The Vocal Flutter of Multiple System Atrophy: A Parkinsonian-Type Phenomenon?

Autor: Mir MJ; Department of Physical Therapy, BREATHE Center, University of Florida, Gainesville, Florida, USA., Herndon NE; Department of Speech, Language, and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.; UF Health Norman Fixel Institute for Neurological Diseases, Gainesville, Florida, USA., Wagle Shukla A; UF Health Norman Fixel Institute for Neurological Diseases, Gainesville, Florida, USA.; Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida, USA., Wheeler-Hegland K; Department of Speech, Language, and Hearing Sciences, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.; UF Health Norman Fixel Institute for Neurological Diseases, Gainesville, Florida, USA., McFarland NR; UF Health Norman Fixel Institute for Neurological Diseases, Gainesville, Florida, USA.; Department of Neurology, College of Medicine, University of Florida, Gainesville, Florida, USA.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2024 Apr; Vol. 11 (4), pp. 403-410. Date of Electronic Publication: 2024 Feb 05.
DOI: 10.1002/mdc3.13988
Abstrakt: Background: Early features of multiple system atrophy (MSA) are similar to those in Parkinson's disease (PD), which can challenge differential diagnosis. Identifying clinical markers that help distinguish MSA from forms of parkinsonism is essential to promptly implement the most appropriate management plan. In the context of a thorough neurological evaluation, the presence of a vocal flutter might be considered a potential feature of MSA-parkinsonian type (MSA-P).
Cases: This case series describes clinical histories of 3 individuals with MSA-P. In each case, vocal flutter was detected during neurological and motor speech evaluations. It seemed to be a concomitant feature with the constellation of other signs and symptoms that led to the clinical diagnosis.
Literature Review: The vocal flutter may be described as pitch and loudness fluctuations during phonation. Different from a vocal tremor, the flutter phenomenon has higher oscillation frequencies. The neuropathological underpinnings of vocal flutter may be related to generalized laryngeal dysfunction that is commonly described in MSA-P.
Conclusion: Vocal flutter may be a unique speech feature in some individuals who have MSA-P. Future studies using perceptual and acoustic measures of speech are warranted to quantify these observations and directly compare to other MSA variants, PD, and a control group.
(© 2024 International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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