Effects of Contact Location and Voltage Amplitude on Speech and Movement in Bilateral Subthalamic Nucleus Deep Brain Stimulation

被引:116
|
作者
Tripoliti, Elina [1 ]
Zrinzo, Ludvic [1 ]
Martinez-Torres, Irene [1 ]
Tisch, Stephen [1 ]
Frost, Eleanor [1 ]
Borrell, Ellie [1 ]
Hariz, Marwan I. [1 ]
Limousin, Patricia [1 ]
机构
[1] Inst Neurol, Sobell Dept, Unit Funct Neurosurg, London WC1N 3BG, England
基金
美国国家卫生研究院;
关键词
speech; deep brain stimulation; electrical parameters; contact location;
D O I
10.1002/mds.22296
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Subthalamic nucleus deep brain stimulation (STN-DBS) is particularly effective in improving limb symptoms in Parkinson's disease. However, speech shows a variable response. Contact site and amplitude of stimulation have been suggested as possible factors influencing speech. In this double blind study, we assessed 14 patients post bilateral STN-DBS, without medication. Six conditions were studied in random order as follows: stimulation inside the STN at low voltage (2 V) and at high voltage (4 V); above the STN at 2 V and at 4 V, at usual clinical parameters, and off-stimulation. The site of stimulation was defined on the postoperative stereotactic MRI data. Speech protocol consisted of the assessment of intelligibility of the dysarthric speech, maximum sustainedphonation, and a 1-minute monologue. Movement was assessed using the UPDRS-III. Stimulation at 4 V significantly reduced the speech intelligibility (P = 0.004) independently from the site of stimulation. Stimulation at 4 V significantly improved the motor function. Stimulation inside the nucleus was significantly more effective than outside the nucleus (P = 0.0006). The significant improvement in movement coupled with significant deterioration in speech intelligibility when patients are stimulated inside the nucleus at high voltage indicates a critical role for electrical stimulation parameters in speech motor control. (c) 2008 Movement Disorder Society
引用
收藏
页码:2377 / 2383
页数:7
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