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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Non-Invasive Imaging Approach to Understanding Speech Changes following Deep Brain Stimulation in Parkinson’s Disease</title><author><name sortKey="Narayana, Shalini" sort="Narayana, Shalini" uniqKey="Narayana S" first="Shalini" last="Narayana">Shalini Narayana</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Jacks, Adam" sort="Jacks, Adam" uniqKey="Jacks A" first="Adam" last="Jacks">Adam Jacks</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Robin, Donald A" sort="Robin, Donald A" uniqKey="Robin D" first="Donald A." last="Robin">Donald A. Robin</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Neurology, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Honors College, The University of Texas, San Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Poizner, Howard" sort="Poizner, Howard" uniqKey="Poizner H" first="Howard" last="Poizner">Howard Poizner</name><affiliation><nlm:aff id="A4">Institute for Neural Computation, The University of California, San Diego, CA</nlm:aff></affiliation></author><author><name sortKey="Zhang, Wei" sort="Zhang, Wei" uniqKey="Zhang W" first="Wei" last="Zhang">Wei Zhang</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Franklin, Crystal" sort="Franklin, Crystal" uniqKey="Franklin C" first="Crystal" last="Franklin">Crystal Franklin</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Liotti, Mario" sort="Liotti, Mario" uniqKey="Liotti M" first="Mario" last="Liotti">Mario Liotti</name><affiliation><nlm:aff id="A5">Department of Psychology, Simon Fraser University, Burnaby, BC, Canada</nlm:aff></affiliation></author><author><name sortKey="Vogel, Deanie" sort="Vogel, Deanie" uniqKey="Vogel D" first="Deanie" last="Vogel">Deanie Vogel</name><affiliation><nlm:aff id="A6">Department of Communication and Learning Disorders, Our Lady of the Lake, University, San Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Fox, Peter T" sort="Fox, Peter T" uniqKey="Fox P" first="Peter T." last="Fox">Peter T. Fox</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation><affiliation><nlm:aff id="A7">South Texas Veterans Health Care Center, San Antonio, TX</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19029533</idno><idno type="pmc">2779712</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779712</idno><idno type="RBID">PMC:2779712</idno><idno type="doi">10.1044/1058-0360(2008/08-0004)</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000439</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000439</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Non-Invasive Imaging Approach to Understanding Speech Changes following Deep Brain Stimulation in Parkinson’s Disease</title><author><name sortKey="Narayana, Shalini" sort="Narayana, Shalini" uniqKey="Narayana S" first="Shalini" last="Narayana">Shalini Narayana</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Jacks, Adam" sort="Jacks, Adam" uniqKey="Jacks A" first="Adam" last="Jacks">Adam Jacks</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Robin, Donald A" sort="Robin, Donald A" uniqKey="Robin D" first="Donald A." last="Robin">Donald A. Robin</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Neurology, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Honors College, The University of Texas, San Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Poizner, Howard" sort="Poizner, Howard" uniqKey="Poizner H" first="Howard" last="Poizner">Howard Poizner</name><affiliation><nlm:aff id="A4">Institute for Neural Computation, The University of California, San Diego, CA</nlm:aff></affiliation></author><author><name sortKey="Zhang, Wei" sort="Zhang, Wei" uniqKey="Zhang W" first="Wei" last="Zhang">Wei Zhang</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Franklin, Crystal" sort="Franklin, Crystal" uniqKey="Franklin C" first="Crystal" last="Franklin">Crystal Franklin</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Liotti, Mario" sort="Liotti, Mario" uniqKey="Liotti M" first="Mario" last="Liotti">Mario Liotti</name><affiliation><nlm:aff id="A5">Department of Psychology, Simon Fraser University, Burnaby, BC, Canada</nlm:aff></affiliation></author><author><name sortKey="Vogel, Deanie" sort="Vogel, Deanie" uniqKey="Vogel D" first="Deanie" last="Vogel">Deanie Vogel</name><affiliation><nlm:aff id="A6">Department of Communication and Learning Disorders, Our Lady of the Lake, University, San Antonio, TX</nlm:aff></affiliation></author><author><name sortKey="Fox, Peter T" sort="Fox, Peter T" uniqKey="Fox P" first="Peter T." last="Fox">Peter T. Fox</name><affiliation><nlm:aff id="A1">Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</nlm:aff></affiliation><affiliation><nlm:aff id="A7">South Texas Veterans Health Care Center, San Antonio, TX</nlm:aff></affiliation></author></analytic><series><title level="j">American journal of speech-language pathology / American Speech-Language-Hearing Association</title><idno type="ISSN">1058-0360</idno><idno type="eISSN">1558-9110</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title><p id="P1">To explore the use of non-invasive functional imaging and “virtual” lesion techniques to study the neural mechanisms underlying motor speech disorders in Parkinson’s disease. Here, we report the use of Positron Emission Tomography (PET) and transcranial magnetic stimulation (TMS) to explain exacerbated speech impairment following subthalamic nucleus deep brain stimulation (STN-DBS) in a patient with Parkinson’s disease.</p></sec><sec sec-type="methods" id="S2"><title>Method</title><p id="P2">Perceptual and acoustic speech measures as well as cerebral blood flow (CBF) during speech as measured by PET were obtained with STN-DBS on and off. TMS was applied to a region in the speech motor network found to be abnormally active during DBS. Speech disruption by TMS was compared both perceptually and acoustically with that resulting from DBS on.</p></sec><sec id="S3"><title>Results</title><p id="P3">Speech production was perceptually inferior and acoustically less contrastive during left STN stimulation compared to no stimulation. Increased neural activity in left dorsal premotor cortex (PMd) was observed during DBS on. “Virtual” lesioning of this region resulted in speech characterized by decreased speech segment duration, increased pause duration, and decreased intelligibility.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">This case report provides evidence that impaired speech production accompanying STN-DBS may be resulting from unintended activation of PMd. Clinical application of functional imaging and TMS may lead to optimizing the delivery of STN-DBS to improve outcomes for speech production as well as general motor abilities.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9114726</journal-id><journal-id journal-id-type="pubmed-jr-id">30233</journal-id><journal-id journal-id-type="nlm-ta">Am J Speech Lang Pathol</journal-id><journal-title>American journal of speech-language pathology / American Speech-Language-Hearing Association</journal-title><issn pub-type="ppub">1058-0360</issn><issn pub-type="epub">1558-9110</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19029533</article-id><article-id pub-id-type="pmc">2779712</article-id><article-id pub-id-type="doi">10.1044/1058-0360(2008/08-0004)</article-id><article-id pub-id-type="manuscript">NIHMS117667</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>A Non-Invasive Imaging Approach to Understanding Speech Changes following Deep Brain Stimulation in Parkinson’s Disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Narayana</surname><given-names>Shalini</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Jacks</surname><given-names>Adam</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Robin</surname><given-names>Donald A.</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A2">2</xref><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Poizner</surname><given-names>Howard</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Zhang</surname><given-names>Wei</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Franklin</surname><given-names>Crystal</given-names></name><degrees>B.S.</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Liotti</surname><given-names>Mario</given-names></name><degrees>M.D., Ph.D.</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Vogel</surname><given-names>Deanie</given-names></name><degrees>Ph.D.</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Fox</surname><given-names>Peter T.</given-names></name><degrees>M.D.</degrees><xref ref-type="aff" rid="A1">1</xref><xref ref-type="aff" rid="A7">7</xref></contrib></contrib-group><aff id="A1"><label>1</label>Research Imaging Center, The University of Texas Health Science Center, San, Antonio, TX</aff><aff id="A2"><label>2</label>Department of Neurology, The University of Texas Health Science Center, San, Antonio, TX</aff><aff id="A3"><label>3</label>Honors College, The University of Texas, San Antonio, TX</aff><aff id="A4"><label>4</label>Institute for Neural Computation, The University of California, San Diego, CA</aff><aff id="A5"><label>5</label>Department of Psychology, Simon Fraser University, Burnaby, BC, Canada</aff><aff id="A6"><label>6</label>Department of Communication and Learning Disorders, Our Lady of the Lake, University, San Antonio, TX</aff><aff id="A7"><label>7</label>South Texas Veterans Health Care Center, San Antonio, TX</aff><author-notes><corresp id="cor1">Address correspondence to: Shalini Narayana, Ph.D., Research Imaging Center, The University of Texas Health Science Center, San Antonio, 7703 Floyd Curl Drive MSC 6240, San Antonio, TX 78229-3900, Phone: 210 567-8100, Fax: 210 567-8152, Email: <email>narayana@uthscsa.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>22</day><month>5</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>24</day><month>11</month><year>2008</year></pub-date><pub-date pub-type="ppub"><month>5</month><year>2009</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>5</month><year>2010</year></pub-date><volume>18</volume><issue>2</issue><fpage>146</fpage><lpage>161</lpage><abstract><sec id="S1"><title>Purpose</title><p id="P1">To explore the use of non-invasive functional imaging and “virtual” lesion techniques to study the neural mechanisms underlying motor speech disorders in Parkinson’s disease. Here, we report the use of Positron Emission Tomography (PET) and transcranial magnetic stimulation (TMS) to explain exacerbated speech impairment following subthalamic nucleus deep brain stimulation (STN-DBS) in a patient with Parkinson’s disease.</p></sec><sec sec-type="methods" id="S2"><title>Method</title><p id="P2">Perceptual and acoustic speech measures as well as cerebral blood flow (CBF) during speech as measured by PET were obtained with STN-DBS on and off. TMS was applied to a region in the speech motor network found to be abnormally active during DBS. Speech disruption by TMS was compared both perceptually and acoustically with that resulting from DBS on.</p></sec><sec id="S3"><title>Results</title><p id="P3">Speech production was perceptually inferior and acoustically less contrastive during left STN stimulation compared to no stimulation. Increased neural activity in left dorsal premotor cortex (PMd) was observed during DBS on. “Virtual” lesioning of this region resulted in speech characterized by decreased speech segment duration, increased pause duration, and decreased intelligibility.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">This case report provides evidence that impaired speech production accompanying STN-DBS may be resulting from unintended activation of PMd. Clinical application of functional imaging and TMS may lead to optimizing the delivery of STN-DBS to improve outcomes for speech production as well as general motor abilities.</p></sec></abstract><contract-num rid="NS1">R56 NS036449-09A1
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