Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility.
Identifieur interne : 001032 ( PubMed/Corpus ); précédent : 001031; suivant : 001033Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility.
Auteurs : Marc Rousseaux ; Pierre Krystkowiak ; Odile Kozlowski ; Canan Ozsancak ; Serge Blond ; Alain DestéeSource :
- Journal of neurology [ 0340-5354 ] ; 2004.
English descriptors
- KwdEn :
- Aged, Analysis of Variance, Dysarthria (physiopathology), Dysarthria (therapy), Electric Stimulation Therapy (methods), Electric Stimulation Therapy (statistics & numerical data), Female, Humans, Male, Middle Aged, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Prospective Studies, Speech Intelligibility (physiology), Subthalamic Nucleus (physiology).
- MESH :
- methods : Electric Stimulation Therapy.
- physiology : Speech Intelligibility, Subthalamic Nucleus.
- physiopathology : Dysarthria, Parkinson Disease.
- statistics & numerical data : Electric Stimulation Therapy.
- therapy : Dysarthria, Parkinson Disease.
- Aged, Analysis of Variance, Female, Humans, Male, Middle Aged, Prospective Studies.
Abstract
Subthalamic stimulation is known to improve tremor, akinesia and rigidity in Parkinson's disease. However, other signs such as hypophonia and swallowing disorders can be relatively resistant to this technique. The effect on dysarthria remains unclear. The aim of this study was to investigate the effects of implantation of electrode and stimulation of the subthalamic nucleus (STN) on parkinsonian dysarthria. Seven patients were prospectively included. Electrodes (Medtronic) were implanted in both STN. The electrode contacts and stimulation parameters were adjusted to provide best relief of symptoms with fewest side effects. Assessment used global scales (Unified Parkinson Disease Rating Scale, UPDRS II and III), dyskinesia scale, exhaustive dysarthria assessment (bucco-facial movements, voice, articulation, intelligibility) and the 'dysarthria' item from the UPDRS III. Evaluations were performed in six conditions: before and three months after surgery (pre-op, post-op) stimulation turned off or on (off-stim, onstim), and without or with a suprathreshold levodopa dose (offdrug, on-drug). Performance level on the UPDRS III significantly improved following electrode implantation and stimulation. For dysarthria, modest beneficial effects were observed on several motor parameters, especially lip movements. Voice mildly improved, especially for the modulation in loudness and pitch. Articulation was not affected. Furthermore, intelligibility was slightly reduced in the on-stimulation condition, especially when patients received levodopa. At an individual level, negative effects on intelligibility were observed in two patients, and this was associated with a discrete increase in facial and trunk dyskinesias, but not with the electrode position or stimulation parameters. In conclusion, surgery had weak effects on dysarthria. Intelligibility can be worsened, especially in the on-drug condition. Thus, adaptation of the stimulation parameters can be difficult.
