Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech

Autor: Serge Pinto, Pierre Pollak, Alim-Louis Benabid, Valérie Fraix, Paul Krack, Michèle Gentil, Paul Sauleau
Přispěvatelé: Neurosciences précliniques, Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de neurologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Service de neurologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Département de neurochirurgie, Savasta, Marc, Université de Rennes (UR)
Jazyk: angličtina
Rok vydání: 2005
Předmět:
Parkinson's disease
Parkinsonian Disorders/*physiopathology/*therapy
Stimulation
Audiology
Severity of Illness Index
Functional Laterality
Levodopa
Dysarthria
0302 clinical medicine
Motor speech
Language disorder
MESH: Levodopa
MESH: Middle Aged
05 social sciences
Middle Aged
Dysarthria/*etiology
Subthalamic nucleus
surgical procedures
operative
Neurology
Levodopa/*adverse effects
medicine.symptom
Subthalamic Nucleus/*physiopathology/radiation effects
Psychology
therapeutics
medicine.drug
Adult
medicine.medical_specialty
Electric Stimulation Therapy/*adverse effects
MESH: Dysarthria
MESH: Electric Stimulation Therapy
Electric Stimulation Therapy
050105 experimental psychology
03 medical and health sciences
Parkinsonian Disorders
Subthalamic Nucleus
MESH: Severity of Illness Index
medicine
[SDV.BBM] Life Sciences [q-bio]/Biochemistry
Molecular Biology
otorhinolaryngologic diseases
Humans
0501 psychology and cognitive sciences
[SDV.BBM]Life Sciences [q-bio]/Biochemistry
Molecular Biology
MESH: Functional Laterality
MESH: Subthalamic Nucleus
Dyskinesias
MESH: Humans
MESH: Parkinsonian Disorders
MESH: Dyskinesias
MESH: Adult
medicine.disease
nervous system diseases
Aphonia
nervous system
Neurology (clinical)
030217 neurology & neurosurgery
Dyskinesias/etiology
Zdroj: Movement Disorders, Vol. 20, No 11 (2005) pp. 1507-1515
Movement Disorders
Movement Disorders, Wiley, 2005, 20 (11), pp.1507-15. ⟨10.1002/mds.20601⟩
Movement Disorders, 2005, 20 (11), pp.1507-15. ⟨10.1002/mds.20601⟩
ISSN: 0885-3185
1531-8257
DOI: 10.1002/mds.20601⟩
Popis: International audience; 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.
Databáze: OpenAIRE
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