Deep Brain Stimulation of the Subthalamic Nucleus Parameter Optimization for Vowel Acoustics and Speech Intelligibility in Parkinson's Disease Purpose The settings of 3 electrical stimulation parameters were adjusted in 12 speakers with Parkinson's disease (PD) with deep brain stimulation of the subthalamic nucleus (STN-DBS) to examine their effects on vowel acoustics and speech intelligibility. Method Participants were tested under permutations of low, mid, and high STN-DBS ... Research Article
Research Article  |   March 15, 2018
Deep Brain Stimulation of the Subthalamic Nucleus Parameter Optimization for Vowel Acoustics and Speech Intelligibility in Parkinson's Disease
 
Author Affiliations & Notes
  • Thea Knowles
    School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
    Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
  • Scott Adams
    School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
    Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
    Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada
  • Anita Abeyesekera
    School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
    Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
  • Cynthia Mancinelli
    School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
    Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
  • Greydon Gilmore
    Department of Biomedical Engineering, Western University, London, Ontario, Canada
  • Mandar Jog
    Department of Clinical Neurological Sciences, University Hospital, London, Ontario, Canada
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Thea Knowles: tknowle3@uwo.ca
  • Editor-in-Chief: Julie Liss
    Editor-in-Chief: Julie Liss×
Article Information
Speech, Voice & Prosodic Disorders / Hearing & Speech Perception / Acoustics / Special Populations / Older Adults & Aging / Speech, Voice & Prosody / Speech / Research Articles
Research Article   |   March 15, 2018
Deep Brain Stimulation of the Subthalamic Nucleus Parameter Optimization for Vowel Acoustics and Speech Intelligibility in Parkinson's Disease
Journal of Speech, Language, and Hearing Research, March 2018, Vol. 61, 510-524. doi:10.1044/2017_JSLHR-S-17-0157
History: Received April 27, 2017 , Revised July 15, 2017 , Accepted November 16, 2017
 
Journal of Speech, Language, and Hearing Research, March 2018, Vol. 61, 510-524. doi:10.1044/2017_JSLHR-S-17-0157
History: Received April 27, 2017; Revised July 15, 2017; Accepted November 16, 2017

Purpose The settings of 3 electrical stimulation parameters were adjusted in 12 speakers with Parkinson's disease (PD) with deep brain stimulation of the subthalamic nucleus (STN-DBS) to examine their effects on vowel acoustics and speech intelligibility.

Method Participants were tested under permutations of low, mid, and high STN-DBS frequency, voltage, and pulse width settings. At each session, participants recited a sentence. Acoustic characteristics of vowel production were extracted, and naive listeners provided estimates of speech intelligibility.

Results Overall, lower-frequency STN-DBS stimulation (60 Hz) was found to lead to improvements in intelligibility and acoustic vowel expansion. An interaction between speaker sex and STN-DBS stimulation was found for vowel measures. The combination of low frequency, mid to high voltage, and low to mid pulse width led to optimal speech outcomes; however, these settings did not demonstrate significant speech outcome differences compared with the standard clinical STN-DBS settings, likely due to substantial individual variability.

Conclusions Although lower-frequency STN-DBS stimulation was found to yield consistent improvements in speech outcomes, it was not found to necessarily lead to the best speech outcomes for all participants. Nevertheless, frequency may serve as a starting point to explore settings that will optimize an individual's speech outcomes following STN-DBS surgery.

Supplemental Material https://doi.org/10.23641/asha.5899228

Acknowledgments
This research was supported by funding awarded to Greydon Gilmore from the Canadian Institutes of Health Research.
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