Journal article
Effect of deep brain stimulation on vocal motor control mechanisms in Parkinson's disease
Parkinsonism & related disorders, Vol.63, pp.46-53
06/2019
DOI: 10.1016/j.parkreldis.2019.03.002
PMID: 30871801
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment for limb motor symptoms in Parkinson's disease (PD); however, its effect on vocal motor function has yielded conflicted and highly variable results. The present study investigated the effects of STN-DBS on the mechanisms of vocal production and motor control.
A total of 10 PD subjects with bilateral STN-DBS implantation were tested with DBS ON and OFF while they performed steady vowel vocalizations and received randomized upward or downward pitch-shift stimuli (±100 cents) in their voice auditory feedback.
Data showed that the magnitude of vocal compensation responses to pitch-shift stimuli was significantly attenuated during DBS ON vs. OFF (p = 0.012). This effect was direction-specific and was only observed when subjects raised their voice fundamental frequency (F0) in the opposite direction to downward stimuli (p = 0.019). In addition, we found that voice F0 perturbation (i.e. jitter) was significantly reduced during DBS ON vs. OFF (p = 0.022), and this DBS-induced modulation was positively correlated with the attenuation of vocal compensation responses to downward pitch-shift stimuli (r = +0.57, p = 0.028).
These findings provide the first data supporting the role of STN in vocal F0 motor control in response to altered auditory feedback. The DBS-induced attenuation of vocal compensation responses may result from increased inhibitory effects of the subcortical hyperdirect (fronto-subthalamic) pathways on the vocal motor cortex, which can help stabilize voice F0 and ameliorate vocal motor symptoms by impeding PD subjects’ abnormal (i.e. overshooting) vocal responses to alterations in the auditory feedback.
•Vocal motor control mechanisms are impaired in Parkinson's disease (PD).•Deep brain stimulation (DBS) can ameliorate vocal motor impairment in PD.•DBS attenuates abnormal vocal responses to altered auditory feedback (AAF).•DBS effect on vocal responses to AAF is specific to downward pitch-shift stimuli.•DBS increases vocal motor stability by reducing F0 variability during vocalization.
Details
- Title: Subtitle
- Effect of deep brain stimulation on vocal motor control mechanisms in Parkinson's disease
- Creators
- Roozbeh Behroozmand - Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29028, USAKarim Johari - Speech Neuroscience Lab, Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC 29028, USARyan M Kelley - Medical Scientist Training Program, University of Iowa, Iowa City, IA 52242, USAEfthymia C Kapnoula - Basque Center on Cognition, Brain and Language, San Sebastian, SpainNandakumar S Narayanan - Department of Neurology, University of Iowa, Iowa City, IA 52242, USAJeremy D.W Greenlee - Human Brain Research Lab, Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
- Resource Type
- Journal article
- Publication Details
- Parkinsonism & related disorders, Vol.63, pp.46-53
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.parkreldis.2019.03.002
- PMID
- 30871801
- ISSN
- 1353-8020
- eISSN
- 1873-5126
- Language
- English
- Date published
- 06/2019
- Academic Unit
- Neurology; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040342802771
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