Effects of bilateral subthalamic nucleus stimulation and medication on parkinsonian speech impairment
Effects of bilateral subthalamic nucleus stimulation and medication on parkinsonian speech impairment
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DOI：
10.1016/j.jvoice.2006.10.010
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发表时间：
2008-05-01
期刊：
影响因子：
2.2
通讯作者：
Bentivoglio, Anna Rita
中科院分区：
文献类型：
--
作者：
D'Alatri, Lucia;Paludetti, Gaetano;Bentivoglio, Anna Rita
本研究旨在定量评估双侧丘脑下核（STN）刺激和药物治疗对帕金森性构音障碍的影响。研究了12例意大利特发性帕金森病（平均年龄60.29±7.50岁）双侧STN植入患者（男1例，女1例）。在四种临床条件下进行神经学评估和声学记录，结合刺激和药物来评估运动障碍和语言障碍的程度。声学分析是通过多维语音程序和高级运动语音轮廓（Kay Elemetrics, Lincoln Park， NJ）进行的。经STN脑深部刺激后，各项评价指标均无恶化。STN刺激可显著改善运动表现和声带震颤，并为声门振动提供了主要的稳定性。刺激对这些参数的影响优于左旋多巴。在刺激或药物治疗后，知觉评价和与韵律、发音和强度相关的声学参数没有观察到显著的变化。与声门振动和声音震颤相关的声学参数的改善并没有伴随着对语音清晰度的实质性影响。STN刺激对整体运动肢体功能障碍比构音障碍更有效，但我们没有报道对言语的负面影响。
This study aimed to assess quantitatively the effect of bilateral subthalamic nucleus (STN) stimulation and medication on hypokinetic parkinsonian dysarthria. Twelve Italian patients (I I males and I female) with idiopathic Parkinson's disease (mean age 60.29 +/- 7.50 years) and bilateral STN implantation were studied. Neurological assessments and acoustic recordings were performed in four clinical conditions combining stimulation and medication to assess the degree of motor disabilities and speech impairment. Acoustic analysis was performed by means of the Multidimensional Voice Program and the Advanced Motor Speech Profile (Kay Elemetrics, Lincoln Park, NJ). None of the evaluated parameters deteriorated after STN deep brain stimulation. STN stimulation significantly improved motor performances and vocal tremor and provided a major stability to glottal vibration. Effect of stimulation on these parameters was superior to that of levodopa. No significant variations were observed in perceptual evaluation and in acoustic parameters related to prosody, articulation, and intensity after either stimulation or medication. The improvement of acoustic parameters related to glottal vibration and voice tremor was not accompanied by a substantial effect on speech intelligibility. STN stimulation was more effective on global motor limb dysfunctions than on dysarthria, but we did not report negative consequences on speech.