Swallowing Outcomes Following Voice Therapy in Multiple System Atrophy with Dysphagia: Comparison of Treatment Efficacy with Parkinson’s Disease

• Published in: Dysphagia Vol. 37; no. 1; pp. 198 - 206
• Main Authors: Park, Alyssa, Jang, Su-Jeong, Kim, No-Eul, Kim, Tae-Hui, Sohn, Young Ho, Kim, HyangHee, Cho, Sung-Rae
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2022; Springer; Springer Nature B.V
• Subjects: Atrophy; Basal ganglia; Brain diseases; Central nervous system diseases; Cerebellum; Comparative analysis; Deglutition; Deglutition disorders; Deglutition Disorders - etiology; Deglutition Disorders - therapy; Drug therapy; Dysphagia; Gastroenterology; Hepatology; Humans; Imaging; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Movement disorders; Multiple System Atrophy - complications; Multiple System Atrophy - therapy; Neurodegenerative diseases; Original; Original Article; Otorhinolaryngology; Parkinson Disease; Parkinson's disease; Patients; Pharynx; Quality of Life; Radiology; Speech; Speech therapy; Swallowing; Treatment Outcome; Voice Training; South Korea; Parkinsonism; Multiple system atrophy; Deglutition; Lee silverman voice treatment; Deglutition disorders
• ISSN: 0179-051X; 1432-0460
• DOI: 10.1007/s00455-021-10265-9

Difficulties with speech and swallowing occur in patients with Parkinsonism. Lee Silverman Voice Treatment (LSVT) is proven as an effective treatment for speech and swallowing function in idiopathic Parkinson’s disease (IPD). The effect of LSVT on swallowing function in multiple system atrophy-cerebellar type (MSA-C) is unknown. We sought to determine LSVT’s effect on swallowing function in MSA-C patients compared to IPD patients. LSVT-LOUD was performed on 13 patients with Parkinsonism (6 IPD and 7 MSA-C). Maximum phonation time (MPT), voice intensity, Speech Handicap Index-15 (SHI-15), Swallowing-Quality of Life (SWAL-QOL), National Institutes of Health-swallowing safety scale (NIH-SSS), and videofluoroscopic dysphagia scale (VDS) before and after LSVT were analyzed and reevaluated three months after treatment. The IPD and MSA-C groups showed significant improvements in overall speech and swallowing measures after LSVT. In particular, pharyngeal phase score and total score of VDS improved significantly in both groups. A two-way repeated-measure ANOVA revealed a significant main effect for time in the MPT, voice intensity, NIH-SSS, pharyngeal phase score and total score of VDS, psychosocial subdomain of SHI-15, and SWAL-QOL. The MSA-C group experienced less overall improvement in swallowing function, but the two groups had an analogous pattern of improvement. In conclusion, LSVT is effective for enhancing swallowing function, particularly in the pharyngeal phase, in both IPD and MSA-C patients. This study demonstrated that LSVT elicits significant improvements in MSA-C patients. We deemed LSVT to be an effective treatment for IPD and MSA-C patients who suffer from dysphagia.