Parkinson’s can affect speech in addition to motor skills

Q: What causes the voice to get softer and sometimes hoarse-sounding when you have Parkinson’s disease?

A: Some patients with Parkinson’s disease (PD) may find they develop problems with their speech, causing difficulty in communication and even possibly leading to reduced social interactions. The softening and/or hoarseness of the voice, along with symptoms like slurring of words, a monotone speech pattern and difficulty finding the correct words are caused by damage to a part of the brain called the substansia nigra pars compacta. This is where our nerve cells produce dopamine, a neurotransmitter. Parkinson’s

causes the damage to those nerve cells, which causes a reduction in the production of dopamine. The lack of dopamine in the body is responsible for the motor symptoms, including speech difficulties, seen in those with PD.

While there is no cure for Parkinson’s, there are treatments available to help patients manage symptoms, including the speech difficulties you mentioned. Speech therapy has been shown to be effective for PD patients with speech problems. Patients will usually work with their neurologist, a speech therapist and/or a speech-language pathologist to evaluate and treat their communication problems. Injections of collagen into the vocal folds help in cases where the vocal cords don’t completely close when talking.

It’s very important for both the patient and his or her family to communicate any speech issues with their neurologist. Early detection of speech difficulties and early intervention can make a big difference in managing the problem. It can also improve the emotional well-being of the patient.

— Nathan Wyatt, M.D., Chattanooga Neurology Associates; member, ChattanoogaHamilton County Medical Society