A Noninvasive Imaging Approach to Understanding Speech Changes following Deep Brain Stimulation in Parkinson's Disease

Autor/inn/en	Narayana, Shalini; Jacks, Adam; Robin, Donald A.; Poizner, Howard; Zhang, Wei; Franklin, Crystal; Liotti, Mario; Vogel, Deanie; Fox, Peter T.
Titel	A Noninvasive Imaging Approach to Understanding Speech Changes following Deep Brain Stimulation in Parkinson's Disease
Quelle	In: American Journal of Speech-Language Pathology, 18 (2009) 2, S.146-161 (16 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	1058-0360
DOI	10.1044/1058-0360(2008/08-0004)
Schlagwörter	Stimulation; Speech; Speech Impairments; Diseases; Brain; Neurological Organization; Psychomotor Skills; Acoustics; Evaluation Methods; Outcomes of Treatment; Topography; Symptoms (Individual Disorders); Adults; Males; Texas + Suchen Sie Ihr Suchwort? Speaking; Sprechen; Speech impairment; Speech handicap; Speech handicaps; Language handicps; Language impairments; Sprachbehinderung; Disease; Krankheit; Gehirn; Psychomotorische Aktivität; Akustik; Topografie; Psychiatrische Symptomatik; Male; Männliches Geschlecht
Abstract	Purpose: To explore the use of noninvasive functional imaging and "virtual" lesion techniques to study the neural mechanisms underlying motor speech disorders in Parkinson's disease. Here, we report the use of positron emission tomography (PET) and transcranial magnetic stimulation (TMS) to explain exacerbated speech impairment following subthalamic nucleus deep brain stimulation (STN-DBS) in a patient with Parkinson's disease. Method: Perceptual and acoustic speech measures, as well as cerebral blood flow during speech as measured by PET, were obtained with STN-DBS on and off. TMS was applied to a region in the speech motor network found to be abnormally active during DBS. Speech disruption by TMS was compared both perceptually and acoustically with speech produced with DBS on. Results: Speech production was perceptually inferior and acoustically less contrastive during left STN stimulation compared to no stimulation. Increased neural activity in left dorsal premotor cortex (PMd) was observed during DBS on. "Virtual" lesioning of this region resulted in speech characterized by decreased speech segment duration, increased pause duration, and decreased intelligibility. Conclusions: This case report provides evidence that impaired speech production accompanying STN-DBS may result from unintended activation of PMd. Clinical application of functional imaging and TMS may lead to optimizing the delivery of STN-DBS to improve outcomes for speech production as well as general motor abilities. (Contains 7 figures and 4 tables.) (As Provided).
Anmerkungen	American Speech-Language-Hearing Association (ASHA). 10801 Rockville Pike, Rockville, MD 20852. Tel: 800-638-8255; Fax: 301-571-0457; e-mail: subscribe@asha.org; Web site: http://ajslp.asha.org
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10