Selective left, right and bilateral stimulation of subthalamic nuclei in Parkinson's disease: Differential effects on motor, speech and language function

Geralyn M. Schulz, Lara A. Hosey, Trent J. Bradberry, Sheila V. Stager, Li Ching Lee, Rajesh Pawha, Kelly E. Lyons, Leo Verhagen Metman, Allen R. Braun

Research output: Contribution to journalArticle

Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus improves the motor symptoms of Parkinson's disease, but may produce a worsening of speech and language performance at rates and amplitudes typically selected in clinical practice. The possibility that these dissociated effects might be modulated by selective stimulation of left and right STN has never been systematically investigated. To address this issue, we analyzed motor, speech and language functions of 12 patients implanted with bilateral stimulators configured for optimal motor responses. Behavioral responses were quantified under four stimulator conditions: bilateral DBS, right-only DBS, left-only DBS and no DBS. Under bilateral and left-only DBS conditions, our results exhibited a significant improvement in motor symptoms but worsening of speech and language. These findings contribute to the growing body of literature demonstrating that bilateral STN DBS compromises speech and language function and suggests that these negative effects may be principally due to left-sided stimulation. These findings may have practical clinical consequences, suggesting that clinicians might optimize motor, speech and language functions by carefully adjusting left- and right-sided stimulation parameters.

Original languageEnglish (US)
Pages (from-to)29-40
Number of pages12
JournalJournal of Parkinson's Disease
Volume2
Issue number1
DOIs
StatePublished - Apr 9 2012

Keywords

  • Parkinson's disease
  • deep brain stimulation
  • language
  • lateralization
  • speech

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience

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