Effects of Subthalamic Nucleus Deep Brain Stimulation on the Phonation and Articulation of the Patients with Parkinson's Disease.
- Author:
Jee Eun SUNG
1
;
Hyanghee KIM
;
Hyun Sook KIM
;
Seung Hun OH
;
Ji Man HONG
;
Myung Sik LEE
Author Information
1. Graduate Program in Speech Pathology, Yonsei University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Parkinson's disease;
Subthalamic nucleus stimulation;
Phonation;
Articulation
- MeSH:
Acoustics;
Deep Brain Stimulation*;
Humans;
Levodopa;
Parkinson Disease*;
Phonation*;
Subthalamic Nucleus*;
Tremor;
Voice
- From:Journal of the Korean Neurological Association
2004;22(5):472-477
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The purpose of this study was to investigate the effects of the subthalamic nucleus (STN) deep brain stimulation (DBS) on the phonation and articulation of patients with Parkinson's disease (PD). METHODS: Seven PD patients who underwent bilateral STN DBS were included. The patients were asked to make and sustain the vowel sounds /a/ and /i/ as long as possible and to repeat nonsense syllables, /pa/, /ta/, /ka/ and /pataka/ as quickly as possible for 3 seconds. When the patients were administered levodopa `on' and `off' treatments, we evaluated the effect of DBS on the maximum phonation time (MPT), jitter (pitch perturbation), shimmer (intensity perturbation), tremor index and diadochokinetic rate (DDK). In each condition, using a Unified Parkinson's Disease Rating Scale score, we also measured the motor disability of the patients. RESULTS: During levodopa `off', both the DBS and levodopa treatment caused significant prolongation of the MPT of the vowels /a/ and /i/. Acoustic analysis showed that DBS had an effect on shimmer only when the patients were levodopa `off'. At the articulatory level, no significant changes were found in the diadochokinetic rate under any conditions. However, there was a correlation between the amount of improvement of voice tremor and sum of UPDRS scores measuring `tremor at rest' and `postural tremor'. CONCLUSIONS: In patients with advanced PD, STN DBS improves phonation, but had limited effects on articulation.