The effects of thalamic and posterior subthalamic deep brain stimulation on speech in patients with essential tremor - A prospective, randomized, doubleblind crossover study

Johannes Becker; Tabea Thies; Jan Niklas Petry-Schmelzer; Till A Dembek; Paul Reker; Doris Mücke; Martine Grice; Veerle Visser-Vandewalle; Gereon R Fink; Michael T Barbe

doi:10.1016/j.bandl.2019.104724

The effects of thalamic and posterior subthalamic deep brain stimulation on speech in patients with essential tremor - A prospective, randomized, doubleblind crossover study

Brain Lang. 2020 Mar:202:104724. doi: 10.1016/j.bandl.2019.104724. Epub 2019 Dec 26.

Affiliations

¹ University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Kerpener Str. 62, 50937 Cologne, Germany.
² University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Kerpener Str. 62, 50937 Cologne, Germany; University of Cologne, Faculty of Arts and Humanities, Department of Linguistics, IfL Phonetics, Herbert-Lewin-Str 6, 50931 Cologne, Germany.
³ University of Cologne, Faculty of Arts and Humanities, Department of Linguistics, IfL Phonetics, Herbert-Lewin-Str 6, 50931 Cologne, Germany.
⁴ University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Kerpener Str. 62, 50937 Cologne, Germany.
⁵ University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Kerpener Str. 62, 50937 Cologne, Germany; Research Center Jülich, Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Leo-Brandt-Straße, 52425 Jülich, Germany.
⁶ University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Kerpener Str. 62, 50937 Cologne, Germany. Electronic address: [email protected].

PMID: 31884313
DOI: 10.1016/j.bandl.2019.104724

Abstract

Objective: To prospectively evaluate the effect of PSA- and VIM DBS on speech in ET patients.

Methods: Leads were implanted bilaterally with contacts placed in both VIM and PSA. Thirteen patients were analyzed pre- and postoperatively. Preoperative speech of ET patients was compared to healthy controls. PSA- and VIM-DBS were evaluated in a randomized, double-blind crossover phase.

Results: At preoperative baseline, we found reduced intelligibility. Differences in acoustic and VAS data ('ability to speak') compared to controls were gradient. Articulation rate could be predicted by disease duration. Decreased articulation rate, spirantization and voicing were found for PSA- and VIM-DBS. Targets did not differ in terms of speech deterioration.

Conclusion: Speech in ET patients without DBS can be impaired, dependent on patient's individual characteristics. Both PSA- and VIM-DBS affect speech in a comparable way. Thus, the PSA can be considered an alternative DBS target in ET without higher risk of dysarthria.

Keywords: Deep brain stimulation; Dysarthria; Essential tremor; Movement disorders; Oral diadochokinesia; Speech.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Cross-Over Studies
Deep Brain Stimulation / methods*
Double-Blind Method
Dysarthria / diagnosis
Dysarthria / physiopathology
Dysarthria / therapy
Essential Tremor / diagnosis*
Essential Tremor / physiopathology
Essential Tremor / therapy*
Female
Humans
Male
Middle Aged
Prospective Studies
Speech / physiology*
Thalamus / physiology*
Treatment Outcome
Young Adult