Category: Surgical Therapy: Parkinson's Disease
Objective: To study the effects of Deep Brain Stimulation (DBS) of subthalamic nucleus (STN) and globus pallidus interna (GPi) on voice in patients with Parkinson’s disease (PD)
Background: DBS of STN and GPi can result in deleterious effects on voice in PD patients. There is a paucity of literature examining the effect of unilateral and bilateral STN, GPi DBS on voice in PD patients by using acoustic and patient-reported measures.
Method: We conducted an observational study, in which all patients who underwent STN, GPi DBS surgery at our institution and voice evaluation pre- and six months postoperatively as part of standard of care were included. Voice was evaluated by patient-reported voice handicap index (VHI) which was the primary outcome measure. The secondary outcome measures were acoustic voice measures of sustained phonation and connected speech.
Results: Twenty-eight patients, age 68±9, 82% male were included. Nineteen (68%) had unilateral and 9 (32%) had bilateral procedures. Nineteen had STN and 9 had GPi DBS. Matched pair analysis revealed no significant change in patient reported voice-related quality of life VHI-10(p=0.9). Acoustic measures for spontaneous speech, fluctuations in pitch, loudness, global voice quality, number of breaths and reading speed also did not show any significant change. Self-reported voice when stratified by unilateral vs bilateral, gender and DBS target, did not show any significant change following surgery.
Conclusion: In this study we did not find any voice change in PD patients who underwent unilateral and bilateral DBS of STN and GPi. Though two third of our cohort had unilateral procedures, one-third of the patients who had bilateral procedures also did not experience voice change. Future work will evaluate if unilateral procedures, accuracy in lead placement, stimulation parameters and precise stimulation of targets can prevent deleterious effects of DBS on voice.
To cite this abstract in AMA style:M. Siddiqui, S. Naing, K. Ruckart, R. Hayes, L. Jafri, M. Moya-Mendez, L. Madden, J. Tate. Effects of Unilateral and Bilateral DBS of STN, GPi on Voice in PD Patients [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/effects-of-unilateral-and-bilateral-dbs-of-stn-gpi-on-voice-in-pd-patients/. Accessed September 25, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/effects-of-unilateral-and-bilateral-dbs-of-stn-gpi-on-voice-in-pd-patients/