Objective: To find preoperative predictive factors of short-term postoperative speech worsening in a large cohort of consecutive PD patients treated with bilateral STN-DBS.
Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-recognized effective treatment in both short- and long-term follow-up in patients with advanced Parkinson disease (PD). However, the impact of STN-DBS on speech is mixed, and possible worsening of speech intelligibility can counterbalance the benefits of STN-DBS.
Method: All consecutive PD patients who underwent bilateral STN-DBS at the Grenoble University Hospital (France) from 1993 to 2015 were evaluated before surgery and at 1-year follow-up after surgery. Demographic variables, neuroimaging data and clinical characteristics were collected. Speech poor outcome was defined as a worsening of speech subscore (UPDRS item 18; MDS-UPDRS item 3.1) in the postoperative on-stimulation/off-medication condition compared with the preoperative defined-off condition. Univariate and multivariate logistic regression analyses were applied to identify predictors of postoperative speech worsening.
Results: 324 PD patients (males: 196; disease duration at surgery: 11.10 [±4.13] years; age at surgery: 56.25 [±8.52] years) were included. The 22.50% of the patients (73/324) presented a worsening of speech in the short-term follow-up. A lower preoperative speech subscore in the off-medication condition and a lower degree of motor improvement after surgery predicted the postoperative worsening of speech.
Conclusion: The severity of speech impairment in the preoperative off-medication condition was the main preoperative predictor of speech worsening after STN-DBS in our cohort. This result may give a better understanding of PD features associated with short-term speech worsening after surgery.
This abstract was previously presented at the 9° LIMPE-DISMOV Congress; Padova, Italy; 4-6 May 2023.
To cite this abstract in AMA style:
F. Cavallieri, F. Bove, A. Zampogna, A. Castrioto, S. Meoni, A. Gessani, E. Schmitt, A. Bichon, E. Lhommée, P. Pélissier, A. Kistner, E. Chevrier, F. Valzania, E. Seigneuret, S. Pinto, S. Chabardès, V. Fraix, E. Moro. Bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease: preoperative predictors of speech worsening [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/bilateral-subthalamic-nucleus-deep-brain-stimulation-in-parkinsons-disease-preoperative-predictors-of-speech-worsening/. Accessed November 21, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/bilateral-subthalamic-nucleus-deep-brain-stimulation-in-parkinsons-disease-preoperative-predictors-of-speech-worsening/