Effect of Low versus High Frequency Subthalamic Deep Brain Stimulation on Speech Intelligibility and Verbal Fluency in Parkinson's Disease: A Double-Blind Study.
J Parkinsons Dis
; 9(1): 141-151, 2019.
Article
em En
| MEDLINE
| ID: mdl-30594934
ABSTRACT
BACKGROUND:
Subthalamic deep brain stimulation (STN-DBS) is an established treatment for late stage Parkinson's disease (PD). Speech intelligibility (SI) and verbal fluency (VF) have been shown to deteriorate following chronic STN-DBS. It has been suggested that speech might respond favourably to low frequency stimulation (LFS).OBJECTIVE:
We examined how SI, perceptual speech characteristics, phonemic and semantic VF and processes underlying it (clustering and switching) respond to LFS of 60 and 80âHz in comparison to high frequency stimulation (HFS) (110, 130 and 200âHz).METHODS:
In this double-blind study, 15 STN-DBS PD patients (mean age 65, SDâ=â5.8, 14 right handed, three females), were assessed at five stimulation frequencies 60âHz, 80âHz, 110âHz, 130âHz and 200âHz. In addition to the clinical neurological assessment of speech, VF and SI were assessed.RESULTS:
SI and in particular articulation, respiration, phonation and prosody improved with LFS (all pâ<â0.05). Phonemic VF switching improved with LFS (pâ=â0.005) but this did not translate to an improved phonemic VF score. A trend for improved semantic VF was found. A negative correlation was found between perceptual characteristics of speech and duration of chronic stimulation (all pâ<â0.05).CONCLUSIONS:
These findings highlight the need for meticulous programming of frequency to maximise SI in chronic STN-DBS. The findings further implicate stimulation frequency in changes to specific processes underlying VF, namely phonemic switching and demonstrate the potential to address such deficits through advanced adjustment of stimulation parameters.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Distúrbios da Fala
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Inteligibilidade da Fala
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Núcleo Subtalâmico
/
Estimulação Encefálica Profunda
Tipo de estudo:
Clinical_trials
/
Etiology_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Parkinsons Dis
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Reino Unido