Although medication advancements and surgical interventions such as deep brain stimulation (DBS) have provided significant improvement in managing the motor symptoms of Parkinson’s disease, the non-motor symptoms, which can include drooling, dysphagia, sleep disorders and anxiety, remain problematic  for many individuals and have less available treatment options.

Recently, at our monthly journal club, hosted by a local neurologist, I was asked to review a paper: Drooling in Parkinson’s Disease: Prevalence and Progression from the Non‑motor International Longitudinal Study.(Dysphagia (2020) 35:955–961  

The paper reported on a retrospective analysis of 728 consecutive Idiopathic Parkinson’s Disease patients who had a baseline and follow-up assessment as part of the Non-motor International longitudinal study. A report of drooling was derived from a question on the Non-Motor Symptoms Scale (NMSS).

In addition to drooling, investigators looked at prevalence of dysphagia (swallowing impairment) through self-reported outcomes and also administed a Quality of Life Scale and Cognitive assessment.

The aim of the study was to assess if the prevalence of drooling would increase with age and negatively impact quality of life. A summary of findings indicated that drooling occurs in all stages of PD and all ages with highest prevalence >80yrs, and >15yrs disease duration. At final follow-up (3 yrs) close to half of patients had drooling, reduced quality of life scores, and drooling had an association with cognitive impairment.

At the final follow-up nearly ½ patients had dysphagia, though based on other research, this may have been an underestimate. In this particular study, a diagnosis of dysphagia was made by patient report only, but it has been noted by other researchers that individuals with PD often under-report dysphagia, and as high as 86% of people with drooling have been reported to have oral-pharyngeal dysphagia with day time drooling associated with silent aspiration.(Nóbrega A C, Rodrigues B & Melo A 2008)

Because of dysphagia’s occurrance in patients with drooling, Parkinson’s patients with drooling should undergo a clinical and instrumental swallowing assessment. Drooling also had a high correlation with poorer quality of life scores and management strategies should be offered to patients.

Chewing gum is a simple strategy without side effects to control drooling by increasing the flow of saliva and rate of swallowing.(South A R, Somers SM & Jog M S (2010). I also like to recommend use of a terrycloth sports wrist band which may serve as a cue to swallow before wiping one’s mouth, and also is more hygienic then tissues and handkerchiefs which get set on surfaces.

LOUD Crowd Members in the News

The Punta Gorda/Port Charlotte, Florida LOUD Crowd® recently received a Grant from the Parkinson’s Voice Project. Modeled after the Parkinson’s Voice Project’s SPEAK OUT! program, the LOUD Crowd is a weekly after-therapy program. All members have a diagnosis of Parkinson’s disease or related movement disorder and have completed one-to-one speech therapy. In March the LOUD Crowd went virtual helping members stay connected and committed to maintaining communication skills. Click on the link below to read the full story.

Calling all Parkinson’s Individuals with DBS

Jennifer Revell, a second year grad student pursuing a speech-language pathology degree is developing a research project about the patient-perceived outcomes of receiving DBS in individuals with Parkinson’s disease.  If you are 45-70 years, have a diagnosis of Parkinson’s, and have received DBS in the last 5 years, please take a few moments to complete her survey which consists of 13 questions. For more information:

Internation Aphasia Choir is recruiting new members. (Aphasia is a communication impairment affecting the ability to speak or understand language, and is usually the result of a stroke, head injury, or other damage to the brain).

In May 2020, Trent Barrick, board-certified music therapist, had an idea to connect people with aphasia through music and reached out to Dr. Gillian Velmer, a speech-language pathologist, about recruiting people with aphasia to sing in a “virtual aphasia choir” during Aphasia Awareness Month in June 2020. The event was a success with over 100 participants, and so now, they are recruiting again for 2021.

If you or someone you know has aphasia, please share the contact and registration link:


My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate  and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice

Voice Aerobics the heART and Science of Voice Practice