파킨슨씨병 환자의 뇌심부자극술에 대한 말음성 효과: 섭동적 분석과 비선형 역동적 분석을 이용한 연장 발성과 연속 발화 모음의 음향학적 분석

Choi, Seong Hee

ORIGINAL ARTICLE

Commun Sci Disord. 2012;17(1): 143-155.

Seong Hee Choi^`

최성희(Seong Hee Choi)

ABSTRACT

Background & Objectives
Deep brain stimulation (DBS) of the thalamus or basal ganglia has been considered one of the most stable and long-term effective neurosurgical therapeutic interventions for Parkinson’s Disease (PD). Evidence of a surgical approach with DBS in PD with regard to voice and speech is still lacking. The present study aims to investigate if nonlinear dynamic analysis with vowels from sustained phonation and running speech can be used to investigate the effects of electrode implantation and stimulation of the thalamic nucleus (STN) on patients’ voice and speech in advanced stages of PD.
Methods
Nineteen idiopathic PD patients that received DBS-STN surgery and ten idiopathic PD patients that did not receive DBS-STN surgery participated in the present study. Participants did not receive medication for 12 hours overnight prior to the recording session. For surgical patients, recordings were taken with the stimulator on (for at least 12 hours) and off (for 30 minutes). The sustained and running vowel segments were used to analyze the perturbation including percent jitter, shimmer, signal-to-noise ratio (SNR) values, and nonlinear dynamic method of correlation dimension (D2).
Results
Results showed that the mean D2 value of the surgical group was significantly lower than the mean D2 value of the non-surgical group for sustained and running vowels. The perturbation results failed to achieve significance with DBS, contradicting the results of nonlinear dynamic analysis.
Discussion & Conclusion
Nonlinear dynamic analysis showed effects of DBS on PD patients’ voice and speech and may be a useful substitute for perturbation analysis in the evaluation of running speech because of the short signal length and high noise level. The results indicate that nonlinear dynamic analysis may be useful to evaluate the treatment effect in PD patients with severe voice and speech disorders.