Objective: This study reports on the type and severity of speech problems up to 10 years after bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN).

Background: Speech problems can be a common side effect of bilateral STN DBS in patients with Parkinson’s disease (PD). High electrical parameters, too medially placed electrodes and longer disease duration have been implicated in speech deterioration. Dysarthria can appear a year after surgery and deteriorate gradually.

Methods: Twenty consecutive PD patients (at the time of surgery: disease duration 12.5±4.7yrs, age 58.8±6.3yrs, UPDRS pre-op off-meds 48.10±17.9) treated with bilateral STN-DBS were followed-up to 10 years. A Speech Intelligibility Assessment (% of words understood, Yorkston et al 1983) and the UPDRS-III were administered pre-operatively, at 1 year, 5 years and 10 years.

Results: Speech intelligibility dropped from 93.3% (±10.9) to 77.8% (±24.1) at one year (p<.001) and to 56.7% (±24.5) of words understood at 10 years (p<.001). The deterioration from year 5 to year 10 was not significant.

Conclusions: Speech can significantly deteriorate to a variable degree mainly during the first 5 years post bilateral STN-DBS. Investigating ways to deal with dysarthria could allow patients to maximize the motor benefits of the surgery.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-10-years-post-bilateral-stn-dbs-for-parkinsons-disease/