title: Speech intelligibility in Parkinson's disease patients with zona incerta deep brain stimulation.
abstract: OBJECTIVE
  To investigate the effects of l-dopa (Levodopa) and cZi-DBS (deep brain stimulation in caudal zona incerta) on spontaneous speech intelligibility in patients with PD (Parkinson's disease).
  
  
  METHODS
  Spontaneous utterances were extracted from anechoic recordings from 11 patients with PD preoperatively (off and on l-dopa medication) and 6 and 12 months post bilateral cZi-DBS operation (off and on stimulation, with simultaneous l-dopa medication). Background noise with an amplitude corresponding to a clinical setting was added to the recordings. Intelligibility was assessed through a transcription task performed by 41 listeners in a randomized and blinded procedure.
  
  
  RESULTS
  A group-level worsening in spontaneous speech intelligibility was observed on cZi stimulation compared to off 6 months postoperatively (8 adverse, 1 positive, 2 no change). Twelve months postoperatively, adverse effects of cZi-DBS were not frequently observed (2 positive, 3 adverse, 6 no change). l-dopa administered preoperatively as part of the evaluation for DBS operation provided the overall best treatment outcome (1 adverse, 4 positive, 6 no change).
  
  
  CONCLUSIONS
  cZi-DBS was shown to have smaller negative effects when evaluated from spontaneous speech compared to speech effects reported previously. The previously reported reduction in word-level intelligibility 12 months postoperatively was not transferred to spontaneous speech for most patients. Reduced intelligibility due to cZi stimulation was much more prominent 6 months postoperatively than at 12 months.
authors.affiliation: Division of Speech and Language Pathology Department of Clinical Sciences Umeå University Umeå Sweden.
authors.forename: Linda
authors.initials: L
authors.lastname: Sandström
authors.affiliation: Division of Speech and Language Pathology Department of Clinical Sciences Umeå University Umeå Sweden.
authors.forename: Patricia
authors.initials: P
authors.lastname: Hägglund
authors.affiliation: Division of Speech and Language Pathology Department of Clinical Sciences Umeå University Umeå Sweden.
authors.forename: Louise
authors.initials: L
authors.lastname: Johansson
authors.affiliation: Division of Clinical Neuroscience Department of Pharmacology and Clinical Neuroscience Umeå University Umeå Sweden.
authors.forename: Patric
authors.initials: P
authors.lastname: Blomstedt
authors.affiliation: Division of Speech and Language Pathology Department of Clinical Sciences Umeå University Umeå Sweden.
authors.forename: Fredrik
authors.identifier: 0000-0003-3373-0934
authors.initials: F
authors.lastname: Karlsson
mesh_terms: D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy*; D013065:Speech Intelligibility / Q000502:physiology*; D016896:Treatment Outcome; D065820:Zona Incerta / Q000503:physiopathology*
chemical_list: D007980:Levodopa
keywords: Deep brain stimulation; Levodopa; Parkinson's disease; posterior subthalamic area; spontaneous speech intelligibility; zona incerta