| Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease. | |
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MedLine Citation:
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PMID: 21068426 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson disease (PD). Following STN-DBS, speech intelligibility can deteriorate, limiting its beneficial effect. Here we prospectively examined the short- and long-term speech response to STN-DBS in a consecutive series of patients to identify clinical and surgical factors associated with speech change. METHODS: Thirty-two consecutive patients were assessed before surgery, then 1 month, 6 months, and 1 year after STN-DBS in 4 conditions on- and off-medication with on- and off-stimulation using established and validated speech and movement scales. Fifteen of these patients were followed up for 3 years. A control group of 12 patients with PD were followed up for 1 year. RESULTS: Within the surgical group, speech intelligibility significantly deteriorated by an average of 14.2%±20.15% off-medication and 16.9%±21.8% on-medication 1 year after STN-DBS. The medical group deteriorated by 3.6%±5.5% and 4.5%±8.8%, respectively. Seven patients showed speech amelioration after surgery. Loudness increased significantly in all tasks with stimulation. A less severe preoperative on-medication motor score was associated with a more favorable speech response to STN-DBS after 1 year. Medially located electrodes on the left STN were associated with a significantly higher risk of speech deterioration than electrodes within the nucleus. There was a strong relationship between high voltage in the left electrode and poor speech outcome at 1 year. CONCLUSION: The effect of STN-DBS on speech is variable and multifactorial, with most patients exhibiting decline of speech intelligibility. Both medical and surgical issues contribute to deterioration of speech in STN-DBS patients. Classification of evidence: This study provides Class III evidence that STN-DBS for PD results in deterioration in speech intelligibility in all combinations of medication and stimulation states at 1 month, 6 months, and 1 year compared to baseline and to control subjects treated with best medical therapy. |
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Authors:
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E Tripoliti; L Zrinzo; I Martinez-Torres; E Frost; S Pinto; T Foltynie; E Holl; E Petersen; M Roughton; M I Hariz; P Limousin |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2010-11-10 |
Journal Detail:
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Title: Neurology Volume: 76 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-01-05 Completed Date: 2011-02-11 Revised Date: 2012-01-24 |
Medline Journal Info:
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Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
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Languages: eng Pagination: 80-6 Citation Subset: AIM; IM |
Affiliation:
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Sobell Department, Unit of Functional Neurosurgery, UCL Institute of Neurology, Box 146, Queen Square, London, WC1N 3BG, UK. e.tripoliti@ion.ucl.ac.uk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Deep Brain Stimulation / adverse effects* Female Fourier Analysis Humans Linear Models Linguistics Longitudinal Studies Male Middle Aged Movement / physiology Parkinson Disease / complications*, therapy Retrospective Studies Speech Disorders / etiology* Speech Intelligibility / physiology* Subthalamic Nucleus / physiology* Time Factors |
| Grant Support | |
ID/Acronym/Agency:
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G-4070//Parkinson's UK; R01-NS40902/NS/NINDS NIH HHS |
| Comments/Corrections | |
Comment In:
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J Neurol. 2011 Feb;258(2):340-2
[PMID:
21286743
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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