{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:27:42Z","timestamp":1790702862224,"version":"4.1.0"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NeuroSci"],"abstract":"<jats:p>Background: Hypokinetic dysarthria is a speech disorder observed in almost 90% of PD patients that can appear at any stage of the disease, usually worsening as the disease progresses. Today, speech therapy intervention in PD is seen as a possible therapeutic option to alleviate and slow down the progression of symptoms. This study aims to investigate the validity of traditional speech therapy in dysarthria with the aim of improving the quality of life of PD patients, by comparing subjective clinical assessment with objective instrumental measures (IOPI and voice analysis). Methods: This is an observational study of 30 patients with hypokinetic dysarthria due to PD. The patients underwent speech therapy treatment with a frequency of three times per week for 12 consecutive weeks. Patients were evaluated at the time of enrollment (T0), at the start of treatment (T1), and at the end of the same (T2). Six months after the end of treatment (T3), a follow-up was performed based on disability and phonatory evaluation. Results: This study showed significant improvements (&lt;0.001) from the start (T1) to the end of treatment (T2), with increases in the Barthel Index score, Robertson Dysarthria Profile, and IOPI measurements for tongue and lip strength, along with enhanced phonometer scores and tongue endurance. Correlations highlighted that tongue endurance decreased with age, CIRS, and MDS-UPDRS, while showing a positive association with MoCA scores. Conclusions: Significant improvements were observed in tongue and lip strength, phonatory duration, intensity, and vocal quality between pre- (T1) and post-treatment (T2). This study underscores the importance of early and continuous speech therapy treatment for comprehensive speech function enhancement.<\/jats:p>","DOI":"10.3390\/neurosci6010007","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T10:44:23Z","timestamp":1737024263000},"page":"7","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Intensive Speech Therapy for Hypokinetic Dysarthria in Parkinson\u2019s Disease: Targeting the Five Subsystems of Speech Production with Clinical and Instrumental Evaluation"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2472-2011","authenticated-orcid":false,"given":"Annalisa","family":"Gison","sequence":"first","affiliation":[{"name":"IRCCS San Raffaele Roma, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4894-9456","authenticated-orcid":false,"given":"Marco","family":"Ruggiero","sequence":"additional","affiliation":[{"name":"Physical and Rehabilitation Medicine 2, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Tufarelli","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Roma, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Proietti","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Roma, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Moscariello","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Roma, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Valente","sequence":"additional","affiliation":[{"name":"IRCCS San Raffaele Roma, 00163 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1044\/jshr.1202.246","article-title":"Differential diagnostic patterns of dysarthria","volume":"12","author":"Darley","year":"1969","journal-title":"J. Speech Hear. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1976","DOI":"10.1044\/2020_AJSLP-20-00012","article-title":"Communication Limitations in Patients with Progressive Apraxia of Speech and Aphasia","volume":"29","author":"Utianski","year":"2020","journal-title":"Am. J. Speech Lang. Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1586\/ern.11.43","article-title":"Intensive voice treatment in Parkinson\u2019s disease: Lee Silverman Voice Treatment","volume":"11","author":"Sapir","year":"2011","journal-title":"Expert Rev. Neurother."},{"key":"ref_4","unstructured":"Ruoppolo, G., and Amitrano, A. (2013). Disartria Possiamo Fare di Pi\u00f9?. Omega."},{"key":"ref_5","first-page":"209","article-title":"Voice quality in Parkinson\u2019s disease in the Croatian language speakers","volume":"35","author":"Bauer","year":"2011","journal-title":"Coll. Antropol."},{"key":"ref_6","unstructured":"Duffy Joseph, R. (2019). Motor Speech Disorders\u2014Substrates, Differential Diagnosis, Management, Elsevier. [4th ed.]."},{"key":"ref_7","first-page":"249","article-title":"Current trends in etiology, prognosis and therapeutic aspects of Parkinson\u2019s disease: A review","volume":"88","author":"Jagadeesan","year":"2017","journal-title":"Acta Biomed."