Effects of Pallidal Stimulation on Speech in Three Men With Severe Parkinson’s Disease This project examined the effects of pallidal stimulation and medication on speech in three men with severe Parkinson’s disease. Two participants had bilateral pallidal stimulation and one had unilateral stimulation contralateral to a prior pallidotomy. Measures included general motor function, auditory perceptual characteristics of speech, intelligibility, inter-pause speech rate, and ... Research Article
Research Article  |   August 01, 2000
Effects of Pallidal Stimulation on Speech in Three Men With Severe Parkinson’s Disease
 
Author Affiliations & Notes
  • Nancy Pearl Solomon
    University of Minnesota, Minneapolis
  • Amy S. McKee
    University of Minnesota, Minneapolis
  • Katherine J. Larson
    University of Minnesota, Minneapolis
  • Michael D. Nawrocki
    University of Minnesota, Minneapolis
  • Paul J. Tuite
    University of Minnesota, Minneapolis
  • Sharon Eriksen
    University of Minnesota, Minneapolis
  • Walter C. Low
    University of Minnesota, Minneapolis
  • Robert E. Maxwell
    University of Minnesota, Minneapolis
  • Contact author: Nancy Pearl Solomon, PhD, Department of Communication Disorders, University of Minnesota, Minneapolis, MN 55455. Email: solom006@umn.edu
Article Information
Research Articles
Research Article   |   August 01, 2000
Effects of Pallidal Stimulation on Speech in Three Men With Severe Parkinson’s Disease
American Journal of Speech-Language Pathology, August 2000, Vol. 9, 241-256. doi:10.1044/1058-0360.0903.241
History: Received January 31, 2000 , Accepted June 15, 2000
 
American Journal of Speech-Language Pathology, August 2000, Vol. 9, 241-256. doi:10.1044/1058-0360.0903.241
History: Received January 31, 2000; Accepted June 15, 2000

This project examined the effects of pallidal stimulation and medication on speech in three men with severe Parkinson’s disease. Two participants had bilateral pallidal stimulation and one had unilateral stimulation contralateral to a prior pallidotomy. Measures included general motor function, auditory perceptual characteristics of speech, intelligibility, inter-pause speech rate, and speech aerodynamics. All three participants had improved motor function (better mobility, reduced tremor and dyskinesia), but responses for speech varied widely. The participant with a prior unilateral pallidotomy and contralateral pallidal stimulation had alleviation of painful facial-mandibular dystonia so that he was more willing and better able to talk. One participant developed marked hypophonia postoperatively from a presumed pallidotomy or chronic stimulation effect as this result was not altered by deactivating the bilateral stimulators. The third participant dεmonstrated improved overall speech characterized by reduced vocal strain and tremulousness in the medication-on condition when the stimulators were activated. In the medication-of condition, he developed abnormal speech dysfluencies with bilateral pallidal stimulation, but this impairment was eliminated with medication or when the stimulators were deactivated. Careful exploration of speech sequelae after pallidal stimulation is essential to develop risk/benefit data for future neurosurgical candidates.

Acknowledgments
This research was supported by a Grant-in-Aid of Research, Artistry, and Scholarship from the Office of the Vice President for Research and Dean of the Graduate School and by the Bryng Bryngelson Communication Disorders Research Fund at the University of Minnesota. Medtronic (Minneapolis, MN) donated the Itrel II deep brain stimulators. We appreciate the helpful suggestions provided by Joseph R. Duffy, Ann Bosma Smit, and an anonymous reviewer on previous versions of this manuscript. A preliminary report of this research was presented at the Annual Convention of the American Speech-Language-Hearing Association, November 1998, San Antonio, TX.
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