Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech.
Identifieur interne : 000062 ( Hal/Checkpoint ); précédent : 000061; suivant : 000063Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech.
Auteurs : Serge Pinto [France] ; Michèle Gentil [France] ; Paul Krack [France] ; Paul Sauleau [France] ; Valérie Fraix [France] ; Alim-Louis Benabid [France] ; Pierre Pollak [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2005-11.
Abstract
Levodopa (L-dopa) and subthalamic nucleus (STN) stimulation treatments have been associated with both improvement and exacerbation of dysarthria in Parkinson's disease (PD). We report four cases illustrating variant responses of dysarthria to dopaminergic and STN stimulation therapies. Patients' motor disability and dysarthria were perceptually rated by the Unified Parkinson's Disease Rating Scale (UPDRS) in four conditions according to medication and STN stimulation. Dedicated software packages allowed acquisition and analysis of acoustic recordings. Case 1, who had a severe off period aphonia, experienced improvement of speech induced by both levodopa and STN stimulation. In Case 2, both treatments worsened speech due to the appearance of dyskinesias. Case 3 had a dysarthria exacerbation induced by STN stimulation with parameters above optimal levels, interpreted as current diffusion from the STN to corticobulbar fibers. In Case 4, dysarthria exacerbation occurred with stimulation at an electrode contact located caudally to the target, also arguing for current diffusion as a potential mechanism of speech worsening. The presented cases demonstrated variant effects in relation to L-dopa and STN stimulation on speech. It seems that motor speech subcomponents can be improved like other limb motor aspect, but that complex coordination of all speech anatomical substrates is not responsive to STN stimulation. These hypotheses may be helpful for better understanding and management of STN stimulation effects on motor speech and skeleton-motor subsystems.
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DOI: 10.1002/mds.20601
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38041 Grenoble Cedex 9</addrLine><country key="FR"></country></address><ref type="url">http://www.ujf-grenoble.fr/</ref></desc></org></tutelle><tutelle name="U318" active="#struct-300002" type="direct"><org type="institution" xml:id="struct-300002" status="VALID"><orgName>INSERM</orgName><desc><address><country key="FR"></country></address></desc></org></tutelle></tutelles></hal:affiliation><country>France</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName><orgName type="university">Université Joseph Fourier</orgName><orgName type="institution" wicri:auto="newGroup">Université de Grenoble</orgName></affiliation></author></analytic><idno type="DOI">10.1002/mds.20601</idno><series><title level="j">Movement Disorders</title><idno type="ISSN">0885-3185</idno><imprint><date type="datePub">2005-11</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Levodopa (L-dopa) and subthalamic nucleus (STN) stimulation treatments have been associated with both improvement and exacerbation of dysarthria in Parkinson's disease (PD). We report four cases illustrating variant responses of dysarthria to dopaminergic and STN stimulation therapies. Patients' motor disability and dysarthria were perceptually rated by the Unified Parkinson's Disease Rating Scale (UPDRS) in four conditions according to medication and STN stimulation. Dedicated software packages allowed acquisition and analysis of acoustic recordings. Case 1, who had a severe off period aphonia, experienced improvement of speech induced by both levodopa and STN stimulation. In Case 2, both treatments worsened speech due to the appearance of dyskinesias. Case 3 had a dysarthria exacerbation induced by STN stimulation with parameters above optimal levels, interpreted as current diffusion from the STN to corticobulbar fibers. In Case 4, dysarthria exacerbation occurred with stimulation at an electrode contact located caudally to the target, also arguing for current diffusion as a potential mechanism of speech worsening. The presented cases demonstrated variant effects in relation to L-dopa and STN stimulation on speech. It seems that motor speech subcomponents can be improved like other limb motor aspect, but that complex coordination of all speech anatomical substrates is not responsive to STN stimulation. These hypotheses may be helpful for better understanding and management of STN stimulation effects on motor speech and skeleton-motor subsystems.</div></front></TEI><hal api="V3"><titleStmt><title xml:lang="en">Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech.</title><author role="aut"><persName><forename type="first">Serge</forename><surname>Pinto</surname></persName><email></email><idno type="halauthor">403228</idno><affiliation ref="#struct-2812"></affiliation></author><author role="aut"><persName><forename type="first">Michèle</forename><surname>Gentil</surname></persName><email></email><idno type="halauthor">296410</idno><affiliation ref="#struct-2812"></affiliation></author><author role="aut"><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><email></email><idno type="halauthor">296412</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-14242"></affiliation></author><author role="aut"><persName><forename type="first">Paul</forename><surname>Sauleau</surname></persName><email></email><idno type="halauthor">296413</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-33545"></affiliation></author><author role="aut"><persName><forename type="first">Valérie</forename><surname>Fraix</surname></persName><email></email><idno type="halauthor">296411</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-14242"></affiliation></author><author role="aut"><persName><forename type="first">Alim-Louis</forename><surname>Benabid</surname></persName><email></email><idno type="halauthor">296407</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-92131"></affiliation></author><author role="aut"><persName><forename type="first">Pierre</forename><surname>Pollak</surname></persName><email></email><idno type="halauthor">233619</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-14242"></affiliation></author><editor role="depositor"><persName><forename>Marc</forename><surname>Savasta</surname></persName><email>marc.savasta@ujf-grenoble.fr</email></editor></titleStmt><editionStmt><edition n="v1" type="current"><date type="whenSubmitted">2009-06-04 12:16:02</date><date type="whenModified">2009-06-11 14:58:30</date><date type="whenReleased">2009-06-11 14:58:30</date><date type="whenProduced">2005-11</date></edition><respStmt><resp>contributor</resp><name key="140382"><persName><forename>Marc</forename><surname>Savasta</surname></persName><email>marc.savasta@ujf-grenoble.fr</email></name></respStmt></editionStmt><publicationStmt><distributor>CCSD</distributor><idno type="halId">inserm-00391641</idno><idno type="halUri">http://www.hal.inserm.fr/inserm-00391641</idno><idno type="halBibtex">pinto:inserm-00391641</idno><idno type="halRefHtml">Movement Disorders, Wiley, 2005, 20 (11), pp.1507-15. <10.1002/mds.20601></idno><idno type="halRef">Movement Disorders, Wiley, 2005, 20 (11), pp.1507-15. <10.1002/mds.20601></idno></publicationStmt><seriesStmt><idno type="stamp" n="INSERM">INSERM - Institut national de la santé et de la recherche médicale</idno><idno type="stamp" n="UNIV-GRENOBLE1" p="UGA">Université Joseph Fourier - Grenoble I</idno><idno type="stamp" n="UNIV-RENNES1">Université de Rennes 1</idno><idno type="stamp" n="HL">Publications CHU - Rennes 1</idno><idno type="stamp" n="UGA">HAL Grenoble Alpes</idno></seriesStmt><notesStmt><note type="audience" n="2">International</note><note type="popular" n="0">No</note><note type="peer" n="1">Yes</note></notesStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech.</title><author role="aut"><persName><forename type="first">Serge</forename><surname>Pinto</surname></persName><idno type="halAuthorId">403228</idno><affiliation ref="#struct-2812"></affiliation></author><author role="aut"><persName><forename type="first">Michèle</forename><surname>Gentil</surname></persName><idno type="halAuthorId">296410</idno><affiliation ref="#struct-2812"></affiliation></author><author role="aut"><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><idno type="halAuthorId">296412</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-14242"></affiliation></author><author role="aut"><persName><forename type="first">Paul</forename><surname>Sauleau</surname></persName><idno type="halAuthorId">296413</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-33545"></affiliation></author><author role="aut"><persName><forename type="first">Valérie</forename><surname>Fraix</surname></persName><idno type="halAuthorId">296411</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-14242"></affiliation></author><author role="aut"><persName><forename type="first">Alim-Louis</forename><surname>Benabid</surname></persName><idno type="halAuthorId">296407</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-92131"></affiliation></author><author role="aut"><persName><forename type="first">Pierre</forename><surname>Pollak</surname></persName><idno type="halAuthorId">233619</idno><affiliation ref="#struct-2812"></affiliation><affiliation ref="#struct-14242"></affiliation></author></analytic><monogr><idno type="halJournalId" status="VALID">17211</idno><idno type="issn">0885-3185</idno><idno type="eissn">1531-8257</idno><title level="j">Movement Disorders</title><imprint><publisher>Wiley</publisher><biblScope unit="volume">20</biblScope><biblScope unit="issue">11</biblScope><biblScope unit="pp">1507-15</biblScope><date type="datePub">2005-11</date></imprint></monogr><idno type="doi">10.1002/mds.20601</idno><idno type="pubmed">16037917</idno></biblStruct></sourceDesc><profileDesc><langUsage><language ident="en">English</language></langUsage><textClass><classCode scheme="mesh">Adult</classCode><classCode scheme="mesh">Dysarthria</classCode><classCode scheme="mesh">Subthalamic Nucleus</classCode><classCode scheme="mesh">Dyskinesias</classCode><classCode scheme="mesh">Electric Stimulation Therapy</classCode><classCode scheme="mesh">Functional Laterality</classCode><classCode scheme="mesh">Humans</classCode><classCode scheme="mesh">Levodopa</classCode><classCode scheme="mesh">Middle Aged</classCode><classCode scheme="mesh">Parkinsonian Disorders</classCode><classCode scheme="mesh">Severity of Illness Index</classCode><classCode scheme="halDomain" n="sdv.bbm">Life Sciences [q-bio]/Biochemistry, Molecular Biology</classCode><classCode scheme="halTypology" n="ART">Journal articles</classCode></textClass><abstract xml:lang="en">Levodopa (L-dopa) and subthalamic nucleus (STN) stimulation treatments have been associated with both improvement and exacerbation of dysarthria in Parkinson's disease (PD). We report four cases illustrating variant responses of dysarthria to dopaminergic and STN stimulation therapies. Patients' motor disability and dysarthria were perceptually rated by the Unified Parkinson's Disease Rating Scale (UPDRS) in four conditions according to medication and STN stimulation. Dedicated software packages allowed acquisition and analysis of acoustic recordings. Case 1, who had a severe off period aphonia, experienced improvement of speech induced by both levodopa and STN stimulation. In Case 2, both treatments worsened speech due to the appearance of dyskinesias. Case 3 had a dysarthria exacerbation induced by STN stimulation with parameters above optimal levels, interpreted as current diffusion from the STN to corticobulbar fibers. In Case 4, dysarthria exacerbation occurred with stimulation at an electrode contact located caudally to the target, also arguing for current diffusion as a potential mechanism of speech worsening. The presented cases demonstrated variant effects in relation to L-dopa and STN stimulation on speech. It seems that motor speech subcomponents can be improved like other limb motor aspect, but that complex coordination of all speech anatomical substrates is not responsive to STN stimulation. These hypotheses may be helpful for better understanding and management of STN stimulation effects on motor speech and skeleton-motor subsystems.</abstract></profileDesc></hal></record>Pour manipuler ce document sous Unix (Dilib)
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