Articulation Features of Parkinson's Disease Patients with Subthalamic Nucleus Deep Brain Stimulation

作者：Tanaka Yasuhiro; Tsuboi Takashi; Watanabe Hirohisa^*; Kajita Yasukazu; Nakatsubo Daisuke; Fujimoto Yasushi; Ohdake Reiko; Ito Mizuki; Atsuta Naoki; Yamamoto Masahiko; Wakabayashi Toshihiko; Katsuno Masahisa; Sobue Gen^*

来源：Journal of Parkinson's Disease, 2016, 6(4): 811-819.

DOI：10.3233/JPD-160838

• Parkinson's disease
• deep brain stimulation
• speech
• dysarthria
• speech disorder
• acoustic analysis
• articulation
• speech intelligibility
• formant analysis

Background: Voice and speech disorders are one of the most important issues after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients. However, articulation features in this patient population remain unclear.
Objective: We studied the articulation features of PD patients with STN-DBS.
Methods: Participants were 56 PD patients treated with STN-DBS (STN-DBS group) and 41 patients treated only with medical therapy (medical-therapy-alone group). Articulation function was evaluated with acoustic and auditory-perceptual analyses. The vowel space area (VSA) was calculated using the formant frequency data of three vowels (/a/, /i/, and /u/) from sustained phonation task. The VSA reportedly reflects the distance of mouth/jaw and tongue movements during speech and phonation. Correlations between acoustic and auditory-perceptual measurements were also assessed.
Results: The VSA did not significantly differ between the medical-therapy-alone group and the STN-DBS group in the off-stimulation condition. In the STN-DBS group, the VSA was larger in the on-stimulation condition than in the off-stimulation condition. However, individual analysis showed the VSA changes after stopping stimulation were heterogeneous. In total, 89.8% of the STN-DBS group showed a large VSA size in the on-than in the off-stimulation condition. In contrast, the VSA of the remaining patients in that group was smaller in the on-than the off-stimulation condition.
Conclusions: STN-DBS may resolve hypokinesia of the articulation structures, including the mouth/jaw and tongue, and improve maximal vowel articulation. However, in the on-stimulation condition, the VSA was not significantly correlated with speech intelligibility. This may be because STN-DBS potentially affects other speech processes such as voice and/or respiratory process.

• 出版日期2016