Neuropharmacological and neurosurgical approaches for the treatment of IPD have hadpositive outcomes on limb motor function,but the impact of these treatments on speechand voice production is less compelling. Whilesome studies have reported general positiveeffects of levadopa on limb function, themagnitude and consistency of improvement inspeech tends to be much less impressive.More recent studies reported little variationin speech, voice, and respiratory characteristicsat different points in the drug treatment cycle.Few systematic studies have focused on theeffect of various surgical treatments on speechand voice. Baker and colleagues16 recently observed limited effect of fetal dopamine transplant on speech of individuals with documentedlimb function improvement. Bilateral thalamotomy and pallidotomy surgeries86 havehad reported significant negative effects onspeech and voice. In a recent study, Schulzet al analyzed acoustic measures followingunilateral pallidotomy in six individuals withIPD. At 3 months postsurgery, the investigators found that all individuals demonstratedpositive changes in at least one acoustic measure, but not all of the six patients consistently demonstrated those changes. At this time, itappears that neuropharmacological and neurosurgical approaches alone do not improvespeech and voice consistently and significantly.Therefore, behavioral speech treatment shouldbe considered even for optimally medicatedindividuals and for those having neurosurgicalprocedures.