scholarly journals Speech Function Following Deep Brain Stimulation of the Caudal Zona Incerta: Effects of Habitual and High-Amplitude Stimulation

2021 ◽  
pp. 1-13
Author(s):  
Linda Sandström ◽  
Ellika Schalling ◽  
Fredrik Karlsson ◽  
Patric Blomstedt ◽  
Lena Hartelius
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Amplitude ◽  
Nonparametric Tests ◽  
Zona Incerta ◽  
Maximal Amplitude ◽  
Significant Group ◽  
Preliminary Study ◽  
Deep Brain ◽  
Stimulation Of

Purpose Deep brain stimulation (DBS) is often successful in alleviating motor symptoms of essential tremor (ET); however, DBS may also induce adverse speech effects. The caudal zona incerta (cZi) is a promising DBS target for tremor, but less is known about the consequences of cZi DBS for speech. This preliminary study examined how habitual cZi DBS and cZi stimulation at high amplitudes may affect speech function in persons with ET. Method Fourteen participants with ET were evaluated: off stimulation, on habitual cZi DBS, and with unilateral cZi stimulation at increasing stimulation amplitudes. At each stimulation condition, the participants read three 16-word sentences. Two speech-language pathologists made audio-perceptual consensus ratings of overall speech function, articulation, and voice using a visual sort and rate method. Rated functions when off stimulation, on habitual cZi DBS, and at maximal-amplitude stimulation were compared using Friedman nonparametric tests. For participants with bilateral habitual DBS ( n = 5), the effects of bilateral and unilateral stimulation were described in qualitative terms. Results Habitual cZi DBS had no significant group-level effect on any of the investigated speech parameters. Maximal-amplitude stimulation had a small but significant negative effect on articulation. Participants with reduced articulatory precision ( n = 9) had more medially placed electrodes than the nonaffected group ( n = 5). Bilateral and unilateral left stimulation had comparable effects on speech. Conclusions Findings from this preliminary study of cZi DBS indicate that speech is generally not affected by stimulation at habitual levels. High-amplitude cZi stimulation may, however, induce adverse effects, particularly on articulation. Instances of decreased articulatory function were associated with stimulation of more medial electrode contacts, which could suggest cerebello-rubrospinal involvement.

scholarly journals Control of phonatory onset and offset in Parkinson patients following deep brain stimulation of the subthalamic nucleus and caudal zona incerta

2012 ◽  
Vol 18 (7) ◽  
pp. 824-827 ◽  
Author(s):  
Fredrik Karlsson ◽  
Patric Blomstedt ◽  
Katarina Olofsson ◽  
Jan Linder ◽  
Erik Nordh ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Zona Incerta ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Deep Brain Stimulation of Caudal Zona Incerta and Subthalamic Nucleus in Patients with Parkinson's Disease: Effects on Voice Intensity

2011 ◽  
Vol 2011 ◽  
pp. 1-8 ◽  
Author(s):  
Sofie Lundgren ◽  
Thomas Saeys ◽  
Fredrik Karlsson ◽  
Katarina Olofsson ◽  
Patric Blomstedt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Zona Incerta ◽  
Mean Intensity ◽  
Stn Dbs ◽  
Intensity Decay ◽  
Deep Brain ◽  
Stimulation Of

Deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD) affects speech inconsistently. Recently, stimulation of the caudal zona incerta (cZi-DBS) has shown superior motor outcomes for PD patients, but effects on speech have not been systematically investigated. The aim of this study was to compare the effects of cZi-DBS and STN-DBS on voice intensity in PD patients. Mean intensity during reading and intensity decay during rapid syllable repetition were measured for STN-DBS and cZi-DBS patients (eight patients per group), before- and 12 months after-surgery on- and off-stimulation. For mean intensity, there were small significant differences on- versus off-stimulation in each group: 74.2 (2.0) dB contra 72.1 (2.2) dB () for STN-DBS, and 71.6 (4.1) dB contra 72.8 (3.4) dB () for cZi-DBS, with significant interaction (). Intensity decay showed no significant changes. The subtle differences found for mean intensity suggest that STN-DBS and cZi-DBS may influence voice intensity differently.

scholarly journals Stimulation of zona incerta selectively modulates pain in humans

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charles W. Lu ◽  
Daniel E. Harper ◽  
Asra Askari ◽  
Matthew S. Willsey ◽  
Philip P. Vu ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Pain Perception ◽  
Mechanistic Explanation ◽  
Pain Modulation ◽  
Zona Incerta ◽  
Heat Pain ◽  
Sensory Changes ◽  
Deep Brain ◽  
Stimulation Of

