Sprache · Stimme · Gehör 2022; 46(04): 181-193
DOI: 10.1055/a-1941-3588
Schwerpunktthema

Elektrische Stimulation tiefer Hirnstrukturen: Auswirkungen auf das Sprechen

Electrical Stimulation of Deep Brain Structures: Effects on Speaking
Elina Tripoliti
,
Lorraine Ramig

Die elektrische Stimulation tiefer Hirnstrukturen kann bei Parkinson-Patienten zu einer Verschlechterung des Sprechens und der Stimme führen. Dabei sind die Auswirkungen individuell unterschiedlich und von anatomisch, klinisch-therapeutischen und neurochirurgischen Faktoren abhängig. Teamarbeit zwischen den Berufsgruppen Neurochirurgie/ Neurologie und Sprachtherapie ist notwendig, um mit einer THS und logopädischen Therapie die bestmöglichen Behandlungserfolge zu erzielen.

Abstract

Electrical stimulation of deep brain structures can lead to speech and voice deterioration in Parkinsonʼs patients. The effects are individually different and dependent on anatomical, clinical-therapeutic and neurosurgical factors. Teamwork between the professional groups of neurosurgery/neurology and speech therapy is necessary in order to achieve the best possible treatment success with DBS and speech therapy.

Zusätzliches Material



Publication History

Article published online:
29 November 2022

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  • Literatur

  • 1 Levelt WJM. Speaking From intention to articulation . The MIT Press. MIT Press; 1989. APA PsycNet
  • 2 Darley FL, Aronson AE, Brown JR. Motor Speech Disorders. Philadelphia, USA: W.B. Saunders Company; 1975
  • 3 Logemann JA, Fisher HB, Boshes B. et al. Frequency and cooccurrence of vocal tract dysfunctions in the speech of a large sample of Parkinson patients. J Speech Hear Disord 1978; 43: 47-57
  • 4 Rosen KM, Kent RD, Duffy JR. Task-based profile of vocal intensity decline in Parkinsonʼs disease. Folia Phoniatr Logop 2005; 57: 28-37
  • 5 Metter EJ, Hanson WR. Clinical and acoustical variability in hypokinetic dysarthria. J Commun Disord 1986; 19: 347-366
  • 6 Kent RD, Kim YJ. Toward an acoustic typology of motor speech disorders. Clin Linguist Phon 2003; 17: 427-445
  • 7 De Letter M, Santens P, Van Borsel J. The effects of levodopa on word intelligibility in Parkinsonʼs disease. J Commun Disord 2005; 38: 187-196
  • 8 Goberman AM, Blomgren M. Parkinsonian speech disfluencies: effects of L-dopa-related fluctuations. J Fluency Disord 2003; 28: 55-70
  • 9 Pinto S, Ozsancak C, Tripoliti E. et al. Treatments for dysarthria in Parkinsonʼs disease. Lancet Neurol 2004; 3: 547-556
  • 10 Tepper JM, Abercrombie ED, Bolam JP. Basal ganglia macrocircuits. Prog Brain Res 2007; 160: 3-7
  • 11 Wilson J. The basal ganglia. In: Shepherd GordonM (ed.). The Synaptic Organization of the Brain (5th edn). Oxford: Oxford University Press; 2004: 361-414
  • 12 Horsley VICT, Clarke RH. The structure and functions of the cerebellum examined by a new method. Brain 1908; 31: 45-124
  • 13 Spiegel EA, Wycis HT, Marks M. et al. Stereotaxic apparatus for operations on the human brain. Science 1947; 106: 349-350
  • 14 Buck JF, Cooper IS. Speech problems in parkinsonian patients undergoing anterior choroidal artery occlusion or chemopallidectomy. J Am Geriatr Soc 1956; 4: 1285-1290
  • 15 Guiot G, Hertzog E, Rondot P. et al. Arrest or acceleration of speech evoked by thalamic stimulation in the course of stereotaxic procedures for Parkinsonism. Brain 1961; 84: 363-379
  • 16 Van Buren JM. The question of thalamic participation in speech mechanisms. Brain Lang 1975; 2: 31-44
  • 17 Hassler R, Riechert T, Mundinger F. et al. Physiological observations in stereotaxic operations in extrapyramidal motor disturbances. Brain 1960; 83: 337-350
