Parkinson’s Disease & The Voice

Parkinson's Disease is a condition that affects the nervous system, particularly the brain and nerves. In people with Parkinson's, the brain's cells that produce dopamine are slowly destroyed. Dopamine is a key messenger molecule that helps the brain send signals to nerves. When these dopamine-producing cells are lost, the signals cannot transmit properly, causing muscles to not move correctly or even stop moving altogether. This leads to muscle atrophy, tremors, and loss of coordination. Every muscle can be affected, including those used for walking, talking, swallowing, making facial expressions, and hand coordination.

What are the Symptoms of Parkinson’s Disease?

Symptoms of Parkinson’s Disease are primarily muscular and include the following.

• Problems with balance and walking

• No facial expression (appearing to have a mask)

• Difficulty with movement (speed, starting, continuing)

• Drooling

• Difficulty Swallowing

• Loss of fine coordination, such as eating

• Tremors

• Slowed, quieter speech

• Stooped position

Cognitively, Parkinson’s Disease does not typically cause any deficits, although psychologically, people with Parkinson’s may develop anxiety and depression.

How does Parkinson’s Disease Impact Voice Users?

Parkinson’s is a different disease in everyone. There are varying levels of progression and severity. For actors, singers, or vocal users, it can be difficult to negotiate the demands of high stress careers in TV/film and music. Actors may be able to adapt to certain characters and roles and continue to perform but this is often stressful, and does not work for all roles, leading to early retirement.

One of the symptoms of Parkinson’s is also a monotone, quieter voice, which can be difficult to modulate (vary in pitch and prosody as is typical in spoken language). Voice therapy can help but does not eliminate symptoms. 

Parkinson's can also cause the voice to sound hoarse or breathy due to weakened vocal cords and poor strength in lips, throat, and tongue can lead to slurred speech. Breathing muscles for support are also affected, making vocal endurance and projection difficult. Parkinson’s therefore affects multiple levels of speech coordination.

What is the treatment of Parkinson’s Disease?

There is currently no cure for Parkinson’s Disease, but there are medications that can manage symptoms. Voice therapy is helpful, specifically Lee Silverman Voice Treatment (LSVT). Sometimes, a vocal injection can also help with voice symptoms. Early pursuit of care can help to maximize usable voice and minimize symptoms.