Effect of bilateral stimulation of the subthalamic nucleus on different speech subsystems in patients with Parkinson's disease

Abstract

The effect of deep brain stimulation on the two speech-production subsystems, articulation and phonation, of nine Parkinsonian patients is examined. Production parameters (stop closure voicing; stop closure, VOT, vowel) in fast syllable-repetitions were defined and measured and quantitative, objective metrics of vocal fold function were obtained during vowel production. Speech material was recorded for patients (with and without stimulation) and for a reference group of healthy control speakers. With stimulation, precision of the glottal and supraglottal articulation as well as the phonatory function is reduced for some individuals, whereas for other individuals an improvement is observed. Importantly, the improvement or deterioration is determined not only on the basis of the direction of parameter change but also on the individuals' position relative to the healthy control data. This study also notes differences within an individual in the effects of stimulation on the two speech subsystems. These findings qualify the value of global statements about the effect of neurostimulatory operations on Parkinsonian patients. They also underline the importance of careful consideration of individual differences in the effect of deep brain stimulation on different speech subsystems.

Effects of medication and subthalamic nucleus deep brain stimulation on tongue movements in speakers with Parkinson's disease using electropalatography: A pilot study

“…Evidence can be seen in studies that show an increase or slowing down of the speed of movements under medication (Pinto et al, 2004). Concerning speech associated with hypokinetic dysarthria, most studies focus on temporal aspects (Weismer, 1984;Ludlow, Connor, and Bassich, 1987; for an overview see Schirmer, 2004;Farrell, Theodoros, Ward, Hall, and Silburn, 2005;Pützer, Barry, and Moringlane, 2008) but not on spatial articulatory features. Our aim is to use EPG to investigate whether and in what ways the cortico-striatial circuit affects not only the temporal but also the articulatory spatial aspects of speech production in PD.…”

“…Recent studies (e.g. Pützer et al, 2008) reported the presence of fricated stops ([t]) in five out of nine patients ON stimulation. They discussed the differences in fine motor control of apical tongue movements (with[t]) in comparison to those involving the dorsum (e.g.…”

Quantitative acoustic measurements for characterization of speech and voice disorders in early untreated Parkinson’s disease

“…13,14 Research has shown that medical therapies alone are not as effective for treating speech symptoms as they are for motor functions, 15 and the effect of medical treatment on speech production tends to be individual. [16][17][18] Furthermore, only 3%-4% of PD patients receive speech therapy. 19 Behavioral speech therapy, including intensive voice treatment, appears to be the most effective type of speech intervention in the early and moderate stage of PD at present.…”

Learning about language and speech from Deep Brain Stimulation

“…Different approaches have been chosen to study biolinguistic effects of DBS, comprising the assessment of language under active versus inactive stimulation, under variation of DBS parameters and before versus after surgery (Bordini, Garg, Gallagher, Bell, & Garell, 2007;Carpenter et al, 1998;D'Alatri et al, 2008;Klostermann et al, 2008;Puetzer, Barry, & Moringlane, 2008;Rousseaux et al, 2004;Saint-Cyr, Trépanier, Kumar, Lozano, & Lang, 2000;Santens, De Letter, Van Borsel, De Reuck, & Caemaert, 2003;Toernqvist, Schalén, & Rehncrona, 2005;Tripoliti, Limousin, Tisch, Borrell, & Hariz, 2006;Tripoliti et al, 2008;Wang et al, 2006). Most of these studies were performed under clinical rather than neuroscientific aspects, the major concern being the safety of the therapeutic procedure (Ardouin et al, 1999;Dujardin, Defebvre, Krystkowiak, Blond, & Destee, 2001;Saint-Cyr & Albanese, 2006;Saint-Cyr et al, 2000).…”