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Precision och stabilitet vid klusilexplosionen hos patienter med Parkinsons sjukdom: En jämförelse mellan effekten av Deep Brain Stimulation i kaudala zona incerta (cZi) respektive nucleus subthalamicus (STN)
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Speech and Language Therapy.
2013 (Swedish)Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
Abstract [sv]

Bakgrund: Deep Brain Stimulation (DBS) i nucleus subthalamicus (STN) och i kaudala zona incerta (cZi) har visat positiva effekter på motoriska symtom (rörelseförmåga och balans) vid Parkinsons sjukdom. Efter DBS har dock negativa taleffekter noterats, inklusive nedsatt artikulatorisk precision och stabilitet. Nedsatt artikulatorisk precisionoch stabilitet påverkar klusilproduktionen mest vilket kan resultera i att klusilexplosionen uteblir eller att multipla explosioner uppstår.

Mål: Att undersöka artikulatorisk precision och stabilitet vid klusilexplosionen efter DBS i STN respektive cZi.

Metod: I studien deltog 19 patienter varav 9 deltagare stimulerats i STN och 10 deltagare i cZi. Talinspelningar gjordes innan operation och ett år efter operation med DBSstimulering på och av. Klusilerna i talmaterialet delades in i tre kategorier, de med en klusilexplosion, de med två eller flera klusilexplosioner samt de utan klusilexplosion. Hypotesprövning gjordes gällande fördelningen av klusiler med multipla explosioner samt klusiler utan explosion mellan och inom patientgrupperna samt inom respektive klusil.

Resultat: Multipla explosioner ökade hos cZi-patienterna och minskade hos STNpatienterna. Klusiler som saknade explosion ökade hos STN-patienterna medan de minskade hos cZi-patienterna. För båda patientgrupperna ökade multipla explosioner och klusiler utan explosion då stimuleringen var på jämfört med av. Skillnaderna mellan och inom grupperna var inte signifikanta.

Slutsats: Artikulatorisk precision och stabilitet påverkades efter DBS i form av bristande stabilitet, för kort slutningsrörelse och felaktig koordination av slutningsrörelsen. Detta resulterade i multipla explosioner och uteblivna explosioner med olika effekter för elektrodlokalisationerna.

Abstract [en]

Background: Deep Brain Stimulation (DBS) in Subthalamicus Nucleus (STN) and Caudala zona incerta (cZi) have shown positive effects on motor symptoms in Parkinson‘s disease. Negative effects on speech after DBS has been noted including reduced articulatory precision. Reduced articulatory precision and stability affects the production of stop consonants and as a result, loss of burst or multiple burst can occur.

Aim: To investigate articulatory precision and stability regarding the burst in stop consonants after DBS of STN or cZi.

Method: The study included 19 patients with 9 patients stimulated in STN and 10 patientsin cZi. Speech recordings were made before surgery and one year after with stimulation ON and OFF. The stop consonants were divided into three categories, those with one burst, those with two or more bursts (multiple burst) and those with loss of burst. Hypothesis testing was done on the categorization of the stop consonants in and between the groups and between the stop consonants types.

Results: Multiple burst increased in the cZi group and decreased in the STN group. Stop consonants with loss of burst increased in the STN group but decreased in the cZi group. For both groups multiple burst and stop consonants with loss of burst increased with stimulation on. The differences between and within the groups were not significant.

Conclusion: Articulatory precision and stability were affected by DBS with decreased stability, shortened occlusion and incorrect coordination. As a result multiple burst and loss of burst occurred in both groups.

Place, publisher, year, edition, pages
2013. , 14 p.
Keyword [en]
Parkinson’s disease, DBS, STN, cZi, articulatory precision, articulatory stability, stop consonants, burst, multiple burst
Keyword [sv]
Parkinsons sjukdom, DBS, STN, cZi, artikulatorisk precision, artikulatorisk stabilitet, klusiler, klusilexplosion, multipla explosioner
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-64015OAI: oai:DiVA.org:umu-64015DiVA: diva2:586508
External cooperation
Effects of deep brain stimulation treatment of Parkinson's decease on speech and articulation proficiency: A longitudinal and contrastive study.
Educational program
Speech-Language Pathology
Uppsok
Medicine
Supervisors
Projects
Speech, voice and swallowing outcomes after deep brain stimulation of the zona incerta and the pedunculopontine nucleus in Parkinson’s disease: Comparsion with stimulation of the subthalamic nucleus
Available from: 2014-03-07 Created: 2013-01-11 Last updated: 2014-03-07Bibliographically approved

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