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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease</title>
<author><name sortKey="Tripoliti, E" sort="Tripoliti, E" uniqKey="Tripoliti E" first="E." last="Tripoliti">E. Tripoliti</name>
</author>
<author><name sortKey="Zrinzo, L" sort="Zrinzo, L" uniqKey="Zrinzo L" first="L." last="Zrinzo">L. Zrinzo</name>
</author>
<author><name sortKey="Martinez Torres, I" sort="Martinez Torres, I" uniqKey="Martinez Torres I" first="I." last="Martinez-Torres">I. Martinez-Torres</name>
</author>
<author><name sortKey="Frost, E" sort="Frost, E" uniqKey="Frost E" first="E." last="Frost">E. Frost</name>
</author>
<author><name sortKey="Pinto, S" sort="Pinto, S" uniqKey="Pinto S" first="S." last="Pinto">S. Pinto</name>
</author>
<author><name sortKey="Foltynie, T" sort="Foltynie, T" uniqKey="Foltynie T" first="T." last="Foltynie">T. Foltynie</name>
</author>
<author><name sortKey="Holl, E" sort="Holl, E" uniqKey="Holl E" first="E." last="Holl">E. Holl</name>
</author>
<author><name sortKey="Petersen, E" sort="Petersen, E" uniqKey="Petersen E" first="E." last="Petersen">E. Petersen</name>
</author>
<author><name sortKey="Roughton, M" sort="Roughton, M" uniqKey="Roughton M" first="M." last="Roughton">M. Roughton</name>
</author>
<author><name sortKey="Hariz, M I" sort="Hariz, M I" uniqKey="Hariz M" first="M. I." last="Hariz">M. I. Hariz</name>
</author>
<author><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P." last="Limousin">P. Limousin</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">21068426</idno>
<idno type="pmc">3262409</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262409</idno>
<idno type="RBID">PMC:3262409</idno>
<idno type="doi">10.1212/WNL.0b013e318203e7d0</idno>
<date when="2010">2010</date>
<idno type="wicri:Area/Pmc/Corpus">000515</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000515</idno>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease</title>
<author><name sortKey="Tripoliti, E" sort="Tripoliti, E" uniqKey="Tripoliti E" first="E." last="Tripoliti">E. Tripoliti</name>
</author>
<author><name sortKey="Zrinzo, L" sort="Zrinzo, L" uniqKey="Zrinzo L" first="L." last="Zrinzo">L. Zrinzo</name>
</author>
<author><name sortKey="Martinez Torres, I" sort="Martinez Torres, I" uniqKey="Martinez Torres I" first="I." last="Martinez-Torres">I. Martinez-Torres</name>
</author>
<author><name sortKey="Frost, E" sort="Frost, E" uniqKey="Frost E" first="E." last="Frost">E. Frost</name>
</author>
<author><name sortKey="Pinto, S" sort="Pinto, S" uniqKey="Pinto S" first="S." last="Pinto">S. Pinto</name>
</author>
<author><name sortKey="Foltynie, T" sort="Foltynie, T" uniqKey="Foltynie T" first="T." last="Foltynie">T. Foltynie</name>
</author>
<author><name sortKey="Holl, E" sort="Holl, E" uniqKey="Holl E" first="E." last="Holl">E. Holl</name>
</author>
<author><name sortKey="Petersen, E" sort="Petersen, E" uniqKey="Petersen E" first="E." last="Petersen">E. Petersen</name>
</author>
<author><name sortKey="Roughton, M" sort="Roughton, M" uniqKey="Roughton M" first="M." last="Roughton">M. Roughton</name>
</author>
<author><name sortKey="Hariz, M I" sort="Hariz, M I" uniqKey="Hariz M" first="M. I." last="Hariz">M. I. Hariz</name>
</author>
<author><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P." last="Limousin">P. Limousin</name>
</author>
</analytic>
<series><title level="j">Neurology</title>
<idno type="ISSN">0028-3878</idno>
<idno type="eISSN">1526-632X</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective:</title>
<p>Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson disease (PD). Following STN-DBS, speech intelligibility can deteriorate, limiting its beneficial effect. Here we prospectively examined the short- and long-term speech response to STN-DBS in a consecutive series of patients to identify clinical and surgical factors associated with speech change.</p>
</sec>
<sec><title>Methods:</title>
<p>Thirty-two consecutive patients were assessed before surgery, then 1 month, 6 months, and 1 year after STN-DBS in 4 conditions on- and off-medication with on- and off-stimulation using established and validated speech and movement scales. Fifteen of these patients were followed up for 3 years. A control group of 12 patients with PD were followed up for 1 year.</p>
</sec>
<sec><title>Results:</title>
<p>Within the surgical group, speech intelligibility significantly deteriorated by an average of 14.2% ± 20.15% off-medication and 16.9% ± 21.8% on-medication 1 year after STN-DBS. The medical group deteriorated by 3.6% ± 5.5% and 4.5% ± 8.8%, respectively. Seven patients showed speech amelioration after surgery. Loudness increased significantly in all tasks with stimulation. A less severe preoperative on-medication motor score was associated with a more favorable speech response to STN-DBS after 1 year. Medially located electrodes on the left STN were associated with a significantly higher risk of speech deterioration than electrodes within the nucleus. There was a strong relationship between high voltage in the left electrode and poor speech outcome at 1 year.</p>
</sec>
<sec><title>Conclusion:</title>
<p>The effect of STN-DBS on speech is variable and multifactorial, with most patients exhibiting decline of speech intelligibility. Both medical and surgical issues contribute to deterioration of speech in STN-DBS patients.</p>
</sec>
<sec><title>Classification of evidence:</title>
<p>This study provides Class III evidence that STN-DBS for PD results in deterioration in speech intelligibility in all combinations of medication and stimulation states at 1 month, 6 months, and 1 year compared to baseline and to control subjects treated with best medical therapy.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Neurology</journal-id>
<journal-id journal-id-type="hwp">neurology</journal-id>
<journal-id journal-id-type="publisher-id">neur</journal-id>
<journal-id journal-id-type="pmc">neurology</journal-id>
<journal-id journal-id-type="publisher-id">WNL</journal-id>
<journal-title-group><journal-title>Neurology</journal-title>
</journal-title-group>
<issn pub-type="ppub">0028-3878</issn>
<issn pub-type="epub">1526-632X</issn>
<publisher><publisher-name>Lippincott Williams & Wilkins</publisher-name>
<publisher-loc>Hagerstown, MD</publisher-loc>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">21068426</article-id>
<article-id pub-id-type="pmc">3262409</article-id>
<article-id pub-id-type="publisher-id">WNL202074</article-id>
<article-id pub-id-type="doi">10.1212/WNL.0b013e318203e7d0</article-id>
<article-categories><subj-group subj-group-type="hwp-journal-coll"><subject>313</subject>
<subject>165</subject>
</subj-group>
<subj-group subj-group-type="heading"><subject>Articles</subject>
</subj-group>
</article-categories>
<title-group><article-title>Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Tripoliti</surname>
<given-names>E.</given-names>
</name>
<degrees>MPhil</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Zrinzo</surname>
<given-names>L.</given-names>
</name>
<degrees>MD, MSc</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Martinez-Torres</surname>
<given-names>I.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Frost</surname>
<given-names>E.</given-names>
</name>
<degrees>MSc</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Pinto</surname>
<given-names>S.</given-names>
</name>
<degrees>PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Foltynie</surname>
<given-names>T.</given-names>
</name>
<degrees>MRCP, PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Holl</surname>
<given-names>E.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Petersen</surname>
<given-names>E.</given-names>
</name>
<degrees>MD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Roughton</surname>
<given-names>M.</given-names>
</name>
<degrees>MSc</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Hariz</surname>
<given-names>M.I.</given-names>
</name>
<degrees>MD, PhD</degrees>
</contrib>
<contrib contrib-type="author"><name><surname>Limousin</surname>
<given-names>P.</given-names>
</name>
<degrees>MD, PhD</degrees>
</contrib>
<aff>From the UCL (E.T., L.Z., E.F., T.F., M.I.H., P.L.), Institute of Neurology, Sobell Department, Unit of Functional Neurosurgery, Queen Square, London, UK; Neurological Department (I.M.-T.), University Hospital La Fe, Valencia, Spain; Laboratoire Parole et Langage (S.P.), CNRS/Aix-Marseille Universite, France; Medical University Graz (E.H.), Austria; Department of Neurosurgery (E.P.), University of Texas Southwestern Medical Center, Dallas; and Cancer Research UK & UCL Cancer Trials Centre (M.R.), UCL, London, UK.</aff>
</contrib-group>
<author-notes><corresp>Address correspondence and reprint requests to Dr. Elina Tripoliti, <addr-line>Unit of Functional Neurosurgery, UCL Institute of Neurology, Box 146, Queen Square, London, WC1N 3BG, UK</addr-line>
<email>e.tripoliti@ion.ucl.ac.uk</email>
</corresp>
<fn fn-type="other"><p><italic>Study funding:</italic>
Supported by the Parkinson's Disease Society UK (grant 4070), Parkinson's Appeal, Brain Research Trust, Medtronic, and the NIH (R01-NS40902). This work was undertaken at UCLH/UCL, which received a proportion of funding from the UK Department of Health's NIHR Biomedical Research Centres funding scheme.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub"><day>4</day>
<month>1</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>11</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>4</day>
<month>1</month>
<year>2012</year>
</pub-date>
<pmc-comment> PMC Release delay is 12 months and 0 days and was based on the
. </pmc-comment>
<volume>76</volume>
<issue>1</issue>
<fpage>80</fpage>
<lpage>86</lpage>
<history><date date-type="received"><day>14</day>
<month>12</month>
<year>2009</year>
</date>
<date date-type="accepted"><day>3</day>
<month>9</month>
<year>2010</year>
</date>
</history>
<permissions><copyright-statement>Copyright © 2010 by AAN Enterprises, Inc.</copyright-statement>
<copyright-year>2010</copyright-year>
<copyright-holder>AAN Enterprises, Inc.</copyright-holder>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="znl00111000080.pdf"></self-uri>
<abstract><sec><title>Objective:</title>
<p>Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for advanced Parkinson disease (PD). Following STN-DBS, speech intelligibility can deteriorate, limiting its beneficial effect. Here we prospectively examined the short- and long-term speech response to STN-DBS in a consecutive series of patients to identify clinical and surgical factors associated with speech change.</p>
</sec>
<sec><title>Methods:</title>
<p>Thirty-two consecutive patients were assessed before surgery, then 1 month, 6 months, and 1 year after STN-DBS in 4 conditions on- and off-medication with on- and off-stimulation using established and validated speech and movement scales. Fifteen of these patients were followed up for 3 years. A control group of 12 patients with PD were followed up for 1 year.</p>
</sec>
<sec><title>Results:</title>
<p>Within the surgical group, speech intelligibility significantly deteriorated by an average of 14.2% ± 20.15% off-medication and 16.9% ± 21.8% on-medication 1 year after STN-DBS. The medical group deteriorated by 3.6% ± 5.5% and 4.5% ± 8.8%, respectively. Seven patients showed speech amelioration after surgery. Loudness increased significantly in all tasks with stimulation. A less severe preoperative on-medication motor score was associated with a more favorable speech response to STN-DBS after 1 year. Medially located electrodes on the left STN were associated with a significantly higher risk of speech deterioration than electrodes within the nucleus. There was a strong relationship between high voltage in the left electrode and poor speech outcome at 1 year.</p>
</sec>
<sec><title>Conclusion:</title>
<p>The effect of STN-DBS on speech is variable and multifactorial, with most patients exhibiting decline of speech intelligibility. Both medical and surgical issues contribute to deterioration of speech in STN-DBS patients.</p>
</sec>
<sec><title>Classification of evidence:</title>
<p>This study provides Class III evidence that STN-DBS for PD results in deterioration in speech intelligibility in all combinations of medication and stimulation states at 1 month, 6 months, and 1 year compared to baseline and to control subjects treated with best medical therapy.</p>
</sec>
</abstract>
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</front>
</pmc>
</record>
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