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      Características del habla, el lenguaje y la deglución en la enfermedad de Huntington Translated title: Speech, language and swallowing in Huntington'Disease

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          Abstract

          Resumen La enfermedad de Huntington (EH) ha sido descrita como una afección de causa genética producida por una mutación en la repetición de la secuencia de nucleótidos CAG (citosina-adenina-guanina). Según el estadio que curse la enfermedad, las personas pueden presentar dificultades en el habla, el lenguaje y la deglución. El propósito de este artículo es exponer con detalle dichas dificultades, así como su tratamiento fonoaudiológico. Se destaca que en el habla se encuentran características propias de una disartria hipercinética debido a los movimientos coreicos subyacentes. En el lenguaje, las personas con EH realizan enunciados más cortos y con estructuras sintácticas mucho más simples y presentan dificultades en tareas que requieren procesamiento cognitivo complejo. En la deglución, se presenta una disfagia que progresa a medida que avanza la enfermedad. Una intervención fonoaudiológica oportuna, integral y eficaz es fundamental para mejorar la calidad de vida de las personas y contribuir a su bienestar comunicativo.

          Translated abstract

          Abstract Huntington's disease (HD) has been described as a genetic condition caused by a mutation in the CAG (cytosine-adenine-guanine) nucleotide sequence. Depending on the stage of the disease, people may have difficulties in speech, language and swallowing. The purpose of this paper is to describe these difficulties in detail, as well as to provide an account on speech and language therapy approach to this condition. Regarding speech, it is worth noticing that characteristics typical of hyperkinetic dysarthria can be found due to underlying choreic movements. The speech of people with HD tends to show shorter sentences, with much simpler syntactic structures, and difficulties in tasks that require complex cognitive processing. Moreover, swallowing may present dysphagia that progresses as the disease develops. A timely, comprehensive and effective speech-language intervention is essential to improve the quality of life of people and contribute to their communicative welfare.

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          Most cited references47

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          Effects of a sour bolus on oropharyngeal swallowing measures in patients with neurogenic dysphagia.

          This study examines the effects of a sour bolus (50% lemon juice, 50% barium liquid) on pharyngeal swallow measures in two groups of patients with neurogenic dysphagia. Group 1 consisted of 19 patients who had suffered at least one stroke. Group 2 consisted of 8 patients with dysphagia related to other neurogenic etiologies. All patients were selected because they exhibited delays in the onset of the oral swallow and delays in triggering the pharyngeal swallow on boluses of 1 ml and 3 ml liquid barium during videofluoroscopy. Results showed significant improvement in oral onset of the swallow in both groups of patients and a significant reduction in pharyngeal swallow delay in Group 1 patients and in frequency of aspiration in Group 2 patients with the sour as compared to the non-sour boluses. Other selected swallow measures in both subject groups also improved with the sour bolus. Volume effects were present but not as consistently as in prior studies. Implications for swallow therapy are discussed.
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            Huntington disease: Clinical care and evaluation

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              Effects of an intensive rehabilitation programme on patients with Huntington's disease: a pilot study.

              To investigate the effects of an intensive, inpatient rehabilitation programme on individuals affected by Huntington's disease. A pilot study. Within-subjects design. Inpatient rehabilitation home of the Italian welfare system. Forty patients, early and middle stage of the disease, were recruited to an intensive, inpatient rehabilitation protocol. The treatment programme included respiratory exercises and speech therapy, physical and occupational therapy and cognitive rehabilitation exercises. The programme involved three-week admission periods of intensive treatment that could be repeated three times a year. A standard clinical assessment was performed at the beginning of each admission using the Zung Depression Scale, Mini-Mental State Examination (MMSE), Barthel Index, Tinetti Scale and Physical Performance Test (PPT). Tinetti and PPT were also used at the end of each admission to assess the outcomes in terms of motor and functional performance. Each three-week period of treatment resulted in highly significant (P < 0.001) improvements of motor performance and daily life activities. The average increase was 4.7 for Tinetti and 5.21 for PPT scores. No carry-over effect from one admission to the next was apparent but at the same time, no motor decline was detected over two years, indicating that patients maintained a constant level of functional, cognitive as well as motor performance. Intensive rehabilitation treatments may positively influence the maintenance of functional and motor performance in patients with Huntington's disease.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rfmun
                Revista de la Facultad de Medicina
                rev.fac.med.
                Universidad Nacional de Colombia (Bogotá, Distrito Capital, Colombia )
                0120-0011
                June 2017
                : 65
                : 2
                : 343-348
                Affiliations
                [1] Bogotá orgnameUniversidad Nacional de Colombia orgdiv1Facultad de Medicina orgdiv2Departamento de la Comunicación Humana Colombia
                Article
                S0120-00112017000200343
                10.15446/revfacmed.v65n2.57449
                1e58f520-ff0d-4a33-83ec-d7bc4b37d7e8

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 16 May 2016
                : 21 August 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 50, Pages: 6
                Product

                SciELO Colombia


                Habla,Lenguaje,Deglución (DeCS),Huntington Disease,Speech-Language Pathology,Speech,Language,Deglutition (MeSH),Enfermedad de Huntington,Fonoaudiología

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