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Early detection of speech and voice disorders in Parkinson’s disease patients treated with subthalamic nucleus deep brain stimulation: a 1-year follow-up study

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

We previously reported that Parkinson’s disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS) had distinct phenotypes of speech and voice disorders: hypokinetic dysarthria, stuttering, breathy voice, strained voice, and spastic dysarthria. However, changes over time remain unclear. In the present study, 32 consecutive PD patients were assessed before and up to 1 year after surgery (PD-DBS). Eleven medically treated PD patients were also assessed (PD-Med). Speech, voice, motor, and cognitive functions were evaluated. At baseline, the incidence of hypokinetic dysarthria (63% of PD-DBS vs. 82% of PD-Med), stuttering (50% vs. 45%), breathy voice (66% vs. 73%), and strained voice (3% vs. 9%) was similar between groups. At 1 year, a slight but significant deterioration in speech intelligibility (p < 0.001) and grade of dysphonia (p = 0.001) were observed only in PD-DBS group compared with baseline. During the follow-up, stuttering (9% vs. 18%) and breathy voice (13% vs. 9%) emerged in PD-DBS and PD-Med, but strained voice (28%) and spastic dysarthria (44%) emerged only in PD-DBS. After the stimulation was stopped, strained voice and spastic dysarthria improved in most patients, while stuttering and breathy voice improved in a minority of patients. These findings indicate that the most common DBS-induced speech and voice disorders are strained voice and spastic dysarthria and that STN-DBS potentially aggravates stuttering and breathy voice. An improved understanding of these types of disorders may help detect speech and voice deteriorations during the early phase and lead to appropriate treatments.

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Acknowledgements

This work was supported by JSPS KAKENHI Grant Number JP16K19507.

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Authors and Affiliations

  1. Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Takashi Tsuboi, Hirohisa Watanabe, Yasuhiro Tanaka, Reiko Ohdake, Makoto Hattori, Kazuya Kawabata, Kazuhiro Hara, Mizuki Ito & Masahisa Katsuno

  2. Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yasushi Fujimoto

  3. Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Daisuke Nakatsubo & Satoshi Maesawa

  4. Department of Neurosurgery, National Hospital Organization Nagoya Medical Center, Nagoya, Japan

    Yasukazu Kajita

  5. Brain and Mind Research Center, Nagoya University, Showa-ku, Nagoya, 466-8550, Japan

    Hirohisa Watanabe & Gen Sobue

Authors
  1. Takashi Tsuboi
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  2. Hirohisa Watanabe
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  3. Yasuhiro Tanaka
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  4. Reiko Ohdake
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  7. Kazuhiro Hara
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  8. Mizuki Ito
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  9. Yasushi Fujimoto
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  10. Daisuke Nakatsubo
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  13. Masahisa Katsuno
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  14. Gen Sobue
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Correspondence to Gen Sobue.

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Tsuboi, T., Watanabe, H., Tanaka, Y. et al. Early detection of speech and voice disorders in Parkinson’s disease patients treated with subthalamic nucleus deep brain stimulation: a 1-year follow-up study. J Neural Transm 124, 1547–1556 (2017). https://doi.org/10.1007/s00702-017-1804-x

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  • DOI: https://doi.org/10.1007/s00702-017-1804-x

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