Dysarthria in Parkinson’s Disease patients: a cross-sectional survey

SANTIAGO PEREZ-LLORET; LAURENCE NEGRE-PAGES; MARCELO MERELLO; OLIVIER RASCOL

Paris, Francia

Congreso; Congreso Internacional de Movimientos Anormales; 2009

Introduction: Dysarthria is commonly reported by patients with Parkinson’s Disease (PD). However, this symptom has been rarely evaluated in large samples of patients recruited out of tertiary specialized units and its prevalence, risk factors and impact on health-related quality of life is poorly known in the general PD population. Objective: We explored the prevalence of dysarthria in 450 PD patients of the Toulouse area in a cross-sectional study and compared the demographic, clinical and pharmacological features and health-related quality of life associated with the presence or absence of this symptom. Methods: 450 patients were recruited in different academic and non-academic outpatient neurological clinics and underwent structured standardized clinical examination (UPDRS parts I-IV, MMSE, HADS, PDQ39). The presence of dysarthria was defined as UPDRS II item 5 ≥ 1. Drug consumption was obtained from the clinical records. Results: The mean age of the 450 studied patients was 69±10 years, 57% of them were males, with a mean PD duration of 6±5 years, a mean UPDRS II+III in ON condition of 28±15. They were treated with levodopa for 5±4 years with a mean daily dose of 580±360 mg/day. 212 patients (51%) reported dysarthria. Dysarthric patients had longer disease duration (7±3 vs 4±4 years, p<0.001), greater UPDRS II+III score (36±16 vs 21±12, p<0.001), lower MMSE (27.9±2.2 vs 28.3±2.1, p=0.05), greater depression HADS score (7.3±3.7 vs 5.9±3.8, p<0.0003), longer levodopa treatment (6±5 vs 4±3 years, p<0.0001) and daily dose (651±391 vs 498±295, p<0.0001), more frequent amantadine treatment (12% vs 4%, p<0.003) and higher PDQ39 score (30±13 vs 23±12, p<0.0001). Conclusion: Dysarthria affected 1 out of 2 patients of a large sample of ambulatory PD patients recruited in various academic and non-academic neurological outpatient clinics. Dysarthria was associated with more severe indexes of parkinsonism and poorer health-related quality of life.