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Clinical Trial
. 2010 Oct;257(10):1692-702.
doi: 10.1007/s00415-010-5605-5. Epub 2010 Jun 26.

Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson's disease

Michael J Hammer  1 , Steven M Barlow, Kelly E Lyons, Rajesh Pahwa
Affiliations
Clinical Trial

Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson's disease

Michael J Hammer et al. J Neurol. 2010 Oct.

Abstract

Adequate respiratory and laryngeal motor control are essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on respiratory and laryngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of respiratory and laryngeal control, and whether these changes were correlated with limb function and stimulation parameters. Eighteen PD participants with bilateral STN DBS were tested within a morning session after a minimum of 12 h since their most recent dose of anti-PD medication. Testing occurred when DBS was on, and again 1 h after DBS was turned off, and included aerodynamic measures during syllable production, and standard clinical ratings of limb function. We found that PD participants exhibited changes with DBS, consistent with increased respiratory driving pressure (n = 9) and increased vocal fold closure (n = 9). However, most participants exceeded a typical operating range for these respiratory and laryngeal control variables with DBS. Changes were uncorrelated with limb function, but showed some correlation with stimulation frequency and pulse width, suggesting that speech may benefit more from low-frequency stimulation and shorter pulse width. Therefore, high-frequency STN DBS may be less beneficial for speech-related respiratory and laryngeal control than for limb motor control. It is important to consider these distinctions and their underlying mechanisms when assessing the impact of STN DBS on PD.

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Figures

Fig. 1
Fig. 1
Individual values and corresponding change for each aerodynamic measure (a through f). (PS subglottal pressure, LR laryngeal resistance). Top individual change (DBS ON–DBS OFF). Bottom individual values for each participant with DBS ON (black symbols) and DBS OFF (gray symbols). In each graph, dashed vertical reference lines demarcate boundaries between significant increases (left), non-significant changes (middle), and significant decreases (right). Solid horizontal reference lines in the bottom graph demarcate a typical operating range
Fig. 1
Fig. 1
Individual values and corresponding change for each aerodynamic measure (a through f). (PS subglottal pressure, LR laryngeal resistance). Top individual change (DBS ON–DBS OFF). Bottom individual values for each participant with DBS ON (black symbols) and DBS OFF (gray symbols). In each graph, dashed vertical reference lines demarcate boundaries between significant increases (left), non-significant changes (middle), and significant decreases (right). Solid horizontal reference lines in the bottom graph demarcate a typical operating range
See this image and copyright information in PMC

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