Self-perceptions of speech, voice, and swallowing in motor phenotypes of Parkinson's disease

Abstract

Introduction: The ability of people with Parkinson's Disease (PWPD) to perceive and identify impairments related to communication and swallowing is often impaired. This impairment prolongs the time to diagnosis of dysphonia and dysphagia, and can delay implementation of speech or swallowing therapy. We have limited knowledge of how different motor phenotypes of PD impact speech, voice and swallowing, nor how PWPD perceive these impacts. The purpose of this study was to identify how perceptions of speech and voice impairments predict dysphagia in PD, and how those perceptions differ between motor phenotypes. Methods: 38 PWPD completed clinical surveys including V-RQOL, DHI, and a speech, voice, and swallow symptom questionnaire. Participants were categorized as either tremor dominant (TD) or non-tremor dominant (NTD) phenotypes. Multiple regression and MANOVA were utilized to identify predictors of dysphagia perceptions, and for differentiating between motor phenotype based on perceptual severity. Results: Perceptions of speech and voice impairment predicted perceptions of swallow impairment regardless of phenotype (p<.05, CI=0.08-0.77). NTD participants reported significantly more communication and swallowing impairments than TD (p<.05) and perceived communication impairment severity was the strongest predictor of group classification (OR=0.50). The survey battery displayed a robust discriminatory ability between phenotype (AUC=0.87, CI=0.76-0.98). Conclusion: The use of a noninvasive and cost-efficient survey battery may be useful in predicting patient perceived swallow impairment in PWPD. Speech, voice, and swallow impairments based on survey responses were found to differ between motor phenotypes.