The effects of Thalamic Deep Brain Stimulation on speech dynamics in patients with Essential Tremor: An articulographic study

PLoS One. 2018 Jan 23;13(1):e0191359. doi: 10.1371/journal.pone.0191359. eCollection 2018.

Abstract

Acoustic studies have revealed that patients with Essential Tremor treated with thalamic Deep Brain Stimulation (DBS) may suffer from speech deterioration in terms of imprecise oral articulation and reduced voicing control. Based on the acoustic signal one cannot infer, however, whether this deterioration is due to a general slowing down of the speech motor system (e.g., a target undershoot of a desired articulatory goal resulting from being too slow) or disturbed coordination (e.g., a target undershoot caused by problems with the relative phasing of articulatory movements). To elucidate this issue further, we here investigated both acoustics and articulatory patterns of the labial and lingual system using Electromagnetic Articulography (EMA) in twelve Essential Tremor patients treated with thalamic DBS and twelve age- and sex-matched controls. By comparing patients with activated (DBS-ON) and inactivated stimulation (DBS-OFF) with control speakers, we show that critical changes in speech dynamics occur on two levels: With inactivated stimulation (DBS-OFF), patients showed coordination problems of the labial and lingual system in terms of articulatory imprecision and slowness. These effects of articulatory discoordination worsened under activated stimulation, accompanied by an additional overall slowing down of the speech motor system. This leads to a poor performance of syllables on the acoustic surface, reflecting an aggravation either of pre-existing cerebellar deficits and/or the affection of the upper motor fibers of the internal capsule.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Articulation Disorders / etiology*
  • Articulation Disorders / physiopathology
  • Articulation Disorders / psychology
  • Case-Control Studies
  • Deep Brain Stimulation / adverse effects*
  • Essential Tremor / physiopathology
  • Essential Tremor / psychology
  • Essential Tremor / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Speech / physiology
  • Speech Acoustics
  • Speech Articulation Tests
  • Thalamus / physiopathology*

Grants and funding

This work was supported by the German Research Foundation (DFG) as part of the SFB 1252 “Prominence in Language” in the project A04 “Dynamic modelling of prosodic prominence” at the University of Cologne.