},{"key":"ref_8","first-page":"CD002812","article-title":"Speech and language therapy versus placebo or no intervention for speech problems in Parkinson\u2019s disease","volume":"2012","author":"Herd","year":"2012","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_9","unstructured":"Amitrano, A., Genovese, E., Ruoppolo, G., and Schindler, A. (2012). Manuale di Foniatria e Logopedia, SEU."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"393","DOI":"10.33588\/rn.7011.2019414","article-title":"Acoustic analysis of voice in Parkinson\u2019s disease: A systematic review of voice disability and meta-analysis of studies","volume":"70","author":"Chiaramonte","year":"2020","journal-title":"Rev. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1111\/joor.13417","article-title":"Tongue strength and clinical correlations in Parkinson\u2019s disease","volume":"50","author":"Plaza","year":"2023","journal-title":"J. Oral Rehabil."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e20170200","DOI":"10.1590\/2317-1782\/20182017200","article-title":"Impact of levodopa treatment in the voice pattern of Parkinson\u2019s disease patients: A systematic review and meta-analysis","volume":"30","author":"Pinho","year":"2018","journal-title":"CoDAS"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E896","DOI":"10.1002\/lary.28645","article-title":"Orofacial Strength and Voice Quality as Outcome of Levodopa Challenge Test in Parkinson Disease","volume":"130","author":"Lechien","year":"2020","journal-title":"Laryngoscope"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0028-3932(99)00067-6","article-title":"Speech volume regulation in Parkinson\u2019s disease: Effects of implicit cues and explicit instructions","volume":"37","author":"Ho","year":"1999","journal-title":"Neuropsychologia"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1044\/1092-4388(2009\/08-0184)","article-title":"Formant centralization ratio: A proposal for a new acoustic measure of dysarthric speech","volume":"53","author":"Sapir","year":"2010","journal-title":"J. Speech Lang. Hear. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3109\/13682822.2010.484848","article-title":"Treating disordered speech and voice in Parkinson\u2019s disease online: A randomized controlled non-inferiority trial","volume":"46","author":"Constantinescu","year":"2011","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"102642","DOI":"10.1016\/j.jelekin.2022.102642","article-title":"Effects of a tongue training program in Parkinson\u2019s disease: Analysis of electrical activity and strength of suprahyoid muscles","volume":"63","author":"Plaza","year":"2022","journal-title":"J. Electromyogr. Kinesiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"348","DOI":"10.14639\/0392-100X-N1962","article-title":"Multidimensional voice assessment after Lee Silverman Voice Therapy (LSVT\u00ae) in Parkinson\u2019s disease","volume":"42","author":"Marchese","year":"2022","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1177\/0269215520976267","article-title":"Speech and language therapy treatment on hypokinetic dysarthria in Parkinson disease: Systematic review and meta-analysis","volume":"35","author":"Vigueras","year":"2021","journal-title":"Clin. Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1044\/2024_AJSLP-23-00478","article-title":"Criterion (Concurrent) Validity and Clinical Utility of the Tongueometer Device","volume":"33","author":"Krekeler","year":"2024","journal-title":"Am. J. Speech Lang. Pathol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1177\/070674370705200508","article-title":"The Montreal Cognitive Assessment: Validity and utility in a memory clinic setting","volume":"52","author":"Smith","year":"2007","journal-title":"Can. J. Psychiatry"},{"key":"ref_22","unstructured":"Pirani, A., Tulipani, C., and Neri, M. (2024, October 15). Italian Translation of MoCA Test and of Its Instructions. Available online: http:\/\/www.mocatest.org."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bernetti, A., Ruggiero, M., Ruiu, P., Napoli, M., D\u2019Urzo, R., Mancuso, A., Mariani, F., Tota, L., Agostini, F., and Mangone, M. (2023). Analysis and Report of the Physical and Rehabilitation Medicine Evaluation Activity in Patients Admitted to Acute Care Setting: An Observational Retrospective Study. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20116039"},{"key":"ref_24","first-page":"61","article-title":"Functional Evaluation: The Barthel Index","volume":"14","author":"Mahoney","year":"1965","journal-title":"Md. State Med. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"221","DOI":"10.11138\/FNeur\/2017.32.4.221","article-title":"The culturally adapted Italian version of the Barthel Index (IcaBI): Assessment of structural validity, inter-rater reliability and responsiveness to clinically relevant improvements in patients admitted to inpatient rehabilitation \u2028centers","volume":"22","author":"Castiglia","year":"2017","journal-title":"Funct. Neurol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1001\/jama.1963.03060120024016","article-title":"Studies of illness in the aged. The index of adl: A standardized measure of biological and psychosocial function","volume":"185","author":"Katz","year":"1963","journal-title":"JAMA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/j.1532-5415.1968.tb02103.x","article-title":"Cumulative illness rating scale","volume":"16","author":"Linn","year":"1968","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: Onset, progression, and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"key":"ref_29","unstructured":"Factor, S.A., and Weiner, W.J. (2007). Parkinson\u2019s Disease: Diagnosis and Clinical Management, Demos Medical."},{"key":"ref_30","unstructured":"Fussi, F., Cantagallo, A., and Bertozzini, L. (1999). Profilo di Valutazione Della Disartria: Adattamento Italiano del Test di Robertson, Raccolta di Dati Normativi e Linee di Trattamento, Omega."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"292","DOI":"10.3109\/13682820109177900","article-title":"The efficacy of oro-facial and articulation exercises in dysarthria following stroke","volume":"36","author":"Robertson","year":"2001","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement Disorder Society-sponsored revision of the Unified Parkinson\u2019s Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1159\/000322800","article-title":"Reliability and validity of an instrument to measure quality of life in the dysarthric speaker","volume":"63","author":"Piacentini","year":"2011","journal-title":"Folia Phoniatr. Logop."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"263.e17","DOI":"10.1016\/j.jvoice.2013.07.013","article-title":"Validation of the Italian Voice Handicap Index-10","volume":"28","author":"Forti","year":"2014","journal-title":"J. Voice"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.1002\/lary.30782","article-title":"Concurrent Validity of the IOPI and Tongueometer Orofacial Strength Measurement Devices","volume":"133","author":"Curtis","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"961.e9","DOI":"10.1016\/j.jvoice.2019.04.016","article-title":"Acoustic Analysis of Normal Voice Patterns in Italian Adults by Using Praat","volume":"34","author":"Gorris","year":"2020","journal-title":"J. Voice"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1044\/2015_AJSLP-13-0137","article-title":"The Use of Sound Level Meter Apps in the Clinical Setting","volume":"25","author":"Fava","year":"2016","journal-title":"Am J. Speech. Lang. Pathol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Azadi, H., Akbarzadeh-T, M.R., Shoeibi, A., and Kobravi, H.R. (2021). Evaluating the Effect of Parkinson\u2019s Disease on Jitter and Shimmer Speech Features. Adv. Biomed. Res., 10.","DOI":"10.4103\/abr.abr_254_21"},{"key":"ref_39","first-page":"3366870","article-title":"Lee Silverman Voice Treatment to Improve Speech in Parkinson\u2019s Disease: A Systemic Review and Meta-Analysis","volume":"2021","author":"Pu","year":"2021","journal-title":"Park. Dis."},{"key":"ref_40","unstructured":"McNeil, M.R. (2009). Nonspeech assessment of the speech production mechanism. Clinical Management of Sensorimotor Speech Disorders, Thieme. [2nd ed.]."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1017\/S0140525X13003099","article-title":"Brain mechanisms of acoustic communication in humans and nonhuman primates: An evolutionary perspective","volume":"37","author":"Ackermann","year":"2014","journal-title":"Behav. Brain Sci."}],"container-title":["NeuroSci"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2673-4087\/6\/1\/7\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:30:08Z","timestamp":1759919408000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2673-4087\/6\/1\/7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,16]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["neurosci6010007"],"URL":"https:\/\/doi.org\/10.3390\/neurosci6010007","relation":{},"ISSN":["2673-4087"],"issn-type":[{"value":"2673-4087","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,16]]}}}