender Krankheitsdauer immer wichtiger. Bei der Neurorehabilitation kommen vor allem physiotherapeutische, ergotherapeutische und logopädische Techniken zum Einsatz, deren grösste Bedeutung wohl in der Behandlung der schlecht auf die medikamentöse Therapie ansprechenden axialen Symptome wie freezing, Hypophonie, Dysphagie, posturale Instabilität und Haltungsstörungen besteht. Diese Arbeit gibt eine Übersicht über den aktuellen Stand der Neurorehabilitation in der Behandlung der PK.

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SEHNAL, RICHARD. "A new species of Pegylis Erichson, 1847 (Coleoptera: Scarabaeidae: Melolonthinae: Pegylini) from Ethiopia." Zootaxa 4323, no. 3 (September 22, 2017): 423. http://dx.doi.org/10.11646/zootaxa.4323.3.8.

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The Afrotropical genus Pegylis Erichson, 1847 (Coleoptera: Scarabaeidae: Melolonthinae: Pegylini) was recently treated by Lacroix (2015), who keyed and figured most of the known species and divided the genus into six species groups based on the number of antennomeres, shape of male genitalia and number of teeth on the protibia. Unfortunately, Lacroix (2015) overlooked two earlier papers by Harrison (2014a, 2014b). Harrison (2014a, 2014b) provided a phylogenetic analysis of the tribe, synonymised Hypopholis Erichson, 1847 with Pegylis, and redescribed the three known South African species of Pegylis. Based on these papers, the genus Pegylis currently contains 37 species.

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Möller, Jens Carsten, Raoul Schweinfurther, and Matthias Oechsner. "Parkinson-Syndrome in der Neurorehabilitation." Therapeutische Umschau 74, no. 9 (December 2017): 489–93. http://dx.doi.org/10.1024/0040-5930/a000946.

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Zusammenfassung. Parkinson-Syndrome spielen in der klinischen Neurologie eine wichtige Rolle und sind häufig durch neurodegenerative Krankheiten wie die Parkinson-Krankheit (PK), Multisystematrophie (MSA) oder progressive supranukleäre Blickparese (progressive supranuclear palsy, PSP) verursacht. Die motorischen Symptome Akinese, Rigor und Ruhetremor sprechen bei der PK meist gut auf die symptomatische medikamentöse Therapie an. Im Verlauf ist die PK aber durch Wirkungsfluktuationen der dopaminergen Therapie und durch das Auftreten axialer Symptome wie Hypophonie, Dysphagie, Haltungsstörungen, posturale Instabilität und freezing, die nur bedingt durch Medikamente gebessert werden, charakterisiert. Bei den atypischen Parkinson-Syndromen wie der MSA oder PSP ist das Ansprechen auf die medikamentöse Behandlung erfahrungsgemäß schlecht. Daher gewinnen nicht-medikamentöse neurorehabilitative Methoden bei Parkinson-Syndromen zunehmend an Bedeutung, auch wenn vor allem bei den atypischen Formen die Evidenzlage unbefriedigend ist. Außerdem sind Pumpentherapien (Apomorphin, Duodopa®) sowie die Nachbehandlung von Patienten mit PK nach Tiefer Hirnstimulation (THS) häufig Bestandteil einer stationären Neurorehabilitation.

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Lewis, Ariane. "Finding Your Voice." American Journal of Hospice and Palliative Medicine®, April 22, 2021, 104990912110126. http://dx.doi.org/10.1177/10499091211012610.

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Despite being cognitively intact, patients with Guillain Barre Syndrome are often unable to communicate. Because of this, goals-of-care decisions may need to be made by family members/surrogates. Here, I describe a patient with Guillain Barre Syndrome whose voice was initially stifled by dysarthria, then hypophonia, then intubation, but who ultimately managed to express herself and convey her wishes regarding goals-of-care.

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"Lee Silverman Voice Treatment Versus Standard Speech Therapy Versus Control in Hypophonia Rehabilitation in MS." Case Medical Research, July 26, 2019. http://dx.doi.org/10.31525/ct1-nct04034277.

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Chandra, Avinash, and Basant Pant. "Hypophonia as only presenting symptom in myasthenia gravis – a diagnostic dilemma in poor countries: a case report." Journal of Medical Case Reports 13, no. 1 (March 2, 2019). http://dx.doi.org/10.1186/s13256-019-1970-6.

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Raju, P. V. Rama, P. N. T. L. Durga, B. G. S. Anusha, A. Bhogeswararao, M. BalaSai Krishna, and Dr V. Malleswara Rao. "Analysis and Exposure of Parkinson’s Disease Signal in the Vicinity of Wavelet Transform." International Journal of Electronics Signals and Systems, July 2011, 26–31. http://dx.doi.org/10.47893/ijess.2011.1006.

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Parkinson's disease (PD) is a gradual progressive central neurodegenerative disorder that affects body movement and is characterized by symptoms such as muscle rigidity, resting tremors, loss of facial expression, hypophonia, diminished blinking, and akinesia [4]. This work aims at providing new insights on the Parkinson's disease fragmentation problem using wavelets [1, 2, 3]. The present work describes a computer model to provide a more accurate picture of the Parkinson's disease (PD) signal processing via Wavelet Transform [7, 8, 9, 10]. The Matlab techniques have been uses which provide a system oriented scientific decision making modal [7, 8]. Within this practice the applied signal has been compared in a sequential order with dissimilar cases in attendance in the database. Special biomedical signals have been considered from Gait in Aging and Disease Database [6] and Physio bank [5]. Analyze the signal under consideration and renowned the holder 100% truthfully.