  • 18 Samra K, Riklan M, Levita E. et al. Language and speech correlates of anatomically verified lesions in thalamic surgery for parkinsonism. J Speech Hear Res 1969; 12: 510-540
  • 19 Bell DS. Speech functions of the thalamus inferred from the effects of thalamotomy. Brain 1968; 91: 619-638
  • 20 Schaltenbrand G. The effects on speech and language of stereotactical stimulation in thalamus and corpus callosum. Brain Lang 1975; 2: 70-77
  • 21 Allan C. Treatment of non fluent speech resulting from neurological disease – Treatment of dysarthria. International Journal of Language & Communication Disorders; 2011
  • 22 Cooper IS, Riklan M, Stellar S. et al. Multidisciplinary investigation of neurosurgical rehabilitation in bilateral parkinsonism. J Am Geriatr Soc 1968; 16: 1177-1306
  • 23 Ramig LO, Sapir S, Fox C. et al. Changes in vocal loudness following intensive voice treatment (LSVT) in individuals with Parkinsonʼs disease: a comparison with untreated patients and normal age-matched controls. Mov Disord 2001; 16: 79-83
  • 24 Hariz MI. From functional neurosurgery to “interventional” neurology: survey of publications on thalamotomy, pallidotomy, and deep brain stimulation for Parkinsonʼs disease from 1966 to 2001. Mov Disord 2003; 18: 845-853
  • 25 Benabid AL, Pollak P, Gervason C. et al. Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet 1991; 337: 403-406
  • 26 Limousin P, Krack P, Pollak P. et al. Electrical stimulation of the subthalamic nucleus in advanced Parkinsonʼs disease. N Engl J Med 1998; 339: 1105-1111
  • 27 Siegfried J, Lippitz B. Bilateral chronic electrostimulation of ventroposterolateral pallidum: a new therapeutic approach for alleviating all parkinsonian symptoms. Neurosurgery 1994; 35: 1126-1129
  • 28 Limousin P, Pollak P, Benazzouz A. et al. Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet 1995; 345: 91-95
  • 29 Hariz MI, Fodstad H. Deep brain stimulation in Parkinsonʼs disease. N Engl J Med 2002; 346: 452-453
  • 30 Deep-Brain Stimulation for Parkinsonʼs Disease Study Group. Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinsonʼs disease. N Engl J Med 2001; 345: 956-963 DOI: 10.1056/NEJMoa000827.
  • 31 Gross C, Rougier A, Guehl D. et al. High-frequency stimulation of the globus pallidus internalis in Parkinsonʼs disease: a study of seven cases. J Neurosurg 1997; 87: 491-498
  • 32 Ghika J, Villemure JG, Fankhauser H. et al. Efficiency and safety of bilateral contemporaneous pallidal stimulation (deep brain stimulation) in levodopa-responsive patients with Parkinsonʼs disease with severe motor fluctuations: a 2-year follow-up review. J Neurosurg 1998; 89: 713-718
  • 33 Lyons KE, Wilkinson SB, Troster AI. et al. Long-term efficacy of globus pallidus stimulation for the treatment of Parkinsonʼs disease. Stereotact Funct Neurosurg 2002; 79: 214-220
  • 34 Krause M, Fogel W, Heck A. et al. Deep brain stimulation for the treatment of Parkinsonʼs disease: subthalamic nucleus versus globus pallidus internus. J Neurol Neurosurg Psych 2001; 70: 464-470
  • 35 Rodriguez-Oroz MC, Obeso JA, Lang AE. et al. Bilateral deep brain stimulation in Parkinsonʼs disease: a multicentre study with 4 years follow-up. Brain 2005; 128: 2240-2249
  • 36 Volkmann J, Allert N, Voges J. et al. Safety and efficacy of pallidal or subthalamic nucleus stimulation in advanced PD. Neurology 2001; 56: 548-551
  • 37 Yin Z, Cao Y, Zheng S. et al. Persistent adverse effects following different targets and periods after bilateral deep brain stimulation in patients with Parkinson’s disease. J Neurol Sci 2018; 393: 116-127
