Speech and swallowing disorders in persons with neurodegenerative diseases

Neurodegenerativne bolesti očituju se raznolikim simptomima i poteškoćama, uzrokuju poremećaje u motoričkim funkcijama i dovode do ne-motoričkih simptoma bolesti. Učestalo dovode do poremećaja u govoru i gutanju. Od govornih se poremećaja najčešće javlja dizartrija i usko je vezana uz lokalizaciju oštećenja mozga. Primjerice, u bolesnika s Parkinsonovom bolesti javlja se hipokinetička dizartrija, a u bolesnika s Huntingtonovom bolesti hiperkinetička dizartrija. U bolesnika s amiotrofičnom lateralnom sklerozom javlja se miješana (flacidno-spastična) dizartrija, a u bolesnika s multiplom sklerozom najčešće se javlja miješana (spastično-ataksična) dizartrija. Uz dizartriju, učestalo dolazi do promjena u jezičnim sposobnostima i kombinacija takvih poteškoća negativno utječe na komunikacijske sposobnosti što posljedično moţe dovesti do socijalne izolacije. Za razliku od prethodno opisanih neurodegenerativnih bolesti kod Alzheimerove bolesti prevladavaju jezični poremećaji, dok se govorni poremećaji javljaju u znatno manjoj mjeri. Disfagija se kod neurodegenerativnih bolesti obično javlja u kasnijim stadijima bolesti. Najčešća je orofaringealna disfagija. Disfagija dovodi do ozbiljnih problema kao što su pothranjenost i aspiracijska pneumonija koja je jedan od vodećih uzroka smrti u osoba s neurodegenerativnim bolestima. Razumijevanje ovakvih poteškoća i njihove raznolikosti okosnica je u terapiji i pomaţe nam u donošenju odluka o najboljim mogućim strategijama. Bitno je na vrijeme prepoznati poteškoće i reagirati u skladu s njima kako bi se spriječile komplikacije i izrazito negativan učinak ovih poteškoća na pojedinca i njegovu okolinu.Neurodegenerative diseases are manifested by a variety of symptoms and difficulties. They can cause disorders in motor functions and lead to non-motoric symptoms. They often lead to speech and swallowing disorders. Most common speech disorder is dysarthria and it is closely related to the localization of brain disfunction. For example, patients with Parkinson's disease have hypokinetic dysarthria, and patients with Huntington's disease have hyperkinetic dysarthria. Patients with amyotrophic lateral sclerosis have mixed (flaccid-spastic) dysarthria and patients with multiple sclerosis have mixed (spastic-ataxic) dysarthria. Apart from causing dysarthria, they frequently cause changes in language abilities, and their combination negatively affects communication skills, which can lead to social isolation. Unlike in previously described neurodegenerative diseases, patients with Alzheimer's disease primary have problems with language disorders, while speech disorders occur in a much lesser extent. Dysphagia in neurodegenerative diseases usually occurs in the later stages. The most frequent is oropharyngeal dysphagia and it leads to serious problems such as malnutrition and aspiration pneumonia, which is one of the leading cause of death in people with neurodegenerative diseases. Understanding these difficulties and their variety is the key in therapy and helps speech pathologists in making decisions about the best possible strategies. It is important to recognize and respond in a timely manner to these difficulties in order to prevent complications and the adverse impact of these difficulties on the individual and his environment