Patient-Specific Model-Based Investigation of Speech Intelligibility and Movement during Deep Brain Stimulation
Patient-Specific Model-Based Investigation of Speech Intelligibility and Movement during Deep Brain Stimulation
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DOI：
10.1159/000314357
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Wardell, Karin
中科院分区：
文献类型：
--
作者：
Astrom, Mattias;Tripoliti, Elina;Wardell, Karin
背景/目的：脑深部电刺激（DBS）广泛用于治疗晚期帕金森病患者的运动症状。本研究的目的是调查的解剖方面的电场的言语和运动的影响，在丘脑底核DBS。方法：开发患者特定的DBS有限元模型，用于模拟10例患者的电场。在每例患者中，在2种电气设置（即4 V（高）和2 V（低））下评估语言清晰度和运动。模拟每个电气设置的电场。结果：所有患者在高和低电设置下的运动均得到改善。在一般情况下，高振幅刺激是更一致的改善运动评分比低振幅刺激。在6例病例中，在高振幅电设置期间言语清晰度受损。从位于丘脑底核中心内侧和/或后部的电极刺激小脑丘脑束的一部分被认为是刺激诱导的构音障碍的可能原因。结论：当有源电极位于丘脑底核中心的内侧和/或后部时，应特别注意刺激诱导的言语障碍。版权所有（C）2010 S. Karger AG，巴塞尔
Background/Aims: Deep brain stimulation (DBS) is widely used to treat motor symptoms in patients with advanced Parkinson's disease. The aim of this study was to investigate the anatomical aspects of the electric field in relation to effects on speech and movement during DBS in the subthalamic nucleus. Methods: Patient-specific finite element models of DBS were developed for simulation of the electric field in 10 patients. In each patient, speech intelligibility and movement were assessed during 2 electrical settings, i.e. 4 V (high) and 2 V (low). The electric field was simulated for each electrical setting. Results: Movement was improved in all patients for both high and low electrical settings. In general, high-amplitude stimulation was more consistent in improving the motor scores than low-amplitude stimulation. In 6 cases, speech intelligibility was impaired during high-amplitude electrical settings. Stimulation of part of the fasciculus cerebellothalamicus from electrodes positioned medial and/or posterior to the center of the subthalamic nucleus was recognized as a possible cause of the stimulation-induced dysarthria. Conclusion: Special attention to stimulation-induced speech impairments should be taken in cases when active electrodes are positioned medial and/or posterior to the center of the subthalamic nucleus. Copyright (C) 2010 S. Karger AG, Basel