Background:Although earlier studies reported variable speech changes following subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson’s disease (PD) patients, the effects of globus pallidus internus (GPi) DBS on speech performance in PD remain largely unknown. Objective:We aimed to characterize speech changes following PD GPi-DBS. Methods:We retrospectively analyzed clinical and speech outcomes of 25 PD patients treated with bilateral GPi-DBS at a single center. Outcome measures included the Unified Parkinson’s Disease Rating Scale (UPDRS), speech subsystem domains (respiratory, laryngeal, resonance, orofacial, rate, prosody, rhythm, and naturalness), and overall speech intelligibility. Scores at baseline were compared with those at 6 months, 1 year, and the longest clinical follow-up available. Results:In the off-medication state, activities of daily living and motor function based on UPDRS II and III significantly improved postoperatively. We observed unique patterns of speech changes in patients with PD following GPi-DBS in the short- (n = 25) and longer-term (n = 8) follow-up periods. Velopharyngeal (resonance), laryngeal components, and prosody worsened after bilateral GPi-DBS (p < 0.015). Speech intelligibility did not worsen after GPi-DBS in the short-term, but there was a trend to deteriorate at long-term follow-up (e.g., one year and beyond). We observed worsening of hypokinetic dysarthria in individual patients. Also, a minority of patients developed stuttering, spastic dysarthria, or ataxic dysarthria. Conclusion:Bilateral GPi-DBS worsened several modalities of parkinsonian speech without compromising overall speech intelligibility. GPi-DBS can potentially worsen or induce hypokinetic dysarthria, stuttering, spastic dysarthria, or ataxic dysarthria. GPi-DBS may have different and variable effects on speech function when compared to STN-DBS.

中文翻译：

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帕金森氏病苍白球内部深部脑刺激后的构音障碍和言语清晰度。

背景：虽然早期的研究报告了帕金森病 (PD) 患者丘脑底核 (STN) 深部脑刺激 (DBS) 后的可变语音变化，但苍白球内部 (GPi) DBS 对 PD 语音性能的影响仍然很大程度上未知。目的：我们旨在表征 PD GPi-DBS 后的语音变化。方法：我们回顾性分析了单中心双侧 GPi-DBS 治疗的 25 例 PD 患者的临床和言语结果。结果测量包括统一帕金森病评定量表 (UPDRS)、语音子系统领域（呼吸、喉、共振、口面部、速率、韵律、节奏和自然度）和整体语音清晰度。将基线评分与 6 个月、1 年和最长可用临床随访时的评分进行比较。结果：在停药状态下，基于UPDRS II和III的日常生活活动和运动功能在术后显着改善。我们在短期 (n = 25) 和长期 (n = 8) 随访期间观察到 GPi-DBS 后 PD 患者的独特语音变化模式。双侧 GPi-DBS 后腭咽部（共振）、喉部成分和韵律恶化（p < 0.015）。GPi-DBS 术后语音清晰度在短期内没有恶化，但在长期随访中（例如一年及以后）有恶化的趋势。我们观察到个别患者的运动减退性构音障碍恶化。此外，少数患者出现口吃、痉挛性构音障碍或共济失调性构音障碍。结论：双侧 GPi-DBS 在不影响整体语音清晰度的情况下恶化了帕金森病的几种语音模式。GPi-DBS 可能会加重或诱发运动减退性构音障碍、口吃、痉挛性构音障碍或共济失调性构音障碍。与 STN-DBS 相比，GPi-DBS 可能对语音功能产生不同且可变的影响。