Declines in speech intelligibility and verbal fluency are among the most common adverse effects from DBS and other functional neurosurgery procedures for movement disorders. A more detailed understanding of speech side effects from DBS could inform target selection and better define postoperative risk for speech dysfunction following both DBS and ablative procedures. We measured speech side effects from DBS in the subthalamic nucleus (STN), ventral intermediate thalamus (VIM), and globus pallidus interna (GPi) as part of routine provocative testing during device activation in a cross-section of 397 leads from 380 unique patients. We described the proportion of contacts with speech side effects (±95% confidence interval) and analyzed their associated voltage thresholds (mean ± standard error) with analysis of variance across variables of interest. Brain target had the strongest effect on both prevalence (0.32 95% CI [0.30 0.35], 0.26 [0.23 0.29], and 0.16 [0.14 0.19]) and thresholds (3.0±0.1, 3.4±0.1, and 3.8±0.1) for speech side effects during DBS activation (STN, VIM, and GPi targets, respectively, p<0.001). Handedness and brain hemisphere contribute to speech side effects from DBS, as well (p=0.048 and p=0.042, respectively). Gender played no significant role in prevalence or thresholds for speech side effects from DBS (p=0.76). Target, hemisphere, and handedness all influence potential risk for speech side effects from DBS. This retrospective, acute study provides supportive evidence for selecting the GPi rather than the STN target in PD patients with concerns for speech dysfunction following surgery. #stuttering
Memon, Adeel, Kaur, Manmeet, Faulk, Jesse, Futhrie, Bart, and Walker, Harrison. (2018). Speech Side Effects from DBS: Differential Effects of Target, Handedness, and Hemisphere. Neurology Apr 2018, 90 (15 Supplement) P4.058.
[Deep Brain Stimulation, effects, target, handedness, hemisphere]