Articulation Features of Parkinson’s Disease Patients with Subthalamic Nucleus Deep Brain Stimulation

Abstract

STN-DBS may resolve hypokinesia of the articulation structures, including the mouth/jaw and tongue, and improve maximal vowel articulation. However, in the on-stimulation condition, the VSA was not significantly correlated with speech intelligibility. This may be because STN-DBS potentially affects other speech processes such as voice and/or respiratory process.

Elektrische Stimulation tiefer Hirnstrukturen: Auswirkungen auf das Sprechen

“…Das Sprechen ist die einzige Funktion, die nach 5-jähriger STN-Stimulation keine Verbesserung zeigte [40,44], wobei einige Patienten im Verlauf und nach der Operation über eine eindeutige Verschlechterung des Sprechens berichteten. Auch zeigten sie eine allmähliche Progredienz der Schwierigkeiten beim Sprechen, die durch Anpassung der Medikation und Stimulation nicht zu kontrollieren war [45,46]. Die längste Nachbeobachtungsdauer betrug 15 Jahre nach STN-THS [47].…”

“…Die Patienten bemerken einen stärkeren Effekt auf die Artikulation mit verminderten Lippen-und Zungenbewegungen und Schwierigkeiten bei der Kontrolle des Stimmvolumens. Es fühlt sich für sie an, als wären sie außer Atem [43,84,85]. In der Literatur wird diskutiert, inwiefern diese Veränderungen auf die Einwirkung des elektrischen Stroms auf die angrenzenden zerebellothalamischen und kortikobulbären Bahnen zurückzuführen ist.…”

Deep Brain Stimulation of the Subthalamic Nucleus Parameter Optimization for Vowel Acoustics and Speech Intelligibility in Parkinson's Disease

“…These included additional speech tasks as well as a number of tasks related to gait and limb kinematics. Although several studies have used a similarly small group of listeners (e.g., Adams, Dykstra, Jenkins, & Jog, 2008;Dromey, 2003;Dykstra, Adams, & Jog, 2012, 2015Moreau et al, 2011;Rousseaux et al, 2014;Tanaka et al, 2016;Tripoliti et al, 2014), there is presently no published evidence that provides clear guidelines on the number of listeners required to obtain a stable measure of intelligibility. metrics, such as vowel space area.…”

“…Although some authors have reported impaired vowel expansion following STN-DBS (Dromey & Bjarnason, 2011;Martel-Sauvageau et al, 2014;Martel-Sauvageau, Roy, Cantin, et al, 2015;Sidtis, Alken, Tagliati, Alterman, & Van Lancker Sidtis, 2016), others have found increased vowel space, for example, in prolonged vowels (Tanaka et al, 2016). Still others have found an interaction between STN-DBS and levodopa medication, finding improved vowel articulation following STN-DBS when individuals were on but not off their titrated levodopa doses (Martel-Sauvageau, Roy, Cantin, et al, 2015).…”

Subthalamic stimulation breaks the balance between distal and axial signs in Parkinson’s disease

“…In detail, L dopa can improve some dimensions of speech such as vocal loudness 13 , 14 , but not intelligibility 12 , 15 . STN-DBS can improve articulation features but might alter voice and respiratory functions 16 . Vowel production is often assessed in PD patients, as a single phonatory production that can address several information on laryngeal dysfunction; it can be considered as a marker of PD progression 17 and reliable to study articulatory dysfunction and treatment effects such as STN-DBS 18 .…”