Parkinson's Disease, Speech and Neurosurgery

Area of Science:

• Neuroscience
• Neurology
• Neurosurgery

Background:

• Speech impairment is an unpredictable adverse effect of sub-thalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients.
• The PREDISTIM study investigated STN-DBS outcomes in 417 PD patients.

Purpose of the Study:

• To determine the prevalence of speech impairment one year post-STN-DBS in PD patients.
• To identify predictive factors for speech outcomes following STN-DBS.

Main Methods:

• Compared speech outcomes using MDS-UPDRS III.1 and PDQ39 self-assessment questionnaires.
• Analyzed demographic, clinical, and STN-DBS parameters in relation to speech worsening, stability, or improvement.
• Utilized data from 417 patients in the French national PREDISTIM study.

Main Results:

• A significant speech deterioration was observed one year after combined STN-DBS and dopaminergic treatment.
• Four factors predicted speech deterioration: absence of preoperative impairment, motor daily living severity (MDS-UPDRS II), high left electrode intensity (>3.6V), and no change in non-motor daily life experiences (MDS-UPDRS I).

Conclusions:

• Careful speech monitoring is crucial post-STN-DBS for Parkinson's disease.
• Patients without preoperative speech issues, with motor difficulties, or high left electrode stimulation require particular attention.