Speech Technology and Applied Research Corporation, Bedford, MA 01730-1417, USA.
Parkinsons Dis. 2011;2011:435232. doi: 10.4061/2011/435232. Epub 2011 Oct 3.
According to the U.S. National Institutes of Health, approximately 500,000 Americans have Parkinson's disease (PD), with roughly another 50,000 receiving new diagnoses each year. 70%-90% of these people also have the hypokinetic dysarthria associated with PD. Deep brain stimulation (DBS) substantially relieves motor symptoms in advanced-stage patients for whom medication produces disabling dyskinesias. This study investigated speech changes as a result of DBS settings chosen to maximize motor performance. The speech of 10 PD patients and 12 normal controls was analyzed for syllable rate and variability, syllable length patterning, vowel fraction, voice-onset time variability, and spirantization. These were normalized by the controls' standard deviation to represent distance from normal and combined into a composite measure. Results show that DBS settings relieving motor symptoms can improve speech, making it up to three standard deviations closer to normal. However, the clinically motivated settings evaluated here show greater capacity to impair, rather than improve, speech. A feedback device developed from these findings could be useful to clinicians adjusting DBS parameters, as a means for ensuring they do not unwittingly choose DBS settings which impair patients' communication.
根据美国国立卫生研究院的数据，大约有 50 万美国人患有帕金森病（PD），每年约有 5 万人被新诊断为该病。这些人中的 70%-90%也患有与 PD 相关的运动性构音障碍。深度脑刺激（DBS）可显著缓解药物治疗导致运动障碍的晚期患者的运动症状。本研究调查了为最大程度提高运动表现而选择的 DBS 设置对言语变化的影响。分析了 10 名 PD 患者和 12 名正常对照者的音节率和可变性、音节长度模式、元音分数、起始时间变异性和流音化。通过控制组的标准差进行标准化，以表示与正常的距离，并将其组合成一个综合指标。结果表明，缓解运动症状的 DBS 设置可以改善言语，使其接近正常的程度可达三个标准差。然而，这里评估的临床动机设置显示出更大的损害言语的能力，而不是改善言语。从这些发现中开发的反馈设备可能对调整 DBS 参数的临床医生有用，作为确保他们不会无意中选择损害患者交流的 DBS 设置的一种手段。
