Comparative analysis of gait and speech in Parkinson’s disease: hypokinetic or dysrhythmic disorders?
- Stéphanie Cantiniaux1,
- Marianne Vaugoyeau2,
- Danièle Robert3,
- Christine Horrelou-Pitek3,
- Julien Mancini1,
- Tatiana Witjas3,
- Jean-Philippe Azulay1,*
- 1 APHM- Université Aix-marseille II, France;
- 2 CNRS-Universite de Provence, LNIA, France;
- 3 APHM, France
- Correspondence to: J-P Azulay, CHU Timone, Movement Disorders Unit, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille, cedex 5, France; jean-philippe.azulay{at}ap-hm.fr
- Received 3 February 2009
- Accepted 22 July 2009
- Published Online First 30 September 2009
Abstract
Gait and speech are automatic motor activities which are frequently impaired in Parkinson’s disease (PD).
Obvious clinical similarities exist between these disorders but were never investigated. We propose to determine whether there exist any common features in PD between spatiotemporal gait disorders and temporal speech disorders.
Gait and speech were analyzed on eleven PP undergoing deep-brain-stimulation of the sub-thalamic-nucleus (STN-DBS) and eleven control subjects (CS) under 3 conditions of velocity (natural, slow and speed). The patients were tested with and without L-Dopa and stimulator ON or OFF. Locomotor parameters were recorded using an optoelectronic system. Speech parameters were recorded with a headphone while subjects were reading a short paragraph.
The results confirmed that PP walk and read more slowly than controls. Patient’s difficulties in modulating walking and speech velocities seem to be due mainly to an inability to internally control the step length and the interpause-speech duration ISD.
STN-DBS and levodopa increased patients’ walking velocity by increasing the step length. STN-DBS and levodopa had no effect on speech velocity but restored the patients’ ability to modulate the ISD. The walking cadence and speech index of rythmicity (SPIR) tended to be lower in patients and were not significantly improved by STN-DBS or levodopa. Speech and walking velocity as well as ISD and step length were correlated in both groups. Negative correlations between SPIR and walking cadence were observed in both groups
Similar fundamental hypokinetic impairment and probably a similar rhythmic factor affected similarly the patients’ speech and gait. These results suggest a similar physiopathological process in both walking and speaking dysfunction.
