Session Information
Date: Thursday, June 23, 2016
Session Title: Clinical trials and therapy in movement disorders
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To assess the effect of subthalamic deep brain stimulation (STN-DBS) on speech in Parkinson’s disease patients with early fluctuations and dyskinesia.
Background: The effect of STN-DBS on speech is still a matter of debate. Many factors contribute to quality of speech including disease progression, medication, surgical intervention and stimulation. So far, controlled prospective studies are still lacking.
Methods: Ninety-nine patients with STN-DBS and best medical treatment (BMT) were compared to 102 patients with BMT alone. Statistical analyses compared changes of speech parameters from baseline (T0) to twenty-four months after (T24), between the two patient groups. Established speech tasks were applied: 1) Maximal phonation time for the sustained production of the vowel /A/; 2) Oral diadochokinesia measured during a 30 sec sequence of repeated syllabi /ba, /da/ and /ga/;and 3) Speech intelligibility, measured by 84 listeners who were asked to identify words and sentences pronounced by the patients. All 3 tests were recorded OFF and ON optimal medication at T0. The BMT and STN-DBS patient groups repeated the protocol at T24. STN-BDS patients had to perform four conditions with Med ON/OFF and Stim ON/OFF.
Results: For the BMT group, all 3 parameters showed a slight worsening during the 2 years period both in the ON and OFF-med condition, reflecting disease progression. The STN-DBSgroup showed a similar worsening for maximal phonation time and intelligibility. Oral diadochokinesia in the STN-DBS group in the OFF-stim condition, either off or on medication and when compared to the BMT group, showed a slight but significant impairment which was completely compensated in the stim-ON condition.
Conclusions: Surgery for the implantation is worsening one out of three meaningful speech tasks due to the lesion effect while the other two tasks remain unaffected. Stimulation of the STN does compensate this worsening over a 2 years period.
To cite this abstract in AMA style:
S. Pinto, A. Nebel, R. Espesser, J. Rau, P. Maillochon, O. Krack, K. Knudsen, A. Ghio, O. Niebuhr, Y. Agid, M. Schüpbach, G. Deuschl. Changes of speech after neurostimulation for Parkinson’s disease with early fluctuations: A 2-years randomized controlled trial (earlystim-speech) [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/changes-of-speech-after-neurostimulation-for-parkinsons-disease-with-early-fluctuations-a-2-years-randomized-controlled-trial-earlystim-speech/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/changes-of-speech-after-neurostimulation-for-parkinsons-disease-with-early-fluctuations-a-2-years-randomized-controlled-trial-earlystim-speech/