%0 Journal Article
%T Perceived Changes in Communication as an Effect of STN Surgery in Parkinson's Disease: A Qualitative Interview Study
%A Emilia Ahlberg
%A Katja Laakso
%A Lena Hartelius
%J Parkinson's Disease
%D 2011
%I Hindawi Publishing Corporation
%R 10.4061/2011/540158
%X The aim of the present study was to explore four individuals' perspective of the way their speech and communication changed as a result of subthalamic nucleus deep brain stimulation treatment for Parkinson's disease. Interviews of two men and two women were analyzed using qualitative content analysis. Three themes emerged as a result of the analysis. The first theme included sub-themes describing both increased and unexpected communication difficulties such as a more vulnerable speech function, re-emerging stuttering and cognitive difficulties affecting communication. The second theme comprised strategies to improve communication, using different speech techniques and communicative support, as well as trying to achieve changes in medical and stimulation parameters. The third theme included descriptions of mixed feelings surrounding the surgery. Participants described the surgery as an unavoidable dramatic change, associated both with improved quality of life but also uncertainty and lack of information, particularly regarding speech and communication changes. Despite negative effects on speech, the individuals were generally very pleased with the surgical outcome. More information before surgery regarding possible side effects on speech, meeting with a previously treated patient and possibly voice and speech therapy before or after surgery are suggested to facilitate the adjustment to the new speech conditions. 1. Introduction Although subthalamic nucleus deep brain stimulation (STN-DBS) treatment for ParkinsonĄ¯s disease (PD) has been reported to be an effective treatment for advanced motor symptoms of the limbs, such as tremor, rigidity, and bradykinesia, the effects on different speech parameters (phonation, articulation, speech rate) and intelligibility are equivocal [1¨C3]. Dysarthria was reported as a persistent adverse event in 5¨C70% of surgical cases reported by Romito and Albanese [2]. A recent study comparing 32 consecutive patients treated with STN-DBS with an optimally medicated control group [3] concluded that most patients exhibited reduced speech intelligibility, a negative change attributed to both medical and surgical factors. Other earlier studies have reported unaffected speech function [4] or improvements [5, 6]. In general, studies of speech effects show that phonatory and articulatory components measured separately are improved by STN-DBS [7¨C9]. However, speech intelligibility, which is more indicative of overall speech production, is often reduced [3]. The speech disorder associated with PD is well described [10, 11] mainly in terms
%U http://www.hindawi.com/journals/pd/2011/540158/