Results of a Randomized Clinical Trial of Speech After Early Neurostimulation in Parkinson's Disease.

The EARLYSTIM trial demonstrated for Parkinson's disease patients with early motor complications that deep brain stimulation of the subthalamic nucleus (STN-DBS) and best medical treatment (BMT) was superior to BMT alone. This prospective, ancillary study on EARLYSTIM compared changes in blinded speech intelligibility assessment between STN-DBS and BMT over 2 years, and secondary outcomes included non-speech oral movements (maximum phonation time [MPT], oral diadochokinesis), physician- and patient-reported assessments. STN-DBS (n = 102) and BMT (n = 99) groups underwent assessments on/off medication at baseline and 24 months (in four conditions: on/off medication, ON/OFF stimulation-for STN-DBS). Words and sentences were randomly presented to blinded listeners, and speech intelligibility rate was measured. Statistical analyses compared changes between the STN-DBS and BMT groups from baseline to 24 months. Over the 2-year period, changes in speech intelligibility and MPT, as well as patient-reported outcomes, were not different between groups, either off or on medication or OFF or ON stimulation, but most outcomes showed a nonsignificant trend toward worsening in both groups. Change in oral diadochokinesis was significantly different between STN-DBS and BMT groups, on medication and OFF STN-DBS, with patients in the STN-DBS group performing slightly worse than patients under BMT only. A signal for clinical worsening with STN-DBS was found for the individual speech item of the Unified Parkinson's Disease Rating Scale, Part III. At this early stage of the patients' disease, STN-DBS did not result in a consistent deterioration in blinded speech intelligibility assessment and patient-reported communication, as observed in studies of advanced Parkinson's Disease. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Pinto S ，Nebel A ，Rau J ，Espesser R ，Maillochon P ，Niebuhr O ，Krack P ，Witjas T ，Ghio A ，Cuartero MC ，Timmermann L ，Schnitzler A ，Hesekamp H ，Meier N ，Müllner J ，Hälbig TD ，Möller B ，Paschen S ，Paschen L ，Volkmann J ，Barbe MT ，Fink GR ，Becker J ，Reker P ，Kühn AA ，Schneider GH ，Fraix V ，Seigneuret E ，Kistner A ，Rascol O ，Brefel-Courbon C ，Ory-Magne F ，Hartmann CJ ，Wojtecki L ，Fradet A ，Maltête D ，Damier P ，Le Dily S ，Sixel-Döring F ，Benecke P ，Weiss D ，Wächter T ，Pinsker MO ，Régis J ，Thobois S ，Polo G ，Houeto JL ，Hartmann A ，Knudsen K ，Vidailhet M ，Schüpbach M ，Deuschl G ，EARLYSTIM Study Group ... -  《-》

Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease.

Tripoliti E ，Zrinzo L ，Martinez-Torres I ，Frost E ，Pinto S ，Foltynie T ，Holl E ，Petersen E ，Roughton M ，Hariz MI ，Limousin P ... -  《-》

Articulation Features of Parkinson's Disease Patients with Subthalamic Nucleus Deep Brain Stimulation.

Tanaka Y ，Tsuboi T ，Watanabe H ，Kajita Y ，Nakatsubo D ，Fujimoto Y ，Ohdake R ，Ito M ，Atsuta N ，Yamamoto M ，Wakabayashi T ，Katsuno M ，Sobue G ... -  《-》

Longitudinal Speech Change After Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease Patients: A 2-Year Prospective Study.

Tanaka Y ，Tsuboi T ，Watanabe H ，Nakatsubo D ，Maesawa S ，Kato S ，Kajita Y ，Sato M ，Oodake R ，Hattori M ，Yamamoto M ，Wakabayashi T ，Katsuno M ，Sobue G ... -  《-》

Effects of deep brain stimulation of the subthalamic nucleus on freezing of gait in Parkinson's disease: a prospective controlled study.

Freezing of gait (FOG) is a debilitating gait disorder in Parkinson's disease (PD) with partial responsiveness to dopaminergic medication. To date, notions about the effects of subthalamic deep brain stimulation (STN-DBS) on FOG remain controversial. To compare the effects of bilateral STN-DBS and continued best medical treatment (BMT) on FOG occurrence, FOG severity and clinical outcomes in PD patients at 6 and 12 months follow-up. In this prospective, controlled study, 41 PD patients with at least 5 years disease duration participated. Twenty-four subjects (20 with FOG) were treated with STN-DBS and seventeen (15 with FOG) continued BMT. The primary outcome was the New Freezing of Gait Questionnaire (NFOGQ) at 6 months postsurgery. Other outcomes were the NFOGQ at 12 months and clinical outcomes (Unified Parkinson's Disease Rating Scale III (UPDRS III), timed gait, falls and quality of life) at both time points. STN-DBS increased the likelihood to convert from being a freezer to a non-freezer at 6 and 12 months follow-up (relative risk reduction=0.4). However, 45% of baseline freezers still experienced FOG 6 and 12 months postsurgery although with reduced severity. Three baseline non-freezers (1/2 BMT-treated, 2/4 STN-DBS-treated) developed FOG during follow-up. STN-DBS-induced benefits on FOG were mostly mediated by baseline levodopa equivalent dose, altered medication-intake and reduced motor fluctuations. In contrast to continued BMT, STN-DBS reduced FOG occurrence and severity at 6 months postsurgery with largely sustained effects at 12 months follow-up. Longer follow-up periods are needed to test whether FOG improvements after STN-DBS persist with disease progression.

Vercruysse S ，Vandenberghe W ，Münks L ，Nuttin B ，Devos H ，Nieuwboer A ... -  《-》