Martel Sauvageau Vincent, Roy Johanna-Pascale, Cantin Léo, Prud'Homme Michel, Langlois Mélanie, Macoir Joël
Centre Interdisciplinaire de Recherche en Réadaptation et en Intégration Sociale, Québec, QC, Canada G1M 2S8.
Centre Interdisciplinaire de Recherche sur les Activités Langagières, Université Laval, Québec, QC, Canada G1V 0A6.
Parkinsons Dis. 2015;2015:382320. doi: 10.1155/2015/382320. Epub 2015 Oct 7.
Purpose. To investigate the impact of deep brain stimulation of the subthalamic nucleus (STN DBS) and levodopa intake on vowel articulation in dysarthric speakers with Parkinson's disease (PD). Methods. Vowel articulation was assessed in seven Quebec French speakers diagnosed with idiopathic PD who underwent STN DBS. Assessments were conducted on- and off-medication, first prior to surgery and then 1 year later. All recordings were made on-stimulation. Vowel articulation was measured using acoustic vowel space and formant centralization ratio. Results. Compared to the period before surgery, vowel articulation was reduced after surgery when patients were off-medication, while it was better on-medication. The impact of levodopa intake on vowel articulation changed with STN DBS: before surgery, levodopa impaired articulation, while it no longer had a negative effect after surgery. Conclusions. These results indicate that while STN DBS could lead to a direct deterioration in articulation, it may indirectly improve it by reducing the levodopa dose required to manage motor symptoms. These findings suggest that, with respect to speech production, STN DBS and levodopa intake cannot be investigated separately because the two are intrinsically linked. Along with motor symptoms, speech production should be considered when optimizing therapeutic management of patients with PD.
目的。研究丘脑底核深部脑刺激（STN DBS）和左旋多巴摄入对帕金森病（PD）构音障碍患者元音发音的影响。方法。对7名被诊断为特发性帕金森病且接受STN DBS的魁北克法语使用者的元音发音进行评估。评估在服药和未服药状态下进行，首先在手术前，然后在1年后。所有录音均在刺激状态下进行。使用声学元音空间和共振峰集中率来测量元音发音。结果。与手术前相比，患者在未服药时手术后元音发音降低，而在服药时则更好。左旋多巴摄入对元音发音的影响随STN DBS而变化：手术前，左旋多巴会损害发音，而手术后它不再有负面影响。结论。这些结果表明，虽然STN DBS可能导致发音直接恶化，但它可能通过减少控制运动症状所需的左旋多巴剂量而间接改善发音。这些发现表明，就言语产生而言，不能单独研究STN DBS和左旋多巴摄入，因为两者内在相关。在优化帕金森病患者的治疗管理时，应连同运动症状一起考虑言语产生。
