Home Others A breath of fresh air: New insights into the treatment of swallowing and speech disorders

A breath of fresh air: New insights into the treatment of swallowing and speech disorders

Swallowing and coughing are life sustaining acts - one obviously to ingest food and drink and the other to keep food, drink, or anything else from going the wrong way.

These two critical functions typically go wrong in brain-based diseases such as Parkinson's disease, amyotrophic lateral sclerosis (ALS), stroke, and some cancers of the head and neck. People with these conditions often lose the ability to cough violently and may end up aspirating food or fluid into their lungs, causing pneumonia, which is often fatal.

While research has shown that it is possible to improve cough function in Parkinson's patients, little research has focused on progressive supranuclear palsy (PSP), which is among a group of disorders collectively known as Parkinson's Plus Syndrome are, is most common. PSP affects approximately 20,000 Americans and approximately 100,000 people worldwide.

The development of dysphagia [difficulty swallowing] seems to be relatively inevitable in these patients, with an average onset of three to four years, says Michelle Troche, associate professor of speech and language pathology. The earlier you start, the shorter your survival. We also need to understand whether these patients have cough disorders and whether it can be rehabilitated to hopefully prevent aspiration pneumonia, which is one of the leading causes of death in PSP.

more than half of all u.s. families living in poverty are

In a study funded by the CurePSP Foundation, Troche and Lisa Edmonds, Associate Professor of Communication Sciences & Disorders, are examining the complex communication, swallowing, and coughing disorders that occur due to PSP and are testing the feasibility of several treatments to rehabilitate these functions in the PSP.

[Read the study by Troche, Edmonds, and their co-authors, 'Immediate Effects of Airway Protection Sensorimotor Training (smTAP) on Cough Outcomes in Progressive Supranuclear Palsy: A Feasibility Study.' ]

COMPLEX INVESTIGATION Michelle Troche (left) and Lisa Edmonds, faculty members at Teachers College, are investigating the communication, swallowing, and coughing disorders that occur due to PSP and are testing the feasibility of several treatments to restore these functions. (Photos: TC archive)

As part of this larger study, Troche and other researchers found that PSP actually had a deeper cough and poor swallowing. People with PSP in particular have trouble realizing that they should cough (when faced with a cough-inducing stimulus) and they also have difficulty producing the cough - and this is worse than people with Parkinson's disease. The study also identifies some therapies that have the potential to improve coughing and swallowing function and improve patients' quality of life.

As part of their study, the team recently published an article in the journal Dysphagie, where they described the use of a technique called Sensorimotor Training in Respiratory Protection (smTAP), co-developed by Troche, to see if they could upregulate the cough function in 15 participants with PSP. During the smTAP, participants were given capsaicin, a mild irritant made from chili peppers, to make them cough involuntarily. Using verbal prompts and viewing a live graph of their performance, 14 out of 15 participants increased their cough strength over 25 repetitions, with 11 participants achieving improvements of more than 10 percent.

This study is the first to demonstrate the ability of people with PSP to instantly upregulate cough function and provides preliminary support for the feasibility of cough rehabilitation in this population using this novel treatment approach, the authors write.

difference-in-differences

Swallowing disorders and language disorders can seriously affect the quality of life. But we see that a lot can be done. The key is early assessment so that patients can receive the appropriate intervention they need.

- Michelle Troche, Associate Professor of Speech and Speech Pathology

In other ongoing research, Troche and other researchers are studying dysarthria, a common language disorder in PSP patients that interferes with the production of speech. To date, they have found some evidence that a device called a SpeechViveTM, which makes loud speaking noises in the wearer's ears, may automatically stimulate louder speech in some people with PSP. They have also tested, with some success, a technique called Verb Network Strengthening Treatment (VNeST), developed by Edmonds, which emphasizes the use of a core set of verbs to help people find meaningful words and phrases better.

Troche suggests that these studies are preliminary and that much remains to be done to confirm and build on their findings. But she is clearly optimistic.

Swallowing and speech disorders can have a huge impact on quality of life, she says. But we see that a lot can be done. The key is early assessment so that patients can receive the appropriate intervention they need. And everything we learn suggests that speech therapists play a very important role in improving the health and quality of life with PSP.

new york times company v.united states

Keywords: Health research

f 1 optional practical training

Program: Communication Sciences and Disorders

Departments: Biosafety Sciences

Interesting Articles

Editor'S Choice

VIRTUAL EVENT. Reporting on the Siege of Sarajevo by Kenneth Morrison and Paul Lowe
VIRTUAL EVENT. Reporting on the Siege of Sarajevo by Kenneth Morrison and Paul Lowe
Book review: 'Köstler
Book review: 'Köstler'
When Arthur Koestler arrived in New York City in March 1948 to tour America, his visit hit the headlines. Carnegie Hall was filled with an audience of 3,000, eager to hear Koestler's thoughts on the radical dilemma and America's urgent need to face Soviet communism.
The hunt for the first Exomoon could be over
The hunt for the first Exomoon could be over
Columbia astronomers David Kipping and Alex Teachey report a moon around a Jupiter-like planet called Kepler-1625b.
Sound and image in modern East Asian music
Sound and image in modern East Asian music
Natacha Diels
Natacha Diels
Natacha Diels (DMA, Composition, 2016) is Assistant Professor at the University of California, San Diego. Her work combines ritual, improvisation, traditional instrumental technique and cynical play to create worlds of curiosity and discomfort. As an accomplished composer and interpreter, Natacha's unique musical approach continues to contribute to the continuous development of new ones
Paul Hogan
Paul Hogan
Paul Damian Hogan is a New York City based composer. He was recently nominated for an Emmy for his score on Birders: The Central Park Effect. He received his PhD in musical composition from Columbia University in 2007 and then decided to write music for film and television. He composed scores for the films Shored Up, Birders: The Central Park Effect (HBO),
Book excerpt: Astrophysics for those in a hurry
Book excerpt: Astrophysics for those in a hurry
By Neil deGrasse Tyson ’92GSAS In his new bestseller collection, the astrophysicist breaks down complex scientific topics - from the big bang to dark energy