Fluency-Enhancing Strategies for Hypokinetic Dysarthria Exacerbated by Subthalamic Nucleus Brain Stimulation: A Case Study Introduction Speech disorders associated with Parkinson's disease (PD) and the pharmaceutical treatments of PD are well documented. A relatively recent treatment alternative for PD is deep brain stimulation (DBS) of the subthalamic nucleus (STN), which is used to manage the symptoms of PD as the disease progresses. This case study ... Article
Article  |   August 20, 2018
Fluency-Enhancing Strategies for Hypokinetic Dysarthria Exacerbated by Subthalamic Nucleus Brain Stimulation: A Case Study
Author Affiliations & Notes
  • Gregory J. Snyder
    The Wheat Laboratory for the Voice, Speech, and Hearing Sciences, Department of Communication Sciences & Disorders, The University of Mississippi, University, MS
  • Molly Grace Williams
    The Wheat Laboratory for the Voice, Speech, and Hearing Sciences, Department of Communication Sciences & Disorders, The University of Mississippi, University, MS
  • Molly E. Gough
    The Wheat Laboratory for the Voice, Speech, and Hearing Sciences, Department of Communication Sciences & Disorders, The University of Mississippi, University, MS
  • Paul G. Blanchet
    Department of Communication Sciences and Disorders, Baylor University, Waco, TX
  • Disclosures
    Disclosures ×
  • Financial: Gregory J. Snyder has no relevant financial interests to disclose. Molly Grace Williams has no relevant financial interests to disclose. Molly E. Gough has no relevant financial interests to disclose. Paul G. Blanchet has no relevant financial interests to disclose.
    Financial: Gregory J. Snyder has no relevant financial interests to disclose. Molly Grace Williams has no relevant financial interests to disclose. Molly E. Gough has no relevant financial interests to disclose. Paul G. Blanchet has no relevant financial interests to disclose.×
  • Nonfinancial: Gregory J. Snyder has no relevant nonfinancial interests to disclose. Molly Grace Williams has no relevant nonfinancial interests to disclose. Molly E. Gough has no relevant nonfinancial interests to disclose. Paul G. Blanchet has no relevant nonfinancial interests to disclose.
    Nonfinancial: Gregory J. Snyder has no relevant nonfinancial interests to disclose. Molly Grace Williams has no relevant nonfinancial interests to disclose. Molly E. Gough has no relevant nonfinancial interests to disclose. Paul G. Blanchet has no relevant nonfinancial interests to disclose.×
Article Information
Speech, Voice & Prosodic Disorders / Dysarthria / Speech, Voice & Prosody / Part 1
Article   |   August 20, 2018
Fluency-Enhancing Strategies for Hypokinetic Dysarthria Exacerbated by Subthalamic Nucleus Brain Stimulation: A Case Study
Perspectives of the ASHA Special Interest Groups, August 2018, Vol. 3, 4-16. doi:10.1044/persp3.SIG4.4
History: Received March 23, 2017 , Revised April 5, 2018 , Accepted April 13, 2018
Perspectives of the ASHA Special Interest Groups, August 2018, Vol. 3, 4-16. doi:10.1044/persp3.SIG4.4
History: Received March 23, 2017; Revised April 5, 2018; Accepted April 13, 2018

Introduction Speech disorders associated with Parkinson's disease (PD) and the pharmaceutical treatments of PD are well documented. A relatively recent treatment alternative for PD is deep brain stimulation (DBS) of the subthalamic nucleus (STN), which is used to manage the symptoms of PD as the disease progresses. This case study documented the speech characteristics of a unique client with PD STN-DBS and reported initial findings on a variety of fluency- and intelligibility-enhancing strategies.

Method A speech-language pathologist referred a 63-year-old man, previously diagnosed by a speech-language pathologist with neurogenic stuttering as a result of an STN-DBS battery change, for a speech evaluation, reporting lack of success with traditional stuttering treatment strategies. The client's speech was assessed, and a variety of fluency- and intelligibility-enhancing techniques were tested during trial therapy.

Results The client's speech exhibited the hallmark characteristics of hypokinetic dysarthria, including speech disfluencies. A variety of pacing and prosthetic strategies were tested, revealing that auditory and tactile prosthetic speech feedback provided optimal improvements in fluency and intelligibility.

Discussion These results suggest that the prosthetic speech feedback provided optimal intelligibility and fluency enhancement and could potentially improve articulation and speech volume, which are also common in cases of hypokinetic dysarthria.

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