AbstractStimulation of zona incerta in rodent models has been shown to modulate behavioral reactions to noxious stimuli. Sensory changes observed in Parkinsonian patients with subthalamic deep brain stimulation suggest that this effect is translatable to humans. Here, we utilized the serendipitous placement of subthalamic deep brain stimulation leads in 6 + 5 Parkinsonian patients to directly investigate the effects of zona incerta stimulation on human pain perception. We found that stimulation at 20 Hz, the physiological firing frequency of zona incerta, reduces experimental heat pain by a modest but significant amount, achieving a 30% reduction in one fifth of implants. Stimulation at higher frequencies did not modulate heat pain. Modulation was selective for heat pain and was not observed for warmth perception or pressure pain. These findings provide a mechanistic explanation of sensory changes seen in subthalamic deep brain stimulation patients and identify zona incerta as a potential target for neuromodulation of pain.

scholarly journals Stimulation of zona incerta selectively modulates pain in humans

2020 ◽  
Author(s):  
Charles W Lu ◽  
Daniel E Harper ◽  
Asra Askari ◽  
Matthew S Willsey ◽  
Philip P Vu ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Pain Perception ◽  
Mechanistic Explanation ◽  
Pain Modulation ◽  
Zona Incerta ◽  
Heat Pain ◽  
Sensory Changes ◽  
Deep Brain ◽  
Stimulation Of

ABSTRACTStimulation of zona incerta in rodent models has been shown to modulate behavioral reactions to noxious stimuli. Sensory changes observed in Parkinsonian patients with subthalamic deep brain stimulation suggest that this effect is translatable to humans. Here, we utilized the serendipitous placement of subthalamic deep brain stimulation leads to directly investigate the effects of zona incerta stimulation on human pain perception. We found that stimulation at 20 Hz, the physiological firing frequency of zona incerta, reduces experimental heat pain by a modest but significant amount, achieving a 30% reduction in one fifth of implants. Stimulation at higher frequencies did not modulate heat pain. Modulation was selective for heat pain and was not observed for warmth perception or pressure pain. These findings provide a mechanistic explanation of sensory changes seen in subthalamic deep brain stimulation patients and identify zona incerta as a potential target for neuromodulation of pain.

Voice Tremor in Patients With Essential Tremor: Effects of Deep Brain Stimulation of Caudal Zona Incerta

2016 ◽  
Vol 30 (2) ◽  
pp. 228-233 ◽  
Author(s):  
Patricia Hägglund ◽  
Linda Sandström ◽  
Patric Blomstedt ◽  
Fredrik Karlsson
Keyword(s):  
Deep Brain Stimulation ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Zona Incerta ◽  
Deep Brain ◽  
Stimulation Of

Articulatory Closure Proficiency in Patients With Parkinson's Disease Following Deep Brain Stimulation of the Subthalamic Nucleus and Caudal Zona Incerta

2014 ◽  
Vol 57 (4) ◽  
pp. 1178-1190 ◽  
Author(s):  
Fredrik Karlsson ◽  
Katarina Olofsson ◽  
Patric Blomstedt ◽  
Jan Linder ◽  
Erik Nordh ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Zona Incerta ◽  
Relative Duration ◽  
Data Set ◽  
Deep Brain ◽  
Stimulation Of

PurposeThe present study aimed at comparing the effects of deep brain stimulation (DBS) treatment of the subthalamic nucleus (STN) and the caudal zona incerta (cZi) on the proficiency in achieving oral closure and release during plosive production of people with Parkinson's disease.MethodNineteen patients participated preoperatively and 12 months after DBS surgery. Nine patients had implantations in the STN, 7 bilaterally and 2 unilaterally (left). Ten had bilateral implantations in the cZi. Postoperative examinations were made off and on stimulation. All patients received simultaneous L-dopa treatment in all conditions. For a series of plosives extracted from a reading passage, absolute and relative measures of duration of frication and amplitude of plosive release were compared between conditions within each treatment group.ResultsRelative duration of frication increased in voiceless plosives in the on-stimulation condition in cZi patients. Similar trends were observed across the data set. Duration of prerelease frication and the release peak prominence increased in voiceless plosives on stimulation for both groups.ConclusionThe increased release prominence suggests that patients achieved a stronger closure gesture because of DBS but that the increased energy available resulted in increased frication.

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