DOI: 10.1007/s00415-004-0327-1
PubMed: 15015014
Links to Exploration step
pubmed:15015014Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility.</title><author><name sortKey="Rousseaux, Marc" sort="Rousseaux, Marc" uniqKey="Rousseaux M" first="Marc" last="Rousseaux">Marc Rousseaux</name><affiliation><nlm:affiliation>Service de Rééducation Neurologique, Hôpital Swynghedauw, CHU Lille, Lille Cedex, 59037, France. mrousseaux@chru-lille.fr</nlm:affiliation></affiliation></author><author><name sortKey="Krystkowiak, Pierre" sort="Krystkowiak, Pierre" uniqKey="Krystkowiak P" first="Pierre" last="Krystkowiak">Pierre Krystkowiak</name></author><author><name sortKey="Kozlowski, Odile" sort="Kozlowski, Odile" uniqKey="Kozlowski O" first="Odile" last="Kozlowski">Odile Kozlowski</name></author><author><name sortKey="Ozsancak, Canan" sort="Ozsancak, Canan" uniqKey="Ozsancak C" first="Canan" last="Ozsancak">Canan Ozsancak</name></author><author><name sortKey="Blond, Serge" sort="Blond, Serge" uniqKey="Blond S" first="Serge" last="Blond">Serge Blond</name></author><author><name sortKey="Destee, Alain" sort="Destee, Alain" uniqKey="Destee A" first="Alain" last="Destée">Alain Destée</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2004">2004</date><idno type="RBID">pubmed:15015014</idno><idno type="pmid">15015014</idno><idno type="doi">10.1007/s00415-004-0327-1</idno><idno type="wicri:Area/PubMed/Corpus">001032</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001032</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility.</title><author><name sortKey="Rousseaux, Marc" sort="Rousseaux, Marc" uniqKey="Rousseaux M" first="Marc" last="Rousseaux">Marc Rousseaux</name><affiliation><nlm:affiliation>Service de Rééducation Neurologique, Hôpital Swynghedauw, CHU Lille, Lille Cedex, 59037, France. mrousseaux@chru-lille.fr</nlm:affiliation></affiliation></author><author><name sortKey="Krystkowiak, Pierre" sort="Krystkowiak, Pierre" uniqKey="Krystkowiak P" first="Pierre" last="Krystkowiak">Pierre Krystkowiak</name></author><author><name sortKey="Kozlowski, Odile" sort="Kozlowski, Odile" uniqKey="Kozlowski O" first="Odile" last="Kozlowski">Odile Kozlowski</name></author><author><name sortKey="Ozsancak, Canan" sort="Ozsancak, Canan" uniqKey="Ozsancak C" first="Canan" last="Ozsancak">Canan Ozsancak</name></author><author><name sortKey="Blond, Serge" sort="Blond, Serge" uniqKey="Blond S" first="Serge" last="Blond">Serge Blond</name></author><author><name sortKey="Destee, Alain" sort="Destee, Alain" uniqKey="Destee A" first="Alain" last="Destée">Alain Destée</name></author></analytic><series><title level="j">Journal of neurology</title><idno type="ISSN">0340-5354</idno><imprint><date when="2004" type="published">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Analysis of Variance</term><term>Dysarthria (physiopathology)</term><term>Dysarthria (therapy)</term><term>Electric Stimulation Therapy (methods)</term><term>Electric Stimulation Therapy (statistics & numerical data)</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>Prospective Studies</term><term>Speech Intelligibility (physiology)</term><term>Subthalamic Nucleus (physiology)</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Speech Intelligibility</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Dysarthria</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dysarthria</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Analysis of Variance</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Subthalamic stimulation is known to improve tremor, akinesia and rigidity in Parkinson's disease. However, other signs such as hypophonia and swallowing disorders can be relatively resistant to this technique. The effect on dysarthria remains unclear. The aim of this study was to investigate the effects of implantation of electrode and stimulation of the subthalamic nucleus (STN) on parkinsonian dysarthria. Seven patients were prospectively included. Electrodes (Medtronic) were implanted in both STN. The electrode contacts and stimulation parameters were adjusted to provide best relief of symptoms with fewest side effects. Assessment used global scales (Unified Parkinson Disease Rating Scale, UPDRS II and III), dyskinesia scale, exhaustive dysarthria assessment (bucco-facial movements, voice, articulation, intelligibility) and the 'dysarthria' item from the UPDRS III. Evaluations were performed in six conditions: before and three months after surgery (pre-op, post-op) stimulation turned off or on (off-stim, onstim), and without or with a suprathreshold levodopa dose (offdrug, on-drug). Performance level on the UPDRS III significantly improved following electrode implantation and stimulation. For dysarthria, modest beneficial effects were observed on several motor parameters, especially lip movements. Voice mildly improved, especially for the modulation in loudness and pitch. Articulation was not affected. Furthermore, intelligibility was slightly reduced in the on-stimulation condition, especially when patients received levodopa. At an individual level, negative effects on intelligibility were observed in two patients, and this was associated with a discrete increase in facial and trunk dyskinesias, but not with the electrode position or stimulation parameters. In conclusion, surgery had weak effects on dysarthria. Intelligibility can be worsened, especially in the on-drug condition. Thus, adaptation of the stimulation parameters can be difficult.