Sandström Linda, Hägglund Patricia, Johansson Louise, Blomstedt Patric, Karlsson Fredrik
Division of Speech and Language Pathology Department of Clinical Sciences Umeå University Umeå Sweden.
Division of Clinical Neuroscience Department of Pharmacology and Clinical Neuroscience Umeå University Umeå Sweden.
Brain Behav. 2015 Sep 25;5(10):e00394. doi: 10.1002/brb3.394. eCollection 2015 Oct.
To investigate the effects of l-dopa (Levodopa) and cZi-DBS (deep brain stimulation in caudal zona incerta) on spontaneous speech intelligibility in patients with PD (Parkinson's disease).
Spontaneous utterances were extracted from anechoic recordings from 11 patients with PD preoperatively (off and on l-dopa medication) and 6 and 12 months post bilateral cZi-DBS operation (off and on stimulation, with simultaneous l-dopa medication). Background noise with an amplitude corresponding to a clinical setting was added to the recordings. Intelligibility was assessed through a transcription task performed by 41 listeners in a randomized and blinded procedure.
A group-level worsening in spontaneous speech intelligibility was observed on cZi stimulation compared to off 6 months postoperatively (8 adverse, 1 positive, 2 no change). Twelve months postoperatively, adverse effects of cZi-DBS were not frequently observed (2 positive, 3 adverse, 6 no change). l-dopa administered preoperatively as part of the evaluation for DBS operation provided the overall best treatment outcome (1 adverse, 4 positive, 6 no change).
cZi-DBS was shown to have smaller negative effects when evaluated from spontaneous speech compared to speech effects reported previously. The previously reported reduction in word-level intelligibility 12 months postoperatively was not transferred to spontaneous speech for most patients. Reduced intelligibility due to cZi stimulation was much more prominent 6 months postoperatively than at 12 months.
研究左旋多巴（L - 多巴）和尾侧未定带深部脑刺激（cZi - DBS）对帕金森病（PD）患者自发语音清晰度的影响。
从11例PD患者术前（未服用和服用左旋多巴药物）以及双侧cZi - DBS手术后6个月和12个月（关闭和开启刺激，同时服用左旋多巴药物）的消声录音中提取自发话语。向录音中添加与临床环境相对应幅度的背景噪声。通过41名听众以随机和盲法程序进行的转录任务评估清晰度。
与术后6个月关闭刺激相比，开启cZi刺激时观察到自发语音清晰度在组水平上恶化（8例恶化，1例改善，2例无变化）。术后12个月，cZi - DBS的不良反应不常见（2例改善，3例恶化，6例无变化）。术前作为DBS手术评估一部分给予的左旋多巴提供了总体最佳治疗效果（1例恶化，4例改善，6例无变化）。
与先前报道的语音效应相比，从自发语音评估时，cZi - DBS显示出较小的负面影响。先前报道的术后12个月单词水平清晰度降低并未在大多数患者的自发语音中出现。cZi刺激导致的清晰度降低在术后6个月比12个月更为明显。
