Early detection of speech and voice disorders in Parkinson’s disease patients treated with subthalamic nucleus deep brain stimulation: a 1-year follow-up study

Abstract

We previously reported that Parkinson's disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS) had distinct phenotypes of speech and voice disorders: hypokinetic dysarthria, stuttering, breathy voice, strained voice, and spastic dysarthria. However, changes over time remain unclear. In the present study, 32 consecutive PD patients were assessed before and up to 1 year after surgery (PD-DBS). Eleven medically treated PD patients were also assessed (PD-Med). Speech, voice, motor, and cognitive functions were evaluated. At baseline, the incidence of hypokinetic dysarthria (63% of PD-DBS vs. 82% of PD-Med), stuttering (50% vs. 45%), breathy voice (66% vs. 73%), and strained voice (3% vs. 9%) was similar between groups. At 1 year, a slight but significant deterioration in speech intelligibility (p < 0.001) and grade of dysphonia (p = 0.001) were observed only in PD-DBS group compared with baseline. During the follow-up, stuttering (9% vs. 18%) and breathy voice (13% vs. 9%) emerged in PD-DBS and PD-Med, but strained voice (28%) and spastic dysarthria (44%) emerged only in PD-DBS. After the stimulation was stopped, strained voice and spastic dysarthria improved in most patients, while stuttering and breathy voice improved in a minority of patients. These findings indicate that the most common DBS-induced speech and voice disorders are strained voice and spastic dysarthria and that STN-DBS potentially aggravates stuttering and breathy voice. An improved understanding of these types of disorders may help detect speech and voice deteriorations during the early phase and lead to appropriate treatments.

The spectrum of involuntary vocalizations in humans: A video atlas

“…Finally, palilalic behaviors may also be encountered in functional neurological disorders and in culture‐bound startle syndromes (eg, Indonesian Latah; also see below) . Of note, palilalia should be distinguished from stuttering, a disorder with dysfluency of speech and repetition of sounds, syllables, or words (eg, Video 1A, palilalia vs Video 1K, stuttering) …”

“…97 Of note, palilalia should be distinguished from stuttering, a disorder with dysfluency of speech and repetition of sounds, syllables, or words (eg, Video 1A, palilalia vs Video 1K, stuttering). 98,99 Echolalia Echolalia is the automatic imitative repetition of sounds, words, or phrases in the absence of explicit awareness. 100 Although echolalia constitutes a physiological neurodevelopmental phenomenon, its unremitting persistence or reemergence may point to pathology.…”

Toward Electrophysiology-Based Intelligent Adaptive Deep Brain Stimulation for Movement Disorders

“…As discussed in the previous sections, emerging evidence suggests that specific DBS parameters can have symptom-specific effects, such as improved freezing of gait through 60-Hz stimulation [166][167][168][169] and stimulation of ventral DBS contacts in the SNr for alleviation of axial motor impairment [155]. Moreover, dyskinesia during medication ON times can limit the therapeutic stimulation amplitude at the cost of better symptom alleviation during OFF times [201], and speech intelligibility and DBSinduced spastic dysarthria can be improved through reduction of stimulation amplitudes [207]. Dynamic adjustment of stimulation parameters to concurrent behavior and demand could therefore have tremendous benefits for the control of symptoms and side effects in patients undergoing deep brain stimulation.…”

Voice and the new coronavirus

“…that have attempted to quantify voice parameters (acoustic amplitude and frequency variations) with the purpose of characterising the idiopathic Parkinson's disease by dysphonic symptoms. 4 Wheezing and coughing, trouble breathing, coughing up mucus and shortness of breath are just a few COPD symptoms and many patients experience voice changes as a result of COPD. 5 Murton et al 6 analysed the voices of heart failure (HF) patients as they underwent treatment for decompensated HF and returned to a stable clinical state.…”

“…A glottal‐flow spectrum and vocal jitter were found to discriminate near‐term risk suicidal subjects 3 . Some studies that have attempted to quantify voice parameters (acoustic amplitude and frequency variations) with the purpose of characterising the idiopathic Parkinson's disease by dysphonic symptoms 4 . Wheezing and coughing, trouble breathing, coughing up mucus and shortness of breath are just a few COPD symptoms and many patients experience voice changes as a result of COPD 5 .…”