Speech outcomes in Parkinson's disease after subthalamic nucleus deep brain stimulation: A systematic review

Aldridge, Danielle; Theodoros, Deborah; Angwin, Anthony J.; Vogel, Adam P.

doi:10.1016/j.parkreldis.2016.09.022

Cited by 90 publications

(68 citation statements)

References 57 publications

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“…General indications are that sites and settings of stimulation compatible with improvement to limb function are neutral or even detrimental to speech intelligibility and language. Pre-existing significant speech problems serve as a contraindication for DBS in some centres 41. Dysarthria and even dysphasia represent adverse effects of DBS, especially bilateral 42–44…”

Section: Language Changesmentioning

confidence: 99%

Communication changes in Parkinson’s disease

Miller

2017

Pract Neurol

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This review looks at the nature and impact of communication changes in Parkinson's disease, approaches to assessment and directions for intervention. This is especially important since medical and surgical interventions that help limb movement are largely ineffective, or even detrimental, for speech. Most people with Parkinson's disease notice changes to their communication. Voice alters early on-even in the prodromal stage. Later, articulation may impair intelligibility further. These changes impact on mood and social participation. However, a full characterisation of communication changes in Parkinson's must acknowledge that changes are far more pervasive and varied than a quiet voice. Communication is affected by marked dysprosody, cognitive-linguistic impairment, alterations to social interaction and pragmatics. Changes entail not just expressive elements but also receptive. A comprehensive evaluation of potential communication challenges faced by people with Parkinson's disease must cover all these aspects. Similarly, interventions that ignore the breadth and depth of changes will always remain incomplete.

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Section: Language Changesmentioning

confidence: 99%

Communication changes in Parkinson’s disease

Miller

2017

Pract Neurol

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“…As noted previously, acoustic measures and judgments of intelligibility also were obtained for a variety of speech tasks. Task-related differences in performance have been reported in a variety of non-surgical PD studies (e.g., Kempler & Lancker, 2002; Tjaden & Wilding, 2011), but speech task effects or factors following STN-DBS are only beginning to be studied (see Aldridge et al, 2016; Van Lancker Sidtis, Rogers, Godier, Tagliati, & Sidtis, 2010). …”

Section: Discussionmentioning

confidence: 99%

“…Acoustic measures like F2 slope also meet the criteria for ease and simplicity of application. However, despite a recent review concluding that STN-DBS prominently impacts articulation (Aldridge et al, 2016), F2 slope has thus far been reported in a single study STN-DBS study employing an On-Off paradigm (Dromey & Bjarnason, 2011). …”

Section: Introductionmentioning

confidence: 95%

“…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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