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Subthalamic nucleus deep brain stimulation changes speech respiratory and laryngeal control in Parkinson\u27s disease

机译:丘脑底核深部脑刺激改变言语 帕金森病的呼吸和喉控制

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摘要

Adequate respiratory and laryngeal motor control are essential for speech, but may be impaired in Parkinson\u27s disease (PD). Bilateral subthalamic nucleus deep brain stimulation (STN DBS) improves limb function in PD, but the effects on respiratory and laryngeal control remain unknown. We tested whether STN DBS would change aerodynamic measures of respiratory and laryngeal control, and whether these changes were correlated with limb function and stimulation parameters. Eighteen PD participants with bilateral STN DBS were tested within a morning session after a minimum of 12 h since their most recent dose of anti-PD medication. Testing occurred when DBS was on, and again 1 h after DBS was turned off, and included aerodynamic measures during syllable production, and standard clinical ratings of limb function. We found that PD participants exhibited changes with DBS, consistent with increased respiratory driving pressure (n = 9) and increased vocal fold closure (n = 9). However, most participants exceeded a typical operating range for these respiratory and laryngeal control variables with DBS. Changes were uncorrelated with limb function, but showed some correlation with stimulation frequency and pulse width, suggesting that speech may benefit more from low-frequency stimulation and shorter pulse width. Therefore, high-frequency STN DBS may be less beneficial for speech-related respiratory and laryngeal control than for limb motor control. It is important to consider these distinctions and their underlying mechanisms when assessing the impact of STN DBS on PD.
机译:适当的呼吸和喉部运动控制对于语音至关重要,但在帕金森氏病(PD)中可能会受损。双边丘脑下核深部脑刺激(STN DBS)改善了PD的肢体功能,但对呼吸和喉管控制的影响尚不清楚。我们测试了STN DBS是否会改变呼吸和喉咙控制的空气动力学指标,以及这些变化是否与肢体功能和刺激参数相关。自从最近一次服用抗PD药物开始至少12小时后,在早晨的一次会议中对18名患有双侧STN DBS的PD参与者进行了测试。测试在DBS开启时进行,然后在DBS关闭后1小时再次进行,包括音节制作过程中的空气动力学测量以及肢体功能的标准临床评分。我们发现,PD参与者表现出DBS的变化,与呼吸驱动压力增加(n = 9)和声带闭合增加(n = 9)一致。但是,对于DBS,这些呼吸和喉咙控制变量的大多数参与者超出了典型的操作范围。变化与肢体功能无关,但与刺激频率和脉宽显示出一定的相关性,表明语音可能会受益于低频刺激和较短的脉宽。因此,高频STN DBS对于语音相关的呼吸和喉咙控制的益处可能不如四肢运动控制。在评估STN DBS对PD的影响时,必须考虑这些区别及其潜在机制。

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