Stuttering and Parkinson's Disease

Below is information on stuttering behavior sometimes seen in association with Parkinson's Disease. If anyone has more information they would like to add, please contact Judy Kuster

  • From Nancy Pearl Solomon, Ph.D., CCC-SLP

    Exerpts from a post on Aug 6, 1999

    In 1971, Canter described three types of stuttering patterns in Parkinson Disease.
    1. "frequent prolongations with a consequent disruption of the flow of speech" ("articulatory freezing")
    2. "rapid syllable, word, and phrase repetitions" which are "effortless"
    3. "long silent blocks" associated with "a transient inability to initiate any kind of motor activity."
    Often, the dysfluencies in PD are described as "palilalia" (Weiner & Singer, 1989). Critchley (1981) reported that palilalia occurs most often in postencephalitic parkinsonism (which isn't found much today because most of that population has since died) and pseudobulbar palsy. Critchley defined palilalia as "a compulsive tendency to psychomotor propulsion manifesting itself in accelerating speech. The patient ... repeats the last word or two of a verbal statement...quickly, less distinctively." Weiner and Singer defined it as a "word, phrase, or sentence being repeated with increasing rapidity and decreasing distinctiveness so that the latter part of the segment becomes inaudible."

    In my own research experience, I have studied one man who was a stutterer from childhood through high school. The stuttering was especially bothersome when he was under stress. He said he'd never had therapy, but he figured out how to deal with it when he started his job, which required eloquence in speaking. The stuttering returned when he got PD (at age 45), again especially when under stress. At age 53, his PD was quite severe and he was treated by fetal cell tissue implantation, but the surgery did not have any impact on his stuttering (by his report). It did, however, have a tremendous impact on his speech (pre-op: able to say about 1 syllable per breath with phonation; post-op: talking in full sentences, still with marked hypophonia and palilalia). I have never seen a published report of stutterers who acquire PD later in life.

    I have worked with several people with idiopathic PD who demonstrated palilalia. Most recently, I have written up a case (manuscript submitted for publication) of a man with severe PD who never had fluency problems and had undergone surgery for bilateral pallidal stimulation. When he was completing my experimental protocol, which included a condition of being unmedicated (for at least 12 hours), we turned on the stimulators and he almost instantly developed dysfluent behaviors! These included phonatory blocks, syllable repetitions (not palilalia), and nonaudible repetitions of tongue and jaw movements. It appeared to me that some of the blocks might have been due to laryngospasm, but that did not explain the other behaviors. When this man was medicated with levodopa, the dysfluencies disappeared even with the stimulators activated. When he was off medication and off stimulation, these behaviors never occurred either. Fascinating case! I was hoping to study him further to experimentally manipulate these behaviors, but he developed equipment problems with the stimulators and the behavior could not be replicated.

    I am fascinated by these behaviors (which I like to think of as speech motor initiation problems) in PD.


    Canter, G. (1971). Observations on neurogenic stuttering: A contribution to differential diagnosis. British Journal of Communication Disorders, 6, 139-143.

    Critchley, E. M. R. (1981). Speech disorders of Parkinsonism: A review. Journal of Neurology, Neurosurgery, and Psychiatry, 44, 751-758.

    Weiner, W. J., & Singer, C. (1989). Parkinson's disease and nonpharmacologic treatment programs. Journal of the American Geriatrics Society, 37, 359-363.

    last modified August 6, 1999