Murdoch Bruce E
The University of Queensland, Brisbane, Australia.
Int J Speech Lang Pathol. 2010 Oct;12(5):375-84. doi: 10.3109/17549507.2010.495785.
Although neurosurgical procedures have been reported to be successful in relieving many of the motor symptoms of Parkinson's disease (PD) (e.g., tremor, rigidity, bradykinesia) in the limb musculature, their effect on speech is much less consistent. This paper will review and evaluate reports in the literature on the effects of various surgical interventions for PD, including thalamotomy, pallidotomy, and DBS, on speech. In particular the paper will focus on the implications of these findings for one's understanding of the neurological control of the speech mechanism. As a foundation, contemporary models of the neuropathophysiology of PD and hypokinetic dysarthria will be outlined and explained. The various neurosurgical treatments for PD will be described and their theoretical underpinning discussed with regard to their proposed effects on subcortical and cortical motor control systems. Evidence suggestive of the need to reconsider contemporary thinking in relation to the neurology of speech and the need to differentiate it from limb neurology will be highlighted.
尽管据报道神经外科手术在缓解帕金森病（PD）肢体肌肉组织的许多运动症状（如震颤、僵硬、运动迟缓）方面取得了成功，但其对言语的影响却不太一致。本文将回顾和评估文献中关于各种治疗PD的手术干预（包括丘脑切开术、苍白球切开术和深部脑刺激术）对言语影响的报告。特别是，本文将重点关注这些发现对人们理解言语机制神经控制的意义。作为基础，将概述和解释PD和运动减少型构音障碍的神经病理生理学的当代模型。将描述治疗PD的各种神经外科治疗方法，并讨论其对皮质下和皮质运动控制系统的预期作用的理论基础。将强调有证据表明需要重新考虑与言语神经学相关的当代思维，以及将其与肢体神经学区分开来的必要性。
