Brain Activity Monitoring for Parkinson's Disease Speech Impairment

Recruiting in Boston (>99 mi)

Overseen By Erin Donahue, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Massachusetts General Hospital

Disqualifiers: Hearing loss, Non-English-speaking

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

80 Participants Needed

Trial Summary

What is the purpose of this trial?

In this research study the researchers want to learn more about brain activity related to speech perception and production.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Electrophysiological data collection for Parkinson's Disease speech impairment?

Research shows that speech impairments in Parkinson's Disease are linked to abnormal brain activity, particularly in areas like the subthalamic nucleus and sensorimotor cortex. Electrophysiological data collection can help monitor these brain activities, potentially improving our understanding and management of speech issues in Parkinson's patients. ^{1 2 3 4 5}

Is brain activity monitoring for speech impairment in Parkinson's disease safe for humans?

The research on brain activity monitoring, such as using subthalamic nucleus stimulation, shows that it can be safe but may have varying effects on speech, sometimes improving or worsening it depending on the individual and treatment settings. This suggests that while generally safe, careful monