Predictive factors of speech intelligibility following subthalamic nucleus stimulation in consecutive patients with Parkinson's disease.
Identifieur interne : 000471 ( Main/Exploration ); précédent : 000470; suivant : 000472Predictive factors of speech intelligibility following subthalamic nucleus stimulation in consecutive patients with Parkinson's disease.
Auteurs : Elina Tripoliti [Royaume-Uni] ; Patricia Limousin ; Tom Foltynie ; Joseph Candelario ; Iciar Aviles-Olmos ; Marwan I. Hariz ; Ludvic ZrinzoSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- physiology : Speech Intelligibility.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Treatment Outcome.
Abstract
Speech changes after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) can be variable, with the majority of patients experiencing speech deterioration over time. The aim of this study was to describe the perceptual characteristics of speech following chronic STN-DBS and to analyze clinical and surgical factors that could predict speech change. Fifty-four consecutive patients (34 men; mean age ± standard deviation (SD), 58.8 ± 6.3 years; mean ± SD disease duration, 12.5 ± 4.7 years; mean ± SD levodopa equivalent, 1556 ± 671 mg/day; mean ± SD Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) off-medication score, 48.1 ± 17.9 [range, 20-89]; and mean ± SD UPDRS-III on-medication score, 12.4 ± 7.8 [range, 2-31]) participated in this study. They were assessed before and at 1 year after surgery using the Assessment of Intelligibility for the Dysarthric Speech, the perceptual scale from Darley et al., and the UPDRS-III. Speech intelligibility deteriorated on average by 14.4% (P = 0.0006) after 1 year of STN-DBS when off-medication and by 12.3% (P = 0.001) when on-medication. The effect on speech was not linked to age at surgery, unlike the effect on motor outcome. The most significant predictive factors for deterioration of speech intelligibility when patients were off-medication/on-stimulation were lower preoperative speech intelligibility on-medication, longer disease duration, and medially placed left hemisphere active electrode contact. Speech change after STN-DBS is variable and multifactorial. Consistent preoperative speech evaluation would help inform patients about the possible effects of surgery. Appropriate consideration of speech deficits might assist surgical targeting, particularly of the left electrode.
DOI: 10.1002/mds.25816
PubMed: 24532491
Affiliations:
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Hariz</name></author><author><name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2014">2014</date><idno type="RBID">pubmed:24532491</idno><idno type="pmid">24532491</idno><idno type="doi">10.1002/mds.25816</idno><idno type="wicri:Area/PubMed/Corpus">000575</idno><idno type="wicri:Area/PubMed/Curation">000575</idno><idno type="wicri:Area/PubMed/Checkpoint">000475</idno><idno type="wicri:Area/Ncbi/Merge">003F22</idno><idno type="wicri:Area/Ncbi/Curation">003F22</idno><idno type="wicri:Area/Ncbi/Checkpoint">003F22</idno><idno type="wicri:Area/Main/Merge">000471</idno><idno type="wicri:Area/Main/Curation">000471</idno><idno type="wicri:Area/Main/Exploration">000471</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Predictive factors of speech intelligibility following subthalamic nucleus stimulation in consecutive patients with Parkinson's disease.</title><author><name sortKey="Tripoliti, Elina" sort="Tripoliti, Elina" uniqKey="Tripoliti E" first="Elina" last="Tripoliti">Elina Tripoliti</name><affiliation wicri:level="3"><nlm:affiliation>Unit of Functional Neurosurgery, University College London (UCL) Institute of Neurology, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Unit of Functional Neurosurgery, University College London (UCL) Institute of Neurology, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Limousin, Patricia" sort="Limousin, Patricia" uniqKey="Limousin P" first="Patricia" last="Limousin">Patricia Limousin</name></author><author><name sortKey="Foltynie, Tom" sort="Foltynie, Tom" uniqKey="Foltynie T" first="Tom" last="Foltynie">Tom Foltynie</name></author><author><name sortKey="Candelario, Joseph" sort="Candelario, Joseph" uniqKey="Candelario J" first="Joseph" last="Candelario">Joseph Candelario</name></author><author><name sortKey="Aviles Olmos, Iciar" sort="Aviles Olmos, Iciar" uniqKey="Aviles Olmos I" first="Iciar" last="Aviles-Olmos">Iciar Aviles-Olmos</name></author><author><name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I" last="Hariz">Marwan I. Hariz</name></author><author><name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2014" type="published">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Speech Intelligibility (physiology)</term><term>Subthalamic Nucleus (physiopathology)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Speech Intelligibility</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Speech changes after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) can be variable, with the majority of patients experiencing speech deterioration over time. The aim of this study was to describe the perceptual characteristics of speech following chronic STN-DBS and to analyze clinical and surgical factors that could predict speech change. Fifty-four consecutive patients (34 men; mean age ± standard deviation (SD), 58.8 ± 6.3 years; mean ± SD disease duration, 12.5 ± 4.7 years; mean ± SD levodopa equivalent, 1556 ± 671 mg/day; mean ± SD Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) off-medication score, 48.1 ± 17.9 [range, 20-89]; and mean ± SD UPDRS-III on-medication score, 12.4 ± 7.8 [range, 2-31]) participated in this study. They were assessed before and at 1 year after surgery using the Assessment of Intelligibility for the Dysarthric Speech, the perceptual scale from Darley et al., and the UPDRS-III. Speech intelligibility deteriorated on average by 14.4% (P = 0.0006) after 1 year of STN-DBS when off-medication and by 12.3% (P = 0.001) when on-medication. The effect on speech was not linked to age at surgery, unlike the effect on motor outcome. The most significant predictive factors for deterioration of speech intelligibility when patients were off-medication/on-stimulation were lower preoperative speech intelligibility on-medication, longer disease duration, and medially placed left hemisphere active electrode contact. Speech change after STN-DBS is variable and multifactorial. Consistent preoperative speech evaluation would help inform patients about the possible effects of surgery. Appropriate consideration of speech deficits might assist surgical targeting, particularly of the left electrode.</div></front></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement></list><tree><noCountry><name sortKey="Aviles Olmos, Iciar" sort="Aviles Olmos, Iciar" uniqKey="Aviles Olmos I" first="Iciar" last="Aviles-Olmos">Iciar Aviles-Olmos</name><name sortKey="Candelario, Joseph" sort="Candelario, Joseph" uniqKey="Candelario J" first="Joseph" last="Candelario">Joseph Candelario</name><name sortKey="Foltynie, Tom" sort="Foltynie, Tom" uniqKey="Foltynie T" first="Tom" last="Foltynie">Tom Foltynie</name><name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I" last="Hariz">Marwan I. Hariz</name><name sortKey="Limousin, Patricia" sort="Limousin, Patricia" uniqKey="Limousin P" first="Patricia" last="Limousin">Patricia Limousin</name><name sortKey="Zrinzo, Ludvic" sort="Zrinzo, Ludvic" uniqKey="Zrinzo L" first="Ludvic" last="Zrinzo">Ludvic Zrinzo</name></noCountry><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Tripoliti, Elina" sort="Tripoliti, Elina" uniqKey="Tripoliti E" first="Elina" last="Tripoliti">Elina Tripoliti</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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