Aggravated stuttering following subthalamic deep brain stimulation in Parkinson's disease - two cases |
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Authors: | Mathias Toft Espen Dietrichs |
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Institution: | (1) Department of Neurology, Oslo University Hospital, Oslo, Norway;(2) Faculty of Medicine, University of Oslo, Oslo, Norway |
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Abstract: | Stuttering is a speech disorder with disruption of verbal fluency which is occasionally present in patients with Parkinson's
disease (PD). Long-term medical management of PD is frequently complicated by fluctuating motor functions and dyskinesias.
High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an effective treatment of motor fluctuations
and is the most common surgical procedure in PD. Here we report the re-occurrence and aggravation of stuttering following
STN-DBS in two male patients treated for advanced PD. In both patients the speech fluency improved considerably when the neurostimulator
was turned off, indicating that stuttering aggravation was related to neurostimulation of the STN itself, its afferent or
efferent projections and/or to structures localized in the immediate proximity. This report supports previous studies demonstrating
that lesions of the basal ganglia-thalamocortical motor circuit, including the STN, is involved in the development of stuttering.
In advanced PD STN-DBS is generally an effective and safe treatment. However, patients with PD and stuttering should be informed
about the risk of aggravated symptoms following surgical therapy. |
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Keywords: | |
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