Ollivier Thomas, Pinto Serge, Rolland Anne-Sophie, Cailliau Emeline, Touzet Gustavo, Thobois S, Eusebio A, Hainque E, Rouaud T, Drapier S, Guehl D, Maltete D, Anheim M, Lagha Boukbiza O, Giordana C, Tir M, Hopes L, Hubsch C, Jarraya B, Marques A, Brefel C, Rascol O, Corvol J C, Benatru I, Defebvre Luc, Devos David, Moreau Caroline
CHU Lille Department of Medical Pharmacology, University of Lille, Lille Neuroscience and Cognition INSERM, U1172, LiCEND, NS-Park/F-CRIN Network, Lille, France.
Neurology and Movement Disorders Department, Expert Center for Parkinson's Disease, Lille University Medical Center, Lille, France.
Brain Behav. 2025 May;15(5):e70101. doi: 10.1002/brb3.70101.
Speech impairment is a recognized but unpredictable adverse effect of sub-thalamic nucleus deep brain stimulation (STN-DBS) for Parkinson's disease (PD).
To evaluate the prevalence of speech impairment 1 year after STN-DBS in PD patients and to determine the predictive factors for speech outcome following STN-DBS.
Data for 417 patients from the French national PREDISTIM study were collected preoperatively. The combined effect of medical treatment and surgery on speech was compared using specific items from dedicated clinical scales (MDS-UPDRS III.1: primary endpoint) and patient self-assessment questionnaires (items 34 and 35 of the PDQ39: secondary endpoints). For each variable, three patient groups were generated according to speech outcome at 1 year: worsening, stability, and improvement. In the second step analysis, the three groups were compared for demographic and clinical variables at baseline and STN-DBS parameters.
There was a significant deterioration in speech of all considered items 1 year after combined STN-DBS and dopaminergic treatment. Four predictive factors for speech deterioration were detected: (i) the absence of preoperative speech impairment (p < 0.001); (ii) severity of motor activity of daily living (MDS-UPDRS II off total score) (p = 0.037); (iii) high-intensity stimulation of the left electrode (i.e., above 3.6 V) (p = 0.046); and (iv) the absence of any change in non-motor experiences of daily life (MDS-UPDRS I total score) (p = 0.048).
Speech outcome should be carefully monitored after STN-DBS, especially in PD patients without preoperative speech impairment, with motor difficulties in daily-living activities, and with increased left electrode intensity.
ClinicalTrials.gov identifier: NCT02360683.
言语障碍是帕金森病（PD）丘脑底核深部脑刺激（STN-DBS）一种已被认识但不可预测的不良反应。
评估帕金森病患者接受STN-DBS 1年后言语障碍的患病率，并确定STN-DBS后言语结果的预测因素。
收集来自法国全国PREDISTIM研究的417例患者术前数据。使用专门临床量表的特定项目（MDS-UPDRS III.1：主要终点）和患者自我评估问卷（PDQ39的项目34和35：次要终点）比较药物治疗和手术对言语的联合影响。对于每个变量，根据1年时的言语结果将患者分为三组：恶化、稳定和改善。在第二步分析中，比较三组在基线时的人口统计学和临床变量以及STN-DBS参数。
在STN-DBS和多巴胺能治疗联合应用1年后，所有考虑项目的言语均有显著恶化。检测到四个言语恶化的预测因素：（i）术前无言语障碍（p<0.001）；（ii）日常生活运动活动的严重程度（MDS-UPDRS II关期总分）（p = 0.037）；（iii）左电极高强度刺激（即高于3.6V）（p = 0.046）；（iv）日常生活非运动体验无任何变化（MDS-UPDRS I总分）（p = 0.048）。
STN-DBS后应仔细监测言语结果，尤其是在术前无言语障碍、日常生活活动有运动困难且左电极强度增加的帕金森病患者中。
ClinicalTrials.gov标识符：NCT02360683。
