Voice handicap Index in Parkinson's patients: Subthalamic versus globus pallidus deep brain stimulation. (April 2022)

• Record Type: Journal Article
• Authors: Kopf, Lisa M.; Rohl, Andrea H.G.; Nagao, Takaaki; Bryant, Karen N.T.; Johari, Karim; Tjaden, Kris; Greenlee, Jeremy D.W.
• Is Part Of: Journal of clinical neuroscience. Volume 98(2022)
• Page Start: 83
• Page End: 88
• Publication Date: 2022-04
• Subjects: Speech -- Surgery -- Parkinson's disease -- Voice -- Deep brain stimulation; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2022.01.029
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Self-rated voice impairment (VHI score) does not differ significantly between GPI and STN targeted DBS groups. Higher stimulation parameters (TEED) are associated with greater levels of voice impairments. STN-DBS results in greater reduction in levodopa equivalent dose than in GPI-DBS patients. Patient-perceived vocal handicap is not associated with levodopa equivalent dose. Speech and voice deficits vary significantly in PD patients irrespective of DBS target. Abstract: Purpose: Subthalamic nucleus (STN) and globus pallidus interna (GPI) are the two most common sites for deep brain stimulation (DBS) in people with Parkinson's disease (PWP). Voice impairments are a common symptom of Parkinson's disease and information about voice outcomes with DBS is limited. Most studies in speech-language pathology have focused on STN-DBS and few have examined the effects of GPI-DBS. This was an initial effort to examine the impact of DBS location on Vocal Handicap Index (VHI) scores, which assess the impact of a voice disorder on an individual. Method: Twenty-four gender-matched PWP (12 STN-DBS and 12 GPI-DBS) completed the VHI post-DBS implantation. Two-tailed independent samples t-tests were used to compare each VHI scale score (physical, functional, emotional, total) and patient factors between the two groups. Results: No significant differences in total or subscale VHI scores were identified between the two DBS groups. A trend toward greater impairment in PWP with GPI-DBS was noted. An association between higher VHI scores and DBS settings was found. Conclusions: Studies directly comparing speech outcomes for different DBS targets are lacking. The current findings provide new insights concerning voice outcomes following DBS by adding to the limited literature directly comparing speech outcomes in multiple DBS targets. Limitations and directions for future research are discussed.