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Dear Bobby and Bruce, I couldn't help but respond to your frustration about your speech problems. I am not a PWP, but I do research with PWP who have speech/voice problems. As Bruce sadly found out, traditional speech therapy doesn't seem to help PWP much, or at least for long. The Lee Silverman Voice Therapy approach has been more successful, but it's not necessarily going to work for everyone. It's certainly worth a try. Collagen injections may help with vocal loudness, but it probably won't help with the "runaway train" problem. However, the people who developed the LSVT say that it can help with speech rate as well as vocal loudness. Speech is one of the more difficult and frustrating problems in PD to treat. Medications may help with tremor, rigidity, etc., but may not help speech. Neurosurgical techniques may help abolish tremor and rigidity, but may actually make speech worse.... THERE ARE VERY LITTLE DATA ON THIS! I requested replies from people on the list who had any type of neurosurgery to tell me about how it affected your speech (positively or negatively). I got 5 responses (Thank You!!), and was hoping to get some more. If anyone out there hasn't responded and would like to, please write to me at [log in to unmask] and I'll summarize your comments in a future posting. Thanks a million. And best of luck to Bobby and Bruce. I feel your frustration, and hope my research can provide some answers sometime in the not-too-distant future. Nancy Nancy Pearl Solomon, Ph.D., CCC-SLP Assistant Professor Department of Communication Disorders University of Minnesota 115 Shevlin Hall 164 Pillsbury Dr. SE Minneapolis, MN 55455 (612)624-1010 (612)624-7586 FAX