  • 38 Hariz Mi, Rehncrona S, Quinn N. et al. Multicentre study on deep brain stimulation in Parkisnon’s disease: an independent assessment of reported adverse events at 4 years. Mov Disord 2008; 23: 416-421
  • 39 Hariz MI, Johansson F, Shamsgovara P. et al. Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study. Mov Disord 2000; 15: 136-139
  • 40 Deuschl G, Herzog J, Kleiner-Fisman G. et al. Deep brain stimulation: Postoperative issues. Mov Disord 2006; 21: S219-S237
  • 41 Tripoliti E, Zrinzo L, Martinez-Torres I. et al. Effects of subthalamic stimulation on speech of consecutive patients with Parkinson Disease. Neurology 2011; 76: 80-86
  • 42 Tripoliti E, Limousin P, Foltynie T. et al. Predictive factors of speech intelligibility following subthalamic nucleus stimulation in consecutive patients with Parkisnon’s disease. Mov Disord 2014; 29: 532-538
  • 43 Tsuboi T, Watanabe H, Tanaka Y. et al. Characteristic laryngoscopic findings in Parkinson’s disease patients after subthalamic nucleus deep brain stimulation and its correlation with voice disorder. J Neural Trasm 2015; 122: 1663-1672
  • 44 Krack P, Batir A, Van Blercom N. et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinsonʼs disease. N Engl J Med 2003; 349: 1925-1934
  • 45 Kleiner-Fisman G, Fisman DN, Zamir O. et al. Subthalamic nucleus deep brain stimulation for parkinsonʼs disease after successful pallidotomy: clinical and electrophysiological observations. Mov Disord 2004; 19: 1209-1214
  • 46 Tanaka Y, Tsuboi T, Watanabe H. et al. Articulation Featured of Parkinson’s Disease Patients with Subthalamic Nucleus Deep Brain Stimulation. J Parkin Dis 2016; 811-819
  • 47 Constantinescu R, Eriksson B, Jansson Y. et al. Key Clinical milestones 15 years and onwards after DBS-STN surgery – A retrospective analysis of patients that underwent surgery between 1993 and 2001. Clin Neurol Neurosurg 2017; 154: 43-48
  • 48 Gentil M, Garcia-Ruiz P, Pollak P. et al. Effect of stimulation of the subthalamic nucleus on oral control of patients with parkinsonism. J Neurol Neurosurg Psych 1999; 67: 329-333
  • 49 Gentil M, Chauvin P, Pinto S. et al. Effect of bilateral stimulation of the subthalamic nucleus on parkinsonian voice. Brain Lang 2001; 78: 233-240
  • 50 Gentil M, Pinto S, Pollak P. et al. Effect of bilateral stimulation of the subthalamic nucleus on parkinsonian dysarthria. Brain Lang 2003; 85: 190-196
  • 51 Dromey C, Kumar R, Lang AE. et al. An investigation of the effects of subthalamic nucleus stimulation on acoustic measures of voice. Mov Disord 2000; 15: 1132-1138
  • 52 Rousseaux M, Krystkowiak P, Kozlowski O. et al. Effects of subthalamic nucleus stimulation on parkinsonian dysarthria and speech intelligibility. J Neurol 2004; 251: 327-334
  • 53 Santens P, De Letter M, Van Borsel J. et al. Lateralized effects of subthalamic nucleus stimulation on different aspects of speech in Parkinsonʼs disease. Brain Lang 2003; 87: 253-258
  • 54 Wang EQ, Metman LV, Bakay RAE. et al. Hemisphere-specific effects on subthalamic nucleus deep brain stimulation on speaking rate and articulatory accuracy of syllable repetitions in Parkinsonʼs Disease. J Med Speech Lang Pathol 2006; 14: 323-333
  • 55 Brun Y, Karachi C, Fernandez-Vidal S. et al. Does unilateral basal ganglia activity functionally influence the contralateral side? What can we learn from STN stimulation in patients with PD. J Neurophysiol 2012; 108: 1575-1583
  • 56 Schulz GM, Hosey LA, Bradberry TJ. et al. Dissociated effects of left, right and bilateral stimulation of the subthalamic nucleus on motor, speech and language function in Parkinson’s disease. J Parkinson’s Dis 2012; 2: 29-40
