CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20242023194en
CoDAS
Artigo Original

Effects of subthalamic nucleus deep brain stimulation on the speech of Spanish-speaking Parkinson’s disease patients during the first year of treatment

Efeitos da estimulação cerebral profunda do núcleo subtalâmico na fala de pacientes com doença de Parkinson de língua espanhola durante o primeiro ano de tratamento

Nicolás Castillo-Triana; Maryluz Camargo-Mendoza; Óscar Bernal-Pacheco

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Abstract

ABSTRACT: Purpose: To describe the effects of subthalamic nucleus deep brain stimulation (STN-DBS) on the speech of Spanish-speaking Parkinson's disease (PD) patients during the first year of treatment.

Methods: The speech measures (SMs): maximum phonation time, acoustic voice measures, speech rate, speech intelligibility measures, and oral diadochokinesis rates of nine Colombian idiopathic PD patients (four females and five males; age = 63 ± 7 years; years of PD = 10 ± 7 years; UPDRS-III = 57 ± 6; H&Y = 2 ± 0.3) were studied in OFF and ON medication states before and every three months during the first year after STN-DBS surgery. Praat software and healthy native listeners’ ratings were used for speech analysis. Statistical analysis tried to find significant differences in the SMs during follow-up (Friedman test) and between medication states (Wilcoxon paired test). Also, a pre-surgery variation interval (PSVI) of reference for every participant and SM was calculated to make an individual analysis of post-surgery variation.

Results: Non-significative post-surgery or medication state-related differences in the SMs were found. Nevertheless, individually, based on PSVIs, the SMs exhibited: no variation, inconsistent or consistent variation during post-surgery follow-up in different combinations, depending on the medication state.

Conclusion: As a group, participants did not have a shared post-surgery pattern of change in any SM. Instead, based on PSVIs, the SMs varied differently in every participant, which suggests that in Spanish-speaking PD patients, the effects of STN-DBS on speech during the first year of treatment could be highly variable.

Keywords

Parkinson’s Disease, Deep Brain Stimulation, Dysarthria, Speech, Voice

Resumo

RESUMO: Objetivo: Descrever os efeitos da estimulação cerebral profunda do núcleo subtalâmico (ECP-NST) na fala de pacientes com doença de Parkinson (DP) falantes de espanhol durante o primeiro ano de tratamento.

Método: As medidas de fala (MFs): tempo máximo de fonação, medidas acústicas de voz, velocidade de fala, medidas de inteligibilidade de fala e taxas de diadococinesia oral de nove pacientes colombianos com DP idiopática (quatro mulheres e cinco homens; idade = 63 ± 7 anos; anos de DP = 10 ± 7 anos; UPDRS-III = 57 ± 6; H&Y = 2 ± 0,3) foram estudados nos estados de medicação OFF e ON antes e durante um ano após a cirurgia de ECP-NST a cada três meses. O software Praat e as avaliações de ouvintes nativos saudáveis foram utilizados para análise de fala. A análise estatística tentou encontrar diferenças significativas entre as avaliações pré-operatórias e de seguimento (Teste de Friedman) e entre os estados de medicação (Teste pareado de Wilcoxon OFF/ON). Também, um intervalo de variação pré-cirúrgico (IVPC) para cada participante e MF foi calculado para fazer uma análise individual da variação durante o seguimento.

Resultados: Não foram encontradas diferenças significativas ao longo do seguimento ou entre os estados medicamentosos em as MFs. No entanto, individualmente, com base nos IVPCs, as MFs exibiram: nenhuma variação, variação inconsistente ou variação consistente durante o seguimento em diferentes combinações, dependendo do estado da medicação.

Conclusão: Os participantes não tiveram um padrão compartilhado de variação de fala durante seguimento. As MFs exibiram diferentes padrões de variação em cada participante, que sugerem que em pacientes com DP de língua espanhola, os efeitos da ECP-NST durante o primeiro ano de tratamento na fala podem ser altamente variáveis.
 

Palavras-chave

Doença de Parkinson, Estimulação Cerebral Profunda, Disartria, Fala, Voz

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