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Raju, P. V. Rama, P. N. T. L. Durga, B. G. S. Anusha, A. Bhogeswararao, M. BalaSai Krishna, and Dr V. Malleswara Rao. "Analysis and Exposure of Parkinson’s Disease Signal in the Vicinity of Wavelet Transform." International Journal of Electronics Signals and Systems, July 2011, 26–31. http://dx.doi.org/10.47893/ijess.2011.1006.

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Parkinson's disease (PD) is a gradual progressive central neurodegenerative disorder that affects body movement and is characterized by symptoms such as muscle rigidity, resting tremors, loss of facial expression, hypophonia, diminished blinking, and akinesia [4]. This work aims at providing new insights on the Parkinson's disease fragmentation problem using wavelets [1, 2, 3]. The present work describes a computer model to provide a more accurate picture of the Parkinson's disease (PD) signal processing via Wavelet Transform [7, 8, 9, 10]. The Matlab techniques have been uses which provide a system oriented scientific decision making modal [7, 8]. Within this practice the applied signal has been compared in a sequential order with dissimilar cases in attendance in the database. Special biomedical signals have been considered from Gait in Aging and Disease Database [6] and Physio bank [5]. Analyze the signal under consideration and renowned the holder 100% truthfully.

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Patel, Roshni Abee, Jessica Joyce, Natalie Witek, and Mitra Afshari. "GAD65 antibody-associated neurologic disease presenting with hemiparkinsonism at onset." Neurology: Clinical Practice, October 19, 2020, 10.1212/CPJ.0000000000000996. http://dx.doi.org/10.1212/cpj.0000000000000996.

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A 60-year old previously healthy left-handed man presented to clinic with 6 months of progressive slowness and stiffness on the left side. He described loss of dexterity in the left hand and feeling of “heaviness” in the left leg. On exam, he exhibited mild bradyphrenia and hypophonia, moderate left arm and leg bradykinesia and rigidity, and left leg hesitations and reduced left arm-swing upon walking (video 1). A month prior, he had undergone MRIs of the brain and cervical spine with and without gadolinium that were unremarkable. Initial serum testing including complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, ceruloplasmin, and vitamin B12 levels were all unremarkable. The differential diagnosis at presentation included the spectrum of parkinsonian disorders with Parkinson's Disease being the most likely given his age group and the asymmetric parkinsonism. He was diagnosed with suspected Parkinson's Disease and levodopa therapy was initiated as the he felt his symptoms were functionally-limiting.

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Manes, Jordan L., Ellen Herschel, Katharine Aveni, Kris Tjaden, Todd Parrish, Tanya Simuni, Daniel M. Corcos, and Angela Roberts. "The effects of a simulated fMRI environment on voice intensity in individuals with Parkinson's disease hypophonia and older healthy adults." Journal of Communication Disorders, August 2021, 106149. http://dx.doi.org/10.1016/j.jcomdis.2021.106149.

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Gallay, Marc N., David Moser, Anouk E. Magara, Fabio Haufler, and Daniel Jeanmonod. "Bilateral MR-Guided Focused Ultrasound Pallidothalamic Tractotomy for Parkinson's Disease With 1-Year Follow-Up." Frontiers in Neurology 12 (February 9, 2021). http://dx.doi.org/10.3389/fneur.2021.601153.

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Objective: Bilateral stereotactic neurosurgery for advanced Parkinson's disease (PD) has a long history beginning in the late 1940s. In view of improved lesioning accuracy and reduced bleeding risk and in spite of long-standing caveats about bilateral approaches, there is a need to investigate bilateral MR-guided focused ultrasound (MRgFUS) interventions. We hereby present the clinical results of bilateral pallidothalamic tractotomy (PTT), i.e., targeting of pallidal efferent fibers below the thalamus at the level of Forel's field H1, followed for 1 year after operation of the second side.Methods: Ten patients suffering from chronic and therapy-resistant PD having received bilateral PTT were followed for 1 year after operation of the second side. The primary endpoints included the Unified Parkinson's Disease Rating Scale (UPDRS) scores in on- and off-medication states, dyskinesias, dystonia, sleep disturbances, pain, reduction in drug intake, and assessment by the patient of her/his global symptom relief as well as tremor control.Results: The time frame between baseline UPDRS score and 1 year after the second side was 36 ± 15 months. The total UPDRS score off-medication at 1 year after the second PTT was reduced by 52% compared to that at baseline on-medication (p < 0.007). Percentage reductions of the mean scores comparing 1 year off- with baseline on-medication examinations were 91% for tremor (p = 0.006), 67% for distal rigidity (p = 0.006), and 54% for distal hypobradykinesia (p = 0.01). Gait and postural instability were globally unchanged to baseline (13% improvement of the mean, p = 0.67, and 5.3% mean reduction, p = 0.83). Speech difficulties, namely, hypophonia, tachyphemia, and initiation of speech, were increased by 58% (p = 0.06). Dyskinesias were suppressed in four over four, dystonia in four over five, and sleep disorders in three over four patients. There was 89% pain reduction. Mean L-Dopa intake was reduced from 690 ± 250 to 110 ± 190.Conclusions: Our results suggest an efficiency of bilateral PTT in controlling tremor, distal rigidity, distal hypobradykinesia, dyskinesias, dystonia, and pain when compared to best medical treatment at baseline. Larger series are of course needed.

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Journal articles on the topic 'Hypophonia'

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