Study Rationale:
Speech and voice disorders are common in people with Parkinson’s disease (PD) and adversely affect their communication and quality of life. Presently, Lee Silverman Voice Treatment (LSVT) is the most effective treatment available for speech disorders in PD, but this program is time intensive. Transcranial magnetic stimulation (TMS) is a safe and non-invasive, complimentary treatment technique. This study is examining if combined LSVT and brain stimulation treatment is more effective and efficient than voice therapy alone.
Hypothesis:
We are testing the hypothesis that TMS applied to the brain areas that control the voice will result in significantly greater improvement in voice intensity and voice quality in people with PD receiving LSVT.
Study Design:
This is a double-blind, randomized clinical trial that is 17 weeks long. We will collect baseline behavioral and brain imaging data from PD patients with moderate to severe speech and voice disorder. Next, the patients will be randomized to treatment groups and the four-week treatment phase will begin, where patients will receive 16 sessions of TMS or placebo TMS and voice therapy. Immediately following this, patients will undergo post-treatment behavioral and imaging assessments. Then the patients will return in week 17 to complete follow-up behavioral and imaging assessments.
Impact on Diagnosis/Treatment of Parkinson’s Disease:
Successful outcome of this project will change the way speech disorders in PD are treated. Patients could receive a combination of voice therapy and brain stimulation, the length of which will be shorter than the length of each treatment alone.
Next Steps for Development:
The findings from this study will lay the foundation for examining the use of brain stimulation with other available treatments to improve motor function in PD. The results from this study will form the basis for future studies aimed at understanding how various treatments in PD mediate changes in brain function.