Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
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SHR Neuro Krebs Kardio Lipid Stoffw Microb
Tripoliti, E; Zrinzo, L; Martinez-Torres, I; Frost, E; Pinto, S; Foltynie, T; Holl, E; Petersen, E; Roughton, M; Hariz, MI; Limousin, P.
Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease.
Neurology. 2011; 76(1): 80-86.
Doi: 10.1212/WNL.0b013e318203e7d0
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- Holl Etienne
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- Abstract:
- Objective: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson disease (PD). Following STN-DBS, speech intelligibility can deteriorate, limiting its beneficial effect. Here we prospectively examined the short-and long-term speech response to STN-DBS in a consecutive series of patients to identify clinical and surgical factors associated with speech change. Methods: Thirty-two consecutive patients were assessed before surgery, then 1 month, 6 months, and 1 year after STN-DBS in 4 conditions on-and off-medication with on-and off-stimulation using established and validated speech and movement scales. Fifteen of these patients were followed up for 3 years. A control group of 12 patients with PD were followed up for 1 year. Results: Within the surgical group, speech intelligibility significantly deteriorated by an average of 14.2% +/- 20.15% off-medication and 16.9% +/- 21.8% on-medication 1 year after STN-DBS. The medical group deteriorated by 3.6% +/- 5.5% and 4.5% +/- 8.8%, respectively. Seven patients showed speech amelioration after surgery. Loudness increased significantly in all tasks with stimulation. A less severe preoperative on-medication motor score was associated with a more favorable speech response to STN-DBS after 1 year. Medially located electrodes on the left STN were associated with a significantly higher risk of speech deterioration than electrodes within the nucleus. There was a strong relationship between high voltage in the left electrode and poor speech outcome at 1 year. Conclusion: The effect of STN-DBS on speech is variable and multifactorial, with most patients exhibiting decline of speech intelligibility. Both medical and surgical issues contribute to deterioration of speech in STN-DBS patients. Classification of evidence: This study provides Class III evidence that STN-DBS for PD results in deterioration in speech intelligibility in all combinations of medication and stimulation states at 1 month, 6 months, and 1 year compared to baseline and to control subjects treated with best medical therapy. Neurology (R) 2011; 76:80-86
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Aged -
- Deep Brain Stimulation - adverse effects
- Female -
- Fourier Analysis -
- Humans -
- Linear Models -
- Linguistics -
- Longitudinal Studies -
- Male -
- Middle Aged -
- Movement - physiology
- Parkinson Disease - complications
- Retrospective Studies -
- Speech Disorders - etiology
- Speech Intelligibility - physiology
- Subthalamic Nucleus - physiology
- Time Factors -