A Preliminary Report on Disordered Speech with Deep Brain Stimulation in Individuals with Parkinson's Disease

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has proven effective in treating the major motor symptoms of advanced Parkinson's disease (PD). The aim of this study was to learn which laryngeal and articulatory acoustic features changed in patients who were reported to have worse speech with stimulation. Six volunteers with PD who had bilateral STN electrodes were recorded with DBS turned on or off. Perceptual ratings reflected poorer speech performance with DBS on. Acoustic measures of articulation (corner vowel formants, diphthong slopes, and a spirantization index) and phonation (perturbation, long-term average spectrum) as well as verbal fluency scores showed mixed results with DBS. Some speakers improved while others became worse on individual measures. The magnitude of DBS effects was not predictable based on the patients' demographic characteristics. Future research involving adjustments to stimulator settings or electrode placement may be beneficial in limiting the negative effects of DBS on speech.

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Intraoperative changes in the H-reflex pathway during deep brain stimulation surgery for Parkinson’s disease: A potential biomarker for optimal electrode placement

Brain Stimulation ◽

10.1016/j.brs.2020.09.024 ◽

2020 ◽

Vol 13 (6) ◽

pp. 1765-1773

Author(s):

Jennifer C. Andrews ◽

François D. Roy ◽

Fang Ba ◽

Tejas Sankar

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

H Reflex ◽

Electrode Placement ◽

Reflex Pathway ◽

Potential Biomarker ◽

Deep Brain Stimulation Surgery ◽

Deep Brain

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Principles of deep brain stimulation

Oxford Textbook of Neurological Surgery ◽

10.1093/med/9780198746706.003.0075 ◽

2019 ◽

pp. 865-872

Author(s):

Erlick A.C Pereira ◽

Alexander L Green ◽

Tipu Z Aziz

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Diffusion Tensor ◽

Electrode Placement ◽

Obsessive Compulsive ◽

Randomized Controlled Clinical Trials ◽

Medication Side ◽

Deep Brain

Deep brain stimulation (DBS) is a minimally invasive targeted neurosurgical intervention that enables structures deep in the brain to be stimulated electrically by an implanted pacemaker. It has become the treatment of choice in Parkinson’s disease patients with either disabling medication side effects, on-off fluctuations, or tremor. Its efficacy in Parkinson’s disease has been demonstrated robustly by randomized controlled clinical trials, with numerous brain areas having been targeted in the last two decades for indications including dystonia and tremor in movement disorders; depression, obsessive-compulsive disorder, and Tourette’s syndrome in psychiatry; epilepsy, cluster headache, and chronic pain. The principles of framed stereotactic surgery enabling DBS electrode placement are reviewed here, before describing the putative mechanisms underlying DBS and its action upon individual neurons. Recent and future developments in DBS technology such as segmented, directional leads, and smart, adaptive stimulation are then discussed alongside related technological advances such as diffusion tensor imaging, robotic surgery, and molecular and cellular therapies. The role of stereotactic lesions in the era of DBS and the different modalities of lesioning are then summarized.

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