Dysarthritic Parkinson speech is characterised by impairment of expressive linguistic prosody, even making it difficult to understand. While rigidity and bradykinesia can be held responsible for a general decline in speaking ability, the origin of prosodic impairment must be seen in the light of the accompanying impairments of receptive prosody such as the inability to recognize intonational meaning and make lexical distinctions based on stress contrasts . The stimulating effect of music on motor coordination in afflicted patients suggests that music might have a similar effect on vocal behavior. It could be hypothesized that the singing of Parkinson patients might remain relatively unaffected by the disease. In this study, vocal improvisation was used to compare the singing of Parkinson patients with that of healthy controls, matched for age and gender. When F0 , range, mean absolute slope, and tempo were contrasted, Parkinson patients did not differ significantly from controls.
Sexual functioning is often impaired in patientswith Parkinson’s disease (PD) and may affect quality oflife of patients and their spouse. However, little is knownabout the practice patterns of neurologists with regard todiscussing sexuality in this field. The aim of this cross-sectional study was to evaluate to what extent neurologistsdiscuss sexuality with PD patients. A 22-item questionnairewas sent to 139 neurologists specializing in PD. The surveycontained questions about their attitudes, knowledge, andpractice patterns with respect to sexual dysfunction (SD) inpatients with PD. The response rate of the survey was66.9%. Most participants (56.8%) stated that they addresssexuality in less than half of their PD patients. High age ofpatients (42.0%), insufficient consultation time (37.5%),and a lack of patients’ initiative to raise the topic them-selves (36.4%) were frequently reported barriers towardsdiscussing sexuality. The majority of participants consid-ered that discussing sexuality is a responsibility that laywith neurologists (85.2%), nurses (73.9%), and patients(72.7%). One quarter of the neurologists reported to haveinsufficient or no knowledge on SD. The majority of par-ticipants regarded screening for SD important or slightlyimportant (85.2%). A large proportion of Dutch neurolo-gists specializing in PD do not routinely discuss sexualitywith their PD patients. Sexual healthcare in PD patientsmay benefit from time-efficient tools and agreements onwho is responsible for discussing SD. Furthermore, rec-ommendations in PD guidelines on screening and manag-ing SD should be adapted to fit everyday practicehttps://creativecommons.org/licenses/by/4.0/ CC BY 4.0https://creativecommons.org/licenses/by/4.0/
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The realization of one’s musical ideas at the keyboard is dependent on the ability to transform sound into movement, a process called audiomotor transformation. Using fMRI, we investigated cerebral activations while classically-trained improvising and non-improvising musicians imagined playing along with recordings of familiar and unfamiliar music excerpts. We hypothesized that audiomotor transformation would be associated with the recruitment of dedicated cerebral networks, facilitating aurally-cued performance. Results indicate that while all classically-trained musicians engage a left-hemisphere network involved in motor skill and action recognition, only improvising musicians additionally recruit a right dorsal frontoparietal network dedicated to spatially-driven motor control. Mobilization of this network, which plays a crucial role in the real-time transformation of imagined or perceived music into goal-directed action, may be held responsible not only for the stronger activation of auditory cortex we observed in improvising musicians in response to the aural perception of music, but also for the superior ability to play ‘by ear’ which they demonstrated in a follow-up study. The results of this study suggest that the practice of improvisation promotes the implicit acquisition of hierarchical music syntax which is then recruited in top-down manner via the dorsal stream during music performance. In a study of audiomotor transformation in Parkinson patients, we demonstrated a dissociation between dysprosody in speech and music. While patients’ speech could reliably be distinguished from that of healthy individuals, purely on the basis of aural perception, no difference was observed between patients and healthy controls in their ability to sing improvised melodies.
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Werken in een multidisciplinair zorgnetwerk, zoals in de zorg voor mensen met de ziekte van Parkinson, vraagt naast vakinhoudelijke competenties, ook meer generieke rollen zoals samenwerken en organiseren. In het voorgaand KIEM-project is geëxperimenteerd met verbeteren van samenwerking en communicatie tussen zorgverleners middels actieleren. In dit project stond een nieuwe werkwijze voor regiobijeenkomsten centraal. Deelnemers in dit regionetwerk zijn positief over de ‘nieuwe’ regiobijeenkomsten. Zo geven ze aan dat ze elkaar beter hebben leren kennen en het heeft bijgedragen aan de juiste zorg op de juiste plek. Ze hebben behoefte aan ondersteuning voor duurzame ontwikkeling van hun netwerk in hun rol als samenwerker en organisator. Daarbij benoemen ze expliciet dat coaches belangrijk zijn tijdens interprofessionele intervisie, maar deze rol nog niet zelf kunnen pakken. Ook zorgverleners in andere regio’s maken kenbaar dat zij ondersteuning en scholing nodig hebben om de rol als samenwerker en organisator op te kunnen pakken. Daarom is het doel van dit voorstel om deelnemers aan het zorgnetwerk ParkinsonNet tools aan te bieden waarmee ze hun rol als samenwerker en organisator zelfstandig verder kunnen ontwikkelen en hun in staat stelt om het multidisciplinaire, regionale netwerk te ondersteunen in duurzame ontwikkeling t.b.v. de beste zorg voor mensen met Parkinson en hun mantelzorgers. In het voorliggende project zal binnen verschillende ParkinsonNet regio’s een groep zorgverleners worden geselecteerd, die deel zal nemen aan een pilot ‘actieleren’. Deze zorgverleners komen 3x bijeen in een periode van ruim een half jaar. In de bijeenkomsten krijgen ze leidende principes in actieleren en lerende netwerken mee en formuleren hun eigen leervraag op basis van concrete ervaringen, passend bij de ontwikkeling in hun als samenwerker/ organisator. Tussen de bijeenkomsten krijgen ze opdrachten om te experimenteren in de eigen werkcontext en reflecteren op de opbrengsten, waarbij er consultatie mogelijk is met de coaches.
