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

Knowles, Thea; Adams, Scott G.; Abeyesekera, Anita; Mancinelli, Cynthia; Gilmore, Greydon; Jog, Mandar

doi:10.1044/2017_jslhr-s-17-0157

Cited by 19 publications

(8 citation statements)

References 86 publications

(99 reference statements)

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“…Anatomical connections between the sensorimotor cortex and the basal ganglia via a corticostriatal-thalamic loop (Alexander, DeLong, and Strick, 1986) suggest that the basal ganglia, including the STN, may also participate in speech production. Indeed, indirect evidence from lesion literature (Brunner et al, 1982;Damasio et al, 1982;Wallesch et al, 1983;Nadeau and Crosson, 1997), from clinical data on deep brain stimulation (DBS) outcomes (Morrison et al, 2004;Witt et al, 2008;Aldridge et al, 2016;Knowles et al, 2018) and neurological disorders involving the basal ganglia (Logemann et al, 1978;Ho et al, 1998;Walsh and Smith, 2012) implicates the basal ganglia in many aspects of speech production. Direct evidence from electrophysiological recordings of STN activity during speech production shows desynchronization of beta power during articulation of non-propositional speech (Hebb, Darvas, and Miller, 2012), and speech-related changes in single unit firing activity (Watson and Montgomery, 2006;Lipski et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Subthalamic nucleus and sensorimotor cortex activity during speech production

Chrabaszcz

Neumann

Stretcu

et al. 2018

Preprint

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The sensorimotor cortex is somatotopically organized to represent the vocal tract articulators, such as lips, tongue, larynx, and jaw. How speech and articulatory features are encoded at the subcortical level, however, remains largely unknown. We analyzed local field potential (LFP) recordings from the subthalamic nucleus (STN) and simultaneous electrocorticography recordings from the sensorimotor cortex of 11 patients (1 female) with Parkinson's disease during implantation of deep brain stimulation (DBS) electrodes, while patients read aloud threephoneme words. The initial phonemes involved either articulation primarily with the tongue (coronal consonants) or the lips (labial consonants). We observed significant increases in high gamma (60-150 Hz) power in both the STN and the sensorimotor cortex that began before speech onset and persisted for the duration of speech articulation. As expected from previous reports, in the sensorimotor cortex, the primary articulator involved in the production of the initial consonant was topographically represented by high gamma activity. We found that STN high gamma activity also demonstrated specificity for the primary articulator, although no clear topography was observed. In general, subthalamic high gamma activity varied along the ventraldorsal trajectory of the electrodes, with greater high gamma power recorded in the more dorsal locations of the STN. These results demonstrate that articulator-specific speech information is contained within high gamma activity of the STN, with similar temporal but less specific topographical organization, compared to similar information encoded in the sensorimotor cortex.

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Section: Introductionmentioning

confidence: 99%

Subthalamic nucleus and sensorimotor cortex activity during speech production

Chrabaszcz

Neumann

Stretcu

et al. 2018

Preprint

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“…Lower frequency stimulation (<90 Hz, LFS) is a setting showing beneficial effects especially on speech intelligibility, articulation, general grade of dysarthria and laryngeal coordination [62][63][64][65]. These data were confirmed by Fabbri et al, who showed that LFS improved speech intelligibility both in the absence of L-dopa effect and with concomitant L-dopa intake among patients with severe speech impairment chronically stimulated with conventional high frequency stimulation [66].…”

Section: Stn Dbs Programmingmentioning

confidence: 82%

Subthalamic nucleus deep brain stimulation for Parkinson’s disease: current trends and future directions

Macerollo

Zrinzo

Akram

et al. 2020

Expert Review of Medical Devices

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Introduction: Over the last three decades, extensive basic and clinical research has been performed on the use of subthalamic nucleus (STN) as the preferred deep brain stimulation (DBS) target for the treatment of Parkinson's disease (PD). Areas covered:The mechanism underlying the benefit for the motor symptoms in PD is related to the modulation of firing patterns within the hyperdirect projections from motor cortical areas, as well as within the afferent and efferent fibers to the motor STN. Advancements in neuroimaging techniques allow us to identify precisely the STN optimizing surgical targeting. Expert opinion:In this review, we provide an update on the current uses of STN-DBS as a routine therapy as well as its experimental indications in PD, the critical aspects associated with its successful implementation and recent advances in DBS technology.

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“…In a recent conference paper, Knowles, Adams, Abeyesekera, Manicinelli, and Jog (2016) investigated the impact of the individual electrical parameters of STN-DBS on multiple acoustic and perceptual speech variables, including F2 slope and intelligibility. They reported that F2 transition extent in diphthongs was significantly correlated with intelligibility, while overall F2 slope was not.…”

Section: Discussionmentioning

confidence: 99%

Vocalic transitions as markers of speech acoustic changes with STN-DBS in Parkinson’s Disease

Martel‐Sauvageau

Tjaden²

2017

Journal of Communication Disorders

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Purpose Deep Brain Stimulation of the subthalamic nucleus (STN-DBS) effectively treats cardinal symptoms of idiopathic Parkinson’s disease (PD) that cannot be satisfactorily managed with medication. Research is equivocal regarding speech changes associated with STN-DBS. This study investigated the impact of STN-DBS on vocalic transitions and the relationship to intelligibility. Methods Eight Quebec-French speakers with PD and eight healthy controls participated. The slope of the second formant frequency (F2 slope) for glides was obtained. Locus equations (LEs) were calculated to capture vocalic transitions in consonant-vowel sequences. A visual analog scale was used to obtain judgments of intelligibility. Measures for the PD group were obtained both On and Off stimulation. Results F2 slopes and LEs differed among groups, but there were no systematic differences for On versus Off STN-DBS. On an individual level, participants with PD exhibited heterogeneous changes with DBS stimulation. Intelligibility was significantly correlated with F2 slope. Conclusion F2 slope appears to be sensitive to articulatory impairment in PD and could be used in clinical settings to distinguish these speakers from healthy controls. However, acoustic metrics failed to identify systematic change with STN-DBS. The heterogeneity of results, as well as the clinical relevance of acoustic metrics are discussed.

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

Abstract: https://doi.org/10.23641/asha.5899228.

Cited by 19 publications

References 86 publications

Subthalamic nucleus and sensorimotor cortex activity during speech production

Subthalamic nucleus and sensorimotor cortex activity during speech production

Subthalamic nucleus deep brain stimulation for Parkinson’s disease: current trends and future directions

Vocalic transitions as markers of speech acoustic changes with STN-DBS in Parkinson’s Disease

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