12 - Misc MSD Treatments

Question 1

What neurotransmitter is often targeted when treating PD pharmacologically?

Answer 1

Dopamine

Question 2

What happens when a person has decreased dopamine?

2

Answer 2

They become less and less able to regulate their movements, body and emotions.

Language and cognition are also affected

Question 3

What Speech Treatments for PD?

Answer 3

Expiratory Muscle Strength Training (EMST)

Lee Silverman Voice Tx (LSVT)

Respiratory Tx

Question 4

What does Lee Silverman Voice Tx (LSVT) emphasize?

3

Answer 4

Designed to improve vocal function in patients with PD

Emphasizes high phonotory- respiratory support

Instruct and constantly stimulating pt’s to produce a loud voice

Question 5

What does Respiratory Tx emphasize?

2

Answer 5

Emphasizes high effort alone

Targeted increased inspiratory and expiratory muscle activity to increase respiratory volume and subglottal air pressure and loudness

Question 6

Which is more effective: LSVT or respiratory tx?

Answer 6

LSVT

Question 7

What type of Deep Brain Stimulation is most effective in treating PD?

(3)

Answer 7

Bilateral subthalamic
nucleus stimulation improves most axial features of PD (gait, posture, postural stability, & rising from a chair)

Speech, swallowing and neck rigidity did not improve

Improvement in axial features not noted on limb signs (akinesia, rigidity, and tremor) suggest a synergistic effect can be obtained when stimulation is used in conjunction with levodopa treatment