Stimulation of the Subthalamic Nucleus Changes Cortical-Subcortical Blood Flow Patterns During Speech: A Positron Emission Tomography Study

Frontiers in Neurology

Vijay Dhawan²  David Eidelberg²  Diana Van Lancker Sidtis³  Michele Tagliati⁴  John J. Sidtis⁵ 

[1] Brain and Behavior Laboratory, Geriatrics Department, Nathan Kline Institute, Orangeburg, NY, United States;Center for Neurosciences, The Feinstein Institute for Medical Research, Manhasset, NY, United States;Department of Communicative Disorders and Sciences, New York University Steinhardt School, New York, NY, United States;Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA, United States;Department of Psychiatry, School of Medicine, New York University Langone, New York, NY, United States;

关键词: Parkinson's disease;    deep brain stimulation;    Positron Emission Tomography;    speech;    subthalamic nucleus;   

DOI  :  10.3389/fneur.2021.684596

来源: DOAJ

【 摘 要 】

Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for Parkinson's disease (PD) but can have an adverse effect on speech. In normal speakers and in those with spinocerebellar ataxia, an inverse relationship between regional cerebral blood flow (rCBF) in the left inferior frontal (IFG) region and the right caudate (CAU) is associated with speech rate. This pattern was examined to determine if it was present in PD, and if so, whether it was altered by STN-DBS.Methods: Positron Emission Tomography (PET) measured rCBF during speech in individuals with PD not treated with STN-DBS (n = 7), and those treated with bilateral STN-DBS (n = 7). Previously reported results from non-PD control subjects (n = 16) were reported for comparison. The possible relationships between speech rate during scanning and data from the left and right IFG and CAU head regions were investigated using a step-wise multiple linear regression to identify brain regions that interacted to predict speech rate.Results: The multiple linear regression analysis replicated previously reported predictive coefficients for speech rate involving the left IFG and right CAU regions. However, the relationships between these predictive coefficients and speech rates were abnormal in both PD groups. In PD who had not received STN-DBS, the right CAU coefficient decreased normally with increasing speech rate but the left IFG coefficient abnormally decreased. With STN-DBS, this pattern was partially normalized with the addition of a left IFG coefficient that increased with speech rate, as in normal controls, but the abnormal left IFG decreasing coefficient observed in PD remained. The magnitudes of both cortical predictive coefficients but not the CAU coefficient were exaggerated with STN-DBS.Conclusions: STN-DBS partially corrects the abnormal relationships between rCBF and speech rate found in PD by introducing a left IFG subregion that increases with speech rate, but the conflicting left IFG subregion response remained. Conflicting IFG responses may account for some of the speech problems observed after STN-DBS. Cortical and subcortical regions may be differentially affected by STN-DBS.

【 授权许可】

Unknown