Department of Neurology, University of Alabama at Birmingham, 1720 7th Avenue, South Birmingham, AL 35212, USA.
J Speech Lang Hear Res. 2009 Dec;52(6):1652-7. doi: 10.1044/1092-4388(2009/08-0089).
In this article, the authors report a case of acquired stuttering associated with Parkinson's disease (PD) that was responsive to unilateral subthalamic nucleus deep-brain stimulation (STN DBS) in the language-dominant hemisphere.
A single-subject, masked, multiple baseline design was used to evaluate the effects of unilateral left STN DBS on stuttering associated with PD. The patient underwent 3 formal speech assessments of spontaneous speech and the reading of passages with DBS off and on. Speech samples were videotaped and placed in random order, and 2 independent speech-language pathologists calculated the percentage of stuttered syllables and classified individual stuttering events.
Stuttering improved significantly in the DBS-on condition. In total, 10% of syllables were affected by stuttering events with DBS off, and less than 1% of syllables were affected by stuttering events with DBS on (n = 2,281 syllables, p < .00001, in a chi(2) test). The effect of unilateral STN DBS on stuttering was relatively independent of whether the patient was on or off dopaminergic medications.
This article emphasizes the important role of the subthalamic region in the motor control of speech and language.
本文作者报告了一例与帕金森病(PD)相关的获得性口吃病例,该病例对优势半球的单侧丘脑底核深部脑刺激(STN-DBS)有反应。
采用单病例、盲法、多基线设计来评估单侧左侧 STN-DBS 对 PD 相关口吃的影响。患者接受了 3 次正式的言语评估,包括自发言语和阅读短文,分别在 DBS 关闭和开启的情况下进行。言语样本被录像并随机排列,2 位独立的言语语言病理学家计算了口吃音节的百分比,并对个体的口吃事件进行分类。
口吃在 DBS 开启状态下显著改善。在 DBS 关闭时,10%的音节受到口吃事件的影响,而在 DBS 开启时,受口吃事件影响的音节不到 1%(n=2281 个音节,p<0.00001,卡方检验)。单侧 STN-DBS 对口吃的影响相对独立于患者是否服用多巴胺能药物。
本文强调了丘脑底核区域在言语和语言运动控制中的重要作用。