  • 57 Paek SH, Lee JY, Kim HJ. et al. Electrode position and the clinical outcome after bilateral subthalamic nucleus stimulation. J Korean Med Sci 2011; 26: 1344-1355
  • 58 Velasco F, Jimenez F, Perez ML. et al. Electrical stimulation of the prelemniscal radiation in the treatment of Parkinsonʼs disease: an old target revised with new techniques. Neurosurgery 2001; 49: 293-306
  • 59 Astrom M, Tripoliti E, Hariz MI. et al. Patient-specific model-based investigation of speech intelligibility and movement during deep brain stimulation. Stereotact Funct Neurosurg 2010; 88: 224-233
  • 60 Plaha P, Ben-Shlomo Y, Patel NK. et al. Stimulation of the caudal zona incerta is superior to stimulation of the subthalamic nucleus in improving contralateral parkinsonism. Brain 2006; 129: 1732-1747
  • 61 Paek SH, Han JH, Lee JY. et al. Electrode position determined by fused images of preoperative and postoperative magnetic resonance imaging and surgical outcome after subthalamic nucleus deep brain stimulation. Neurosurgery 2008; 63: 925-936
  • 62 Fenoy AJ, Schiess MC. Deep brain stimulation of the Dentato-Rubro-Thalamic Tract: Outcomes of direct targeting for Tremor. Neuromodulation 2017; 20: 429-436
  • 63 Mora F, Mogenson GJ, Rolls ET. Activity of neurons in the region of the substantia nigra during feeding in the monkey. Brain Res 1977; 133: 267-276
  • 64 DeLong MR, Crutcher MD, Georgopoulos AP. Relations between movement and single cell discharge in the substantia nigra of the behaving monkey. J Neurosci 1983; 3: 1599-1606
  • 65 Wichmann T, Bergman H, DeLong MR. The primate subthalamic nucleus. I. Functional properties in intact animals. J Neurophysiol 1994; 72: 494-506
  • 66 Rodriguez-Oroz MC, Rodriguez M, Guridi J. et al. The subthalamic nucleus in Parkinsonʼs disease: somatotopic organization and physiological characteristics. Brain 2001; 124: 1777-1790
  • 67 Rodriguez-Oroz MC, Zamarbide I, Guridi J. et al. Efficacy of deep brain stimulation of the subthalamic nucleus in Parkinsonʼs disease 4 years after surgery: double blind and open label evaluation. J Neurol Neurosurg Psychiatry 2004; 75: 1382-1385
  • 68 Krack P, Fraix V, Mendes A. et al. Postoperative management of subthalamic nucleus stimulation for Parkinsonʼs disease. Mov Disord 2002; 17: S188-S197
  • 69 Tornqvist AL, Schalen L, Rehncrona S. Effects of different electrical parameter settings on the intelligibility of speech in patients with Parkinsonʼs disease treated with subthalamic deep brain stimulation. Mov Disord 2005; 20: 416-423
  • 70 Tommasi G, Krack P, Fraix V. et al. Pyramidal tract side effects induced by deep brain stimulation of the subthalamic nucleus. J Neurol Neurosurg Psychiatry 2007; 79: 813-819
  • 71 Moreau C, Pennel-Ployart O, Pinto S. et al. Modulation of dysarthropneumophonia by low-frequency STN-DBS in advanced Parkinson’s Disease. Mov Disord 2011; 26: 659-663
  • 72 Yilmaz A, Sarac ET, Aydinlii FE. et al. Investigating the effect of STN-DBS stimulation and different frequency settings on the acoustic-articulatory features of vowels. Neurol Sci 2018; 39: 1683-1689
  • 73 Nirosen V, Girges C, Wirth T. et al. Long-Term success of low-frequency subthalamic nucleus deep brain stimulation for PD depends on tremor severity and symptom duration. Brain Commun 2021; 3
  • 74 Tripoliti E, Zrinzo L, Martinez-Torres I. et al. Effects of contact location and voltage amplitude on speech and movement in bilateral subthalamic nucleus deep brain stimulation. Mov Disord 2008; 23: 2377-2383
  • 75 Connor NP, Abbs JH. Task-dependent variations in parkinsonian motor impairments. Brain 1991; 114: 321-332
