Abstract Details

Title Unique speech change pattern in Parkinson’s disease after GPi deep brain stimulation

Topic Movement Disorders

Presentation(s) P2 - Poster Session 2 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-005

Objective To characterize changes in speech and voice parameters in patients with Parkinson’s disease (PD) after globus pallidus interna (GPi) deep brain stimulation (DBS).

Background The majority of PD patients develop voice and speech disorders in their disease course, characterized by weak voice, monotonous pitch and loudness, short rushes of speech, and imprecise articulation (termed hypokinetic dysarthria). PD patients have variable speech changes following STN-DBS, but effects of GPi-DBS on speech performance in PD remain unclear.

Design/Methods We used the prospective University of Florida INFORM database and chart review to identify PD patients who underwent bilateral GPi-DBS from 2006-2019. We collected demographics, experiences of daily living, motor and speech function. Our speech evaluation targeted speech subsystem domains (respiratory, laryngeal, velopharyngeal, orofacial, rate, prosody, rhythm, naturalness) and overall intelligibility, with severity ratings on a Likert scale ranging from 0 (no dysfunction) to 7 (anarthric). Patients missing pre- or postsurgical evaluations were excluded. We compared clinical evaluations between baseline and 6-12 months postsurgically.

Results We identified 31 patients of which 58% were male (n=18), with mean age at surgery of 63.7±9.6 years. Baseline Unified Parkinson Disease Rating Scale (UPDRS) part III mean total score off medications was 41.2±10.4, with mean baseline speech subscore of 1.4±0.7. We examined speech subsystem domains and found significant worsening in the following parameters after bilateral GPi-DBS: laryngeal, velopharyngeal, prosody and naturalness (p<0.05). No significant difference was found in overall intelligibility between pre- (98.4±2.8%) and post (98.5±3.7%) GPi-DBS (p=0.46).

Conclusions We found that GPi-DBS worsened several modalities of Parkinsonian speech without compromising overall speech intelligibility. This pattern appears different from impact of STN-DBS, whereby deterioration of articulation, reduced intelligibility and induction of spastic dysarthria are more commonly seen. Speech function may be less compromised after GPi-DBS. More investigation is needed to evaluate differential pathophysiological mechanisms of stimulation-related dysarthria.

Authors/Disclosures
Shannon Y. Chiu, MD, MSc (Mayo Clinic Arizona) PRESENTER	Dr. Chiu has received research support from NIH.
Takashi Tsuboi, PhD (Nagoya University)	No disclosure on file
Matthew R. Burns, MD, PhD (University of Florida)	The institution of Dr. Burns has received research support from NIH. The institution of Dr. Burns has received research support from Mcknight Brain Institute.
Joseph Legacy, MD	No disclosure on file
Kathryn P. Moore, MD (Duke University, Neurology)	Dr. Moore has a non-compensated relationship as a Medical Advisory Board with HD Reach that is relevant to �鶹��ýӳ�� interests or activities.
	No disclosure on file
	No disclosure on file
Adolfo Ramirez Zamora, MD (University of Louisville)	Dr. Ramirez Zamora has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerevel therapeutics. Dr. Ramirez Zamora has received personal compensation in the range of $0-$499 for serving as a Consultant for NeuroPacs. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Iota Inc. Dr. Ramirez Zamora has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Maplight. Dr. Ramirez Zamora has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. The institution of Dr. Ramirez Zamora has received research support from Parkinsons Foundation.
Kelly D. Foote, MD	Kelly D. Foote, MD has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Axio/Neurocrine Biosciences.
Michael S. Okun, MD, F�鶹��ýӳ�� (University of Florida)	Dr. Okun has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Okun has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Parkinson's Foundation. Dr. Okun has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Okun has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Journal Watch. The institution of Dr. Okun has received research support from NIH. The institution of Dr. Okun has received research support from Parkinson's Foundation. The institution of Dr. Okun has received research support from Tourette Association of America. The institution of Dr. Okun has received research support from Michael J Fox. Dr. Okun has received publishing royalties from a publication relating to health care.
Leonardo Almeida (University of Florida College of Medicine - Neurology)	No disclosure on file

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