Characteristic laryngoscopic findings in Parkinson’s disease patients after subthalamic nucleus deep brain stimulation and its correlation with voice disorder

Takashi Tsuboi, Hirohisa Watanabe, Yasuhiro Tanaka, Reiko Ohdake, Noritaka Yoneyama, Kazuhiro Hara, Mizuki Ito, Masaaki Hirayama, Masahiko Yamamoto, Yasushi Fujimoto, Yasukazu Kajita, Toshihiko Wakabayashi, Gen Sobue

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Speech and voice disorders are one of the most common adverse effects in Parkinson’s disease (PD) patients treated with subthalamic nucleus deep brain stimulation (STN-DBS). However, the pathophysiology of voice and laryngeal dysfunction after STN-DBS remains unclear. We assessed 47 PD patients (22 treated with bilateral STN-DBS (PD-DBS) and 25 treated medically (PD-Med); all patients in both groups matched by age, sex, disease duration, and motor and cognitive function) using the objective and subjective voice assessment batteries (GRBAS scale and Voice Handicap Index), and laryngoscopy. Laryngoscopic examinations revealed that PD-DBS patients showed a significantly higher incidence of incomplete glottal closure (77 vs 48 %; p = 0.039), hyperadduction of the false vocal folds (73 vs 44 %; p = 0.047), anteroposterior hypercompression (50 vs 20 %; p = 0.030) and asymmetrical glottal movement (50 vs 16 %; p = 0.002) than PD-Med patients. On- and off-stimulation assessment revealed that STN-DBS could induce or aggravate incomplete glottal closure, hyperadduction of the false vocal folds, anteroposterior hypercompression, and asymmetrical glottal movement. Incomplete glottal closure and hyperadduction of the false vocal folds significantly correlated with breathiness and strained voice, respectively (r = 0.590 and 0.539). We should adjust patients’ DBS settings in consideration of voice and laryngeal functions as well as motor function.

Original languageEnglish
Pages (from-to)1663-1672
Number of pages10
JournalJournal of Neural Transmission
Volume122
Issue number12
DOIs
Publication statusPublished - 01-12-2015

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry

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