Quantitative Analysis Of Gait And Speech Disorders In Patients With Parkinson’s Disease After Subthalamic Nucleus Deep Brain Stimulation

Research Background:Parkinson’s disease(PD)is a neurodegenerative disease with motor and non-motor symptoms that severely affect the daily life of patients.Gait and speech disorders are automatic motor activities which are frequently impaired in Parkinson’s disease,and both are considered to be axial symptoms of Parkinson’s disease.Freezing of gait(FOG)is a common disabling gait disorder in the middle and late stages of Parkinson’s disease,increasing the risk of falls and seriously affecting the quality of life of patients.Currently,the treatment of Parkinson’s disease is based on drug therapy,and deep brain stimulation(DBS)can be used when the patient’s drug efficacy is significantly reduced or when there are obvious motor complications.Objective:We aimed to investigate the changes of speech and gait in patients with Parkinson’s disease after subthalamic nucleus deep brain stimulation and the relationship between the two to provide a basis for postoperative program control.Methods:11 Parkinsonian patients were asked to wear a wearable device to perform Timed Up and Go(TUG)test for movement data collection.Acoustic data were collected using the German XION DIVAS voice test and analysis system.Acoustic and gait data were collected again 1 month after subthalamic nucleus deep brain stimulation(STN-DBS),and pre and postoperative gait and voice patterns were analyzed.Results:Voice acoustic indexes of jitter(P=0.029),maximal phonation time(MPT)(P=0.003),and voice disorder index-10(VHI-10)(P=0.012)improved after STN-DBS.The turning-peak velocity of the gait parameters was was significantly reduced(P=0.033).Preoperative speech parameters were correlated with postoperative gait changes,in particular,preoperative fundamental frequency(F0)was positively correlated with postoperative trunk sagittal peak velocity(r=0.774,p=0.005)and preoperative voice related quality of life(V-RQOL)was positively correlated with postoperative phase coordination index(r=0.742,p=0.009).The standard deviation of fundamental frequency(FOSD)was positively correlated with H&Y staging,UPDRSII and UPDRSIII,and the V-RQOL was significantly and positively correlated with UPDRSII.Several gait parameters were closely correlated with H&Y staging and motor symptom scores and axial score scores.Conclusions:Our data suggested that STN-DBS can improve speech disorders and gait disorders in PD patients who undergoing STN-DBS in the short term.And it was also confirmed that speech parameters in PD patients were correlated with gait parameters,revealed that the two networks of voice disorder and gait disorder in Parkinson’s disease deteriorated in parallel in the disease,and verified that stimulation of the ventral side of STN was beneficial to improve voice and stimulation of the dorsal side of STN was beneficial to improve gait,which provided a basis for postoperative program control.