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">15015014</PMID><DateCreated><Year>2004</Year><Month>03</Month><Day>11</Day></DateCreated><DateCompleted><Year>2004</Year><Month>05</Month><Day>19</Day></DateCompleted><DateRevised><Year>2006</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0340-5354</ISSN><JournalIssue CitedMedium="Print"><Volume>251</Volume><Issue>3</Issue><PubDate><Year>2004</Year><Month>Mar</Month></PubDate></JournalIssue><Title>Journal of neurology</Title><ISOAbbreviation>J. Neurol.</ISOAbbreviation></Journal><ArticleTitle>Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility.</ArticleTitle><Pagination><MedlinePgn>327-34</MedlinePgn></Pagination><Abstract><AbstractText>Subthalamic stimulation is known to improve tremor, akinesia and rigidity in Parkinson's disease. However, other signs such as hypophonia and swallowing disorders can be relatively resistant to this technique. The effect on dysarthria remains unclear. The aim of this study was to investigate the effects of implantation of electrode and stimulation of the subthalamic nucleus (STN) on parkinsonian dysarthria. Seven patients were prospectively included. Electrodes (Medtronic) were implanted in both STN. The electrode contacts and stimulation parameters were adjusted to provide best relief of symptoms with fewest side effects. Assessment used global scales (Unified Parkinson Disease Rating Scale, UPDRS II and III), dyskinesia scale, exhaustive dysarthria assessment (bucco-facial movements, voice, articulation, intelligibility) and the 'dysarthria' item from the UPDRS III. Evaluations were performed in six conditions: before and three months after surgery (pre-op, post-op) stimulation turned off or on (off-stim, onstim), and without or with a suprathreshold levodopa dose (offdrug, on-drug). Performance level on the UPDRS III significantly improved following electrode implantation and stimulation. For dysarthria, modest beneficial effects were observed on several motor parameters, especially lip movements. Voice mildly improved, especially for the modulation in loudness and pitch. Articulation was not affected. Furthermore, intelligibility was slightly reduced in the on-stimulation condition, especially when patients received levodopa. At an individual level, negative effects on intelligibility were observed in two patients, and this was associated with a discrete increase in facial and trunk dyskinesias, but not with the electrode position or stimulation parameters. In conclusion, surgery had weak effects on dysarthria. Intelligibility can be worsened, especially in the on-drug condition. Thus, adaptation of the stimulation parameters can be difficult.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rousseaux</LastName><ForeName>Marc</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Service de Rééducation Neurologique, Hôpital Swynghedauw, CHU Lille, Lille Cedex, 59037, France. mrousseaux@chru-lille.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krystkowiak</LastName><ForeName>Pierre</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Kozlowski</LastName><ForeName>Odile</ForeName><Initials>O</Initials></Author><Author ValidYN="Y"><LastName>Ozsancak</LastName><ForeName>Canan</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Blond</LastName><ForeName>Serge</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Destée</LastName><ForeName>Alain</ForeName><Initials>A</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>J Neurol</MedlineTA><NlmUniqueID>0423161</NlmUniqueID><ISSNLinking>0340-5354</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000704" MajorTopicYN="N">Analysis of Variance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004401" MajorTopicYN="N">Dysarthria</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004599" MajorTopicYN="N">Electric Stimulation Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013065" MajorTopicYN="N">Speech Intelligibility</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D020531" MajorTopicYN="N">Subthalamic Nucleus</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="Y">physiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2003</Year><Month>07</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2003</Year><Month>10</Month><Day>21</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2003</Year><Month>10</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2004</Year><Month>3</Month><Day>12</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2004</Year><Month>5</Month><Day>20</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2004</Year><Month>3</Month><Day>12</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">15015014</ArticleId><ArticleId IdType="doi">10.1007/s00415-004-0327-1</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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