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LSVT® Following Deep Brain Stimulation of the Subthalamic Nucleus: Preliminary Findings
Jennifer Spielman, Jill Petska, Angela Halpern, and Lorraine Ramig

Deep brain stimulation of the subthalamic nucleus (DBS-STN) has been known to affect speech intelligibility in some individuals with Parkinson’s disease (PD), necessitating speech therapy to improve communication. While intensive voice therapy (LSVT®) is known to be effective for individuals with PD, there is little information regarding how DBS-STN may affect outcomes. This study examined the effects of LSVT® on three individuals (one male and two females) with PD, following bilateral DBS-STN completed at least one year prior to treatment. Subjects were judged by two speech-language pathologists as having moderate-severe speech impairments. The two female subjects received typical LSVT® (16 1-hour sessions over 1 month), and the male subject received a slightly altered schedule (19 sessions over 6 weeks) due to illness during the study. Data were collected twice immediately before and twice immediately after treatment. All subjects increased vocal loudness significantly, and 2 subjects increased vowel space. Subjects also showed significant reductions on the Voice Handicap Index and reported improvements. However, clinicians commented that these individuals required more instruction, and more cues to generalize treatment techniques, compared to typical non-surgical patients. More individuals need to be studied to establish whether modifications to LSVT® are required to treat this population.

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