Objective: 1) To describe the evolution of speech in a large cohort of patients before and 1 year after STN-DBS (subthalamic deep brain stimulation). 2) To search for preoperative predictive factors of speech evolution.

Background: The effect of STN-DBS on speech disorders in Parkinson’s disease, although extensively studied, is still debated. This axial symptom of the disease seems to worsen rather in the post-operative period, but the results are very heterogeneous. The aim of this study was to describe the clinical characteristics of speech following chronic STN-DBS and to analyze clinical and surgical factors that could predict speech change.

Method: Data from the MDS-UPDRS III.1 of 418 patients from the French national study PREDISTIM were collected pre-operatively (V0) and at 1 year after surgery (V1). We compared the combined effect of medical treatment and surgery to baseline (MDS-UPDRS III.1, PDQ39-Q34, PDQ39-Q35). The “speech evolution status” was created allowing to create 3 independent groups: group W for deterioration, S for stability and I for improvement, based on speech score evolution. These 3 groups were compared for demographic, clinical variables at V0, and for DBS parameters measured at V1. The location of the active stimulation pads was also analyzed.

Results: A small but significant degradation of speech was found in our study regardless of the score compared. We emphasize here the important discrepancy between hetero- and self-evaluation of speech. The 3 predictive factors of degradation highlighted here are: the absence of pre-operative disorders (p<0.001), the severity of motor evaluation in acts of daily living (MDS-UPDRS II OFF) (p=0.037), and the intensity of stimulation at the level of the left electrode (p=0.046). Above 3.6V of stimulation amplitude at the left electrode, 70% of the patients had degraded speech. The data concerning the location of the active stimulation pads will be specified in the final work.

Conclusion: This is the largest multicentric study on speech evaluation before and after STN-DBS in Parkinson’s disease. This study supports the idea that speech does not evolve in parallel with other motor signs after surgery and brings predictive factors of speech worsening after STN-DBS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/multicentric-prospective-study-of-subthalamic-deep-brain-stimulation-1-year-impact-on-speech-in-parkinsons-disease/