Speech Treatment Post Deep Brain Stimulation in Parkinson’s Disease

Presented by Cynthia M. Fox

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Video Runtime: 78 Minutes; Learning Assessment Time: 29 Minutes

Deep brain stimulation (DBS) surgery is an effective treatment for select motor symptoms in people with Parkinson’s disease (PD). Unfortunately, speech and voice symptoms are not consistently improved post DBS surgery, and in some cases are worsened. Understanding the impact of DBS on speech and effective speech treatment approaches has the potential to improve communication outcomes for people post DBS. This course will briefly describe DBS surgery for PD, inform participants about voice and speech changes often encountered in individuals post DBS, and describe research on the impact of electrode placement of DBS targeting the subthalamic nucleus (DBS-STN) on voice and speech in people with PD. Research on the longitudinal effects of DBS-STN on speech and voice and how speech treatment (LSVT LOUD) may improve communication post DBS-STN will be explored. Finally, additional treatment options that may maximize speech and communication for patients post DBS-STN will be reviewed.

Meet your instructor

Cynthia M. Fox

Cynthia Fox, PhD, CCC-SLP, received her doctorate degree in speech and hearing sciences from the University of Arizona, Tucson. Her training focused in the areas of neuroscience and motor control. She is an expert on rehabilitation, neuroplasticity, and the role of exercise in the improvement of function consequent to neural…

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Chapters & learning objectives

Deep Brain Stimulation and Its Impact on Speech in People With Parkinson’s Disease

1. Deep Brain Stimulation and Its Impact on Speech in People With Parkinson’s Disease

This chapter briefly describes DBS surgery and the impact it can have on speech and voice in people with PD. This information provides a basis for what we can do as SLPs to treat speech disorders post DBS surgery.

Deep Brain Stimulation and Its Impact on Speech in People With Parkinson’s Disease: Expert Interview

2. Deep Brain Stimulation and Its Impact on Speech in People With Parkinson’s Disease: Expert Interview

Building on the descriptions provided in chapter 1, this chapter explores the impact of DBS of the subthalamic nucleus (DBS-STN) in greater detail through an expert interview with Dr. Elina Tripoliti. Dr. Tripoliti shares her research and clinical experience from being part of a leading DBS-STN speech research team at the National Hospital for Neurology and Neurosurgery, Unit of Functional Neurosurgery, Queen Square, London, UK. She describes the impact of medial versus lateral electrode placement and longitudinal effects of DBS-STN on speech, and highlights emerging advances in DBS-STN that may improve speech outcomes in the future.

Speech Treatment (LSVT LOUD) and DBS

3. Speech Treatment (LSVT LOUD) and DBS

The broad role of speech rehabilitation for people post DBS-STN is highlighted, focusing on both pre DBS-STN and post DBS-STN goals. LSVT LOUD treatment concepts are introduced as an example of an evidence-based speech treatment for people with Parkinson's disease. The use of LSVT LOUD pre DBS-STN is introduced. Current research on the use of LSVT LOUD with people post DBS-STN is discussed.

Maximizing LSVT LOUD Delivery to Enhance Outcomes for Patients Post DBS

4. Maximizing LSVT LOUD Delivery to Enhance Outcomes for Patients Post DBS

To provide the best speech treatment outcomes possible for people post DBS-STN, the "dos and don’ts" for maximizing treatment outcomes with LSVT LOUD will be explored. This chapter will feature an expert interview with Angela Halpern, MS, CCC-SLP, chief clinical officer for LSVT LOUD, where she reviews strategies for maximizing treatment outcomes across LSVT LOUD exercises and explains general treatment tips for maximizing treatment outcomes post DBS-STN.

LSVT LOUD Plus

5. LSVT LOUD Plus

This final chapter will describe additional behavioral treatments to improve communication after LSVT LOUD and DBS-STN. These include additional behavioral treatment cues, device-based options, and general communication strategies that may improve communication post DBS-STN.