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Observational Study
. 2023 Jul;30(7):1963-1972.
doi: 10.1111/ene.15803. Epub 2023 Apr 10.

Interplay between speech and gait variables in Parkinson's disease patients treated with subthalamic nucleus deep brain stimulation: A long-term instrumental assessment

Francesco Cavallieri  1   2 , Annalisa Gessani  3 , Andrea Merlo  4 , Isabella Campanini  4 , Carla Budriesi  3 , Valentina Fioravanti  1 , Giulia Di Rauso  1   3 , Alberto Feletti  5   6 , Benedetta Damiano  4 , Sara Scaltriti  4 , Noemi Guagnano  4 , Elisa Bardi  3 , Maria Giulia Corni  3 , Francesca Antonelli  3 , Francesca Cavalleri  7 , Maria Angela Molinari  3 , Sara Contardi  8 , Elisa Menozzi  9 , Annette Puzzolante  6 , Giuseppe Vannozzi  10 , Elena Bergamini  10 , Giacomo Pavesi  6 , Valérie Fraix  11 , Sara Meoni  11 , Alessandro Fraternali  12 , Annibale Versari  12 , Mirco Lusuardi  13 , Giuseppe Biagini  14 , Serge Pinto  15 , Elena Moro  11 , Franco Valzania  1
Affiliations
Observational Study

Interplay between speech and gait variables in Parkinson's disease patients treated with subthalamic nucleus deep brain stimulation: A long-term instrumental assessment

Francesco Cavallieri et al. Eur J Neurol. 2023 Jul.

Abstract

Objective: To evaluate correlations between speech and gait parameters in the long term and under different medication and subthalamic nucleus deep brain stimulation (STN-DBS) conditions in a cohort of advanced Parkinson's disease (PD) patients.

Methods: This observational study included consecutive PD patients treated with bilateral STN-DBS. Axial symptoms were evaluated using a standardized clinical-instrumental approach. Speech and gait were assessed by perceptual and acoustic analyses and by the instrumented Timed Up and Go (iTUG) test, respectively. Disease motor severity was evaluated with the total score and subscores of the Unified Parkinson's Disease Rating Scale (UPDRS) Part III. Different stimulation and drug treatment conditions were assessed: on-stimulation/off-medication, off-stimulation/off-medication, and on-stimulation/on-medication.

Results: Twenty-five PD patients with a 5-year median follow-up after surgery (range 3-7 years) were included (18 males; disease duration at surgery: 10.44 [SD 4.62] years; age at surgery: 58.40 [SD 5.73] years). In the off-stimulation/off-medication and on-stimulation/on-medication conditions, patients who spoke louder had also the greater acceleration of the trunk during gait; whereas in the on-stimulation/on-medication condition only, patients with the poorer voice quality were also the worst to perform the sit to stand and gait phases of the iTUG. Conversely, patients with the higher speech rate performed well in the turning and walking phases of the iTUG.

Conclusions: This study underlines the presence of different correlations between treatment effects of speech and gait parameters in PD patients treated with bilateral STN-DBS. This may allow us to better understand the common pathophysiological basis of these alterations and to develop a more specific and tailored rehabilitation approach for axial signs after surgery.

Keywords: Parkinson's disease; STN-DBS; deep brain stimulation; gait; levodopa; speech.

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References

REFERENCES

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