Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson's disease

Michael J. Hammer, Steven M Barlow, Kelly E. Lyons, Rajesh Pahwa

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Adequate respiratory and laryngeal motor control are essential for speech, but may be impaired in Parkinson's disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on respiratory and laryngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of respiratory and laryngeal control, and whether these changes were correlated with limb function and stimulation parameters. Eighteen PD participants with bilateral STN DBS were tested within a morning session after a minimum of 12 h since their most recent dose of anti-PD medication. Testing occurred when DBS was on, and again 1 h after DBS was turned off, and included aerodynamic measures during syllable production, and standard clinical ratings of limb function. We found that PD participants exhibited changes with DBS, consistent with increased respiratory driving pressure (n = 9) and increased vocal fold closure (n = 9). However, most participants exceeded a typical operating range for these respiratory and laryngeal control variables with DBS. Changes were uncorrelated with limb function, but showed some correlation with stimulation frequency and pulse width, suggesting that speech may benefit more from low-frequency stimulation and shorter pulse width. Therefore, high-frequency STN DBS may be less beneficial for speech-related respiratory and laryngeal control than for limb motor control. It is important to consider these distinctions and their underlying mechanisms when assessing the impact of STN DBS on PD.

Original languageEnglish (US)
Pages (from-to)1692-1702
Number of pages11
JournalJournal of Neurology
Volume257
Issue number10
DOIs
StatePublished - Oct 1 2010

Fingerprint

Subthalamic Nucleus
Deep Brain Stimulation
Parkinson Disease
Extremities
Vocal Cords
Pressure

Keywords

  • Aerodynamics
  • Air flow
  • Air pressure
  • High frequency
  • Laryngeal resistance
  • Voice

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson's disease. / Hammer, Michael J.; Barlow, Steven M; Lyons, Kelly E.; Pahwa, Rajesh.

In: Journal of Neurology, Vol. 257, No. 10, 01.10.2010, p. 1692-1702.

Research output: Contribution to journalArticle

Hammer, Michael J. ; Barlow, Steven M ; Lyons, Kelly E. ; Pahwa, Rajesh. / Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson's disease. In: Journal of Neurology. 2010 ; Vol. 257, No. 10. pp. 1692-1702.
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