刺激频率对接受丘脑下核深部脑刺激手术的帕金森病患者言语质量的影响

IF 0.4 Q4 CLINICAL NEUROLOGY

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management Pub Date : 2025-04-19 DOI:10.1016/j.inat.2025.102034

Radhakrishnan Chella Perumal , Krishnaswamy Visvanathan , Sharon Mizpah Prathana Charan

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引用次数: 0

摘要

针对丘脑底核（STN）的深部脑刺激（DBS）已经成功地改善了核心运动症状，包括运动波动和语言系统，甚至在帕金森病（PD）的晚期也是如此。鉴于DBS频率设置会影响语音清晰度，因此在DBS编程时确定理想的频率设置以最大限度地减少PD患者术后语音质量的下降是很重要的。目的比较和对比丘脑下核深部脑刺激（STN-DBS）中刺激频率（高、低、DBS关闭状态）对PD患者言语质量的影响。方法对6例接受STN-DBS治疗的PD患者在低、高刺激频率和dbs关闭状态下的发音和声音参数进行主观和客观测量。结果friedman 's双向方差分析显示语音的客观测量有显著差异(p <；低、高刺激频率和DBS关闭状态在发音和主观声音参数上差异无统计学意义。结论与运动运动相比，DBS植入STN的位置、高频刺激时电流向邻近通路的扩散、疾病持续时间以及DBS手术后的药物剂量对言语质量的影响是不利的。低频刺激可以提高语言得分，但也可能导致运动功能下降。相反，高频率的刺激对控制震颤和身体运动是有效的，但可能导致语言得分下降。高刺激频率引起的语言退化程度因患者而异，强调需要个性化的深部脑刺激（DBS）参数规划以及整体语言康复，以平衡运动和语言结果。DBS刺激频率的改变可以改变帕金森病患者的语言和运动特征。因此，在编程DBS刺激参数时，需要根据患者的个体需求进行调整，平衡运动功能和语言结果。

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Effect of stimulation frequency on quality of speech in individuals with Parkinson’s disease who have undergone sub thalamic nucleus Deep Brain Stimulation surgery

Background

Deep Brain Stimulation (DBS) targeting the subthalamic nucleus (STN) has been successful in improving the core motor symptoms, including motor fluctuations and speech systems, even in advanced stages of Parkinson’s Disease (PD). Given that the DBS frequency setting influences speech intelligibility, it is important to determine the ideal frequency setting while programming DBS to minimize reduction in speech quality postoperatively in individuals with PD.

Aim

To compare and contrast the effects of stimulation frequency (High, Low, DBS off state) in subthalamic nucleus Deep Brain Stimulation (STN-DBS) on the quality of speech in individuals with PD.

Method

Subjective and objective measures of articulation and voice parameters were estimated in low as well as high stimulation frequencies and the DBS-off state for six individuals with PD treated with STN-DBS.

Results

Friedman’s Two-way ANOVA yielded significant differences in objective measures of voice (p < 0.05) only, however there was no statistically significant difference between the low, high stimulation frequency and DBS off state on the articulatory and subjective voice parameters.

Conclusion

The site of DBS insertion in the STN, the spread of current to adjacent pathways during high-frequency stimulation, the duration of disease, and the dosage of medication post-DBS surgery can cause detrimental effects on the quality of speech compared to motor movements. Low-frequency stimulation can improve speech scores, but it may also lead to a decline in motor function. On the contrary, a high stimulation frequency is effective in controlling tremors and body movements but may result in a decrease in speech scores. The extent of speech deterioration caused by a high stimulation frequency varies among patients, emphasizing the need for individualized programming of deep brain stimulation (DBS) parameters along with holistic rehabilitation for speech to balance motor and speech outcomes.

Key messages

Changes in the DBS stimulation frequency can alter speech and motor characteristics in individuals with Parkinson’s disease. Hence, while programming DBS stimulation parameters, it needs to be tailored to the individual patient’s needs, balancing the motor function with speech outcomes.

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