Research Insights

Perceived Changes in Communication as an Effect of STN Surgery in Parkinson’s Disease: A Qualitative Interview Study.

Ahlberg E, Laakso K, Hartelius L. Perceived Changes in Communication as an Effect of STN Surgery in Parkinson’s Disease: A Qualitative Interview Study. , Parkinsons Dis. 2011;2011:540158. Epub 2011 Aug 14.

This article looked at the impressions/perspectives of four people with Parkinson’s disease (PWP) that underwent DBS-STN and had improvements in motor symptoms (increased mobility and reduced tremor) but also subsequent changes in their speech.  The article begins by listing what research has shown regarding how speech is affected by PD (“hypokinetic dysarthria, weakness, breathiness, monotony, imprecise articulation, and variable rate”) as well as by DBS-STN (variable findings, “improved phonatory and articulatory components,” reduced “speech intelligibility.”  All four of the individuals indicated that they believed that the surgery was life improving and that it was their only option for improvement.  The authors also looked at the impressions of the four individuals and ran analyses that looked for themes that ran through the PWP.  They found three main themes:

1. All four PWP experienced negative speech side effects, including:

  • Re-emergence of childhood stuttering
  • Dysarthria
  • Reduced intelligibility
  • Worsened micrographia
  • Mental Fatigue
  • Reduced concentration
  • Weak/Monotonous Voice
  • Hollow sounding speech
  • Reduction in feeling comfortable when talking with others
  • Worsening of experienced speech problems when fatigued or anxious

2.  All found ways to improve communication, including:

  • Slowing rate of speech.
  • Increase volume of speech.
  • Adjusting schedule to maximize their good speech times.
  • Having supportive others to assist when needed.
  • Adjusting medications.
  • Adjusting stimulator settings.

3.  Mixed feelings about the surgery:

  • Worsening of motor symptoms necessitated surgical intervention.
  • Expectations varied so there was some disappointment but no regrets of having the surgery.
  • Wanting more information both pre and post-surgery, such as talking with PWP who have undergone DBS-STN.
  • Uncertainty about what the future holds.

This paper concludes that there is a significant amount of individual variability in what each PWP experiences due to their PD as well as variability in the adverse events experienced after one undergoes DBS-STN.  It was also pointed out that this group wished they were more informed before and after the surgery, suggesting continued patient education is very necessary by researchers as well as medical professionals.  Lastly, we should be reminded by this study and others like it that the perception of the PWP should not be ignored as those individuals are living with the disease as well as any adverse events from the treatments and that their opinions directly relate to their quality of life and that their voices must be heard. 

This article was available free through PubMed as of this writing November 2011.  After clicking the link below, it will take you to the abstract page.  Once there, two bubble shaped boxes are located towards the top of the page listed as “Free full text article at Hindawi” or “Free full text article in PubMed Central.” Either button will take you directly to the full article.

Click here to read the abstract.


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