Effect of Deep Brain Stimulation on Speech Performance in Parkinson's Disease

Skodda, Sabine

doi:10.1155/2012/850596

Cited by 70 publications

(64 citation statements)

References 99 publications

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“…Studies have been equivocal regarding subthalamic nucleus stimulation in Parkinson's disease (PD), as some have demonstrated improvements in certain aspects of speech and others have shown deterioration, especially regarding dysarthria. 31 The trend is toward worsened speech in subthalamic nucleus DBS for PD; however, GPi DBS in a small series of 7 patients with PD showed improvement in overall speech performance.…”

Section: Improvement Per Muscle Groupmentioning

confidence: 96%

Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Keen¹,

Przekop

Olaya

et al. 2014

PED

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Object Deep brain stimulation (DBS) for dystonic cerebral palsy (CP) has rarely been reported, and its efficacy, though modest when compared with that for primary dystonia, remains unclear, especially in the pediatric population. The authors present a small series of children with dystonic CP who underwent bilateral pallidal DBS, to evaluate the treatment's efficacy and safety in the pediatric dystonic CP population. Methods The authors conducted a retrospective review of patients (under the age of 18 years) with dystonic CP who had undergone DBS of the bilateral globus pallidus internus between 2010 and 2012. Two of the authors independently assessed outcomes using the Barry-Albright Dystonia Scale (BADS) and the Burke-Fahn-Marsden Dystonia Rating Scale–movement (BFMDRS-M). Results Five children were diagnosed with dystonic CP due to insults occurring before the age of 1 year. Mean age at surgery was 11 years (range 8–17 years), and the mean follow-up was 26.6 months (range 2–42 months). The mean target position was 20.6 mm lateral to the midcommissural point. The mean preoperative and postoperative BADS scores were 23.8 ± 4.9 (range 18.5–29.0) and 20.0 ± 5.5 (range 14.5–28.0), respectively, with a mean overall percent improvement of 16.0% (p = 0.14). The mean preoperative and postoperative BFMDRS-M scores were 73.3 ± 26.6 (range 38.5–102.0) and 52.4 ± 21.5 (range 34.0–80.0), respectively, with a mean overall percent improvement of 28.5% (p = 0.10). Those stimulated at least 23 months (4 patients) improved 18.3% (p = 0.14) on the BADS and 30.5% (p = 0.07) on the BFMDRS-M. The percentage improvement per body region yielded conflicting results between rating scales; however, BFMDRS-M scores for speech showed some of the greatest improvements. Two patients required hardware removal (1 complete system, 1 unilateral electrode) within 4 months after implantation because of infections that resolved with antibiotics. Conclusions All postoperative dystonia rating scale scores improved with pallidal stimulation, and the greatest improvements occurred in those stimulated the longest. The results were modest but comparable to findings in other similar series. Deep brain stimulation remains a viable treatment option for childhood dystonic CP, although young children may have an increased risk of infection. Of particular note, improvements in the BFMDRS-M subscores for speech were comparable to those for other muscle groups, a finding not previously reported.

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Section: Improvement Per Muscle Groupmentioning

confidence: 96%

Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Keen¹,

Przekop

Olaya

et al. 2014

PED

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“…High-frequency deep brain stimulation of the subthalamic nucleus (DBS-STN) is an effective treatment in advanced PD and improves the cardinal motor symptoms, but its effects on speech are generally reported as less positive [9]. In fact, presurgical dysarthria can be aggravated by DBS and dysarthria may emerge as a side effect.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Developmental Speech Dysfluencies in Individuals with Parkinson's Disease

Hartelius

2014

Folia Phoniatr Logop

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Objective: The aim of this study was to investigate the incidence of developmental speech dysfluencies in individuals with Parkinson's disease (PD). Background: The possible relationship between PD and dysfluencies such as stuttering has engaged researchers for many years. However, whether there is a higher-than-expected incidence of reported childhood stuttering in adults with a diagnosis of PD is unknown. Participants and Methods: A questionnaire including items regarding present and former speech difficulties was answered by 280 individuals with PD. Results: The total number of persons who reported that they had stuttered (often or sometimes) before the age of 10 years was 11, corresponding to 3.9%. The number of persons who reported unusually fast speech before the age of 10 years was 17, corresponding to 6.1%. The reported incidence of childhood stuttering in this group was consequently not higher than that in previously published reports on childhood stuttering (approx. 5%). The frequency of unusually fast speech was notable, but the lack of a control group made it difficult to conclude on the significance of that finding. Conclusion: Although no direct comparison between self-reported incidences of childhood dysfluencies and published incidence figures regarding childhood stuttering can be made, different possible relationships between speech dysfluency and basal ganglia dysfunction are discussed. © 2014 S. Karger AG, Basel

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“…In general, past studies investigating the impact of On vs Off STN-DBS stimulation on speech production/intelligibility in PD have reported mixed results (Skodda, 2012). For example, Dromey and Bjarnason (2011) analyzed multiple acoustic parameters at On vs Off STN-DBS in six participants with PD.…”

Section: Discussionmentioning

confidence: 99%

“…Collectively, Pre-Post as well as On-Off studies report high inter-subject variability. The high inter-subject variability, in turn, contributes to equivocal outcomes across studies (Aldridge, Theodoros, Angwin, & Vogel, 2016; Schulz & Grant, 2000; Skodda, 2012) (Skodda, 2012). In addition, most Pre-Post studies indicate that speech is not improved by the intervention, and recent research suggests intelligibility is reduced, on average, in the years following surgery (Tripoliti et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…While many studies have used perceptual measures to characterize the effects of STN-DBS on speech production (Aldridge et al, 2016; Skodda, 2012), acoustic measures of phonation, prosody and articulation have also been employed (Choi, 2012; D’Alatri et al, 2008; Hoffman-Ruddy, Schulz, Vitek, & Evatt, 2001). In a recent essay, Weismer and colleagues questioned the choice of measures used in many extant studies investigating the impact of STN-DBS on speech production (Weismer, Yunusova, & Bunton, 2012).…”

Section: Introductionmentioning

confidence: 99%

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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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Effect of Deep Brain Stimulation on Speech Performance in Parkinson's Disease

Cited by 70 publications

References 99 publications

Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Deep brain stimulation for the treatment of childhood dystonic cerebral palsy

Incidence of Developmental Speech Dysfluencies in Individuals with Parkinson's Disease

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

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