  • 76 Riecker A, Ackermann H, Wildgruber D. et al. Opposite hemispheric lateralization effects during speaking and singing at motor cortex, insula and cerebellum. Neuroreport 2000; 11: 1997-2000
  • 77 Ziegler W. Psycholinguistic and motor theories of apraxia of speech. Semin Speech Lang 2002; 23: 231-244
  • 78 Ziegler W. Speech motor control is task-specific: Evidence from dysarthria and apraxia of speech. Aphasiology 2003; 17 (1): 3-36
  • 79 Pinto S, Thobois S, Costes N. et al. Subthalamic nucleus stimulation and dysarthria in Parkinsonʼs disease: a PET study. Brain 2004; 127: 602-615
  • 80 Limousin P, Greene J, Pollak P. et al. Changes in cerebral activity pattern due to subthalamic nucleus or internal pallidum stimulation in Parkinsonʼs disease. Ann Neurol 1997; 42: 283-291
  • 81 Fodstad H, Hariz M. Electricity in the treatment of nervous system disease. Acta Neurochir Suppl 2007; 97: 11-19
  • 82 McIntyre CC, Savasta M, Walter BL. et al. How does deep brain stimulation work? Present understanding and future questions. J Clin Neurophysiol 2004; 21: 40-50
  • 83 Little S, Tripoliti E, Beudel M. et al. Adaptive deep brain stimulation for Parkinson’s disease demonstrates reduced speech side effects compared to conventional stimulation in the acute setting. J Neurol Neurosurg Psychiatry 2016; 87: 1388-1389
  • 84 Tanaka Y, Tsuboi T, Watanabe H. et al. Articulation features of PD patients with Subthalamic Nucleus Deep Brain Stimulation. J Parkinson’s Dis 2016; 811-819
  • 85 Hammer M, Barlow SM, Lyons KE. et al. Subthalamic nucleus deep brain stimulation changes velopharyngeal control in PD. J Commun Disord 2011; 44: 37-48
  • 86 Mahlknecht P, Akram H, Georgiev D. et al. Pyramidal tract activation due to subthalamic deep brain stimulation in PD. Mov Disord 2017; 32: 1174-1182
  • 87 Kraus JK, Lipsman N, Aziz T. et al. Technology of deep brain stimulation: current status and future directions. Nat Rev Neurol 2021; 17: 75-87
  • 88 Luo J. et al. The Lombard Effect: From Acoustics to Neural Mechanisms. Trends in Neurosciences 2018; 41: 12
  • 89 Bergman H, Wichmann T, DeLong MR. Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. Science 1990; 249: 1436-1438
  • 90 Krack P, Pollak P, Limousin P. et al. Subthalamic nucleus or internal pallidal stimulation in young onset Parkinsonʼs disease. Brain 1998; 121: 451-457
  • 91 Weismer G. Philosophy of research in motor speech disorders. Clin Linguist Phon 2006; 20: 315-349
  • 92 Rusz J, Tykalova T, Ramig L. et al. Guidelines for speech Recording and Acoustic analysis in Dysarthrias of Movement Disorders. Mov Disord 2021; 36: 803-814
  • 93 Pinto S, Gentil M, Krack P. et al. Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech. Mov Disord 2005; 20: 1507-1515
  • 94 Dromey C. Spectral measures and paerceptual ratings of hypokinetic dysarthria. J Med Speech Lang Pathol 2003; 11: 85-94
  • 95 Tripoliti E, Limousin P, Tisch S. et al. Speech in Parkinsonʼs Disease following subthalamic nucleus deep brain stimulation: preliminary results. J Med Speech Lang Pathol 2006; 14: 309-315
  • 96 Pinto S, Gentil M, Fraix V. et al. Bilateral subthalamic stimulation effects on oral force control in Parkinsonʼs disease. J Neurol 2003; 250: 179-187
  • 97 Wertheimer J, Gottuso AY, Nuno M. et al. The impact of deep brain stimulation on speech in individuals with Parkinson’s disease: the paient’s perspective. Parkinsonism Relat Disord 2013; 10: 1065-1070
  • 98 Frost E, Tripoliti E, Hariz MI. et al. Self-perception of speech changes in patients wit PD following deep brain stimulation of the subthalamic nucleus. Int J Speech Lang Pathol 2010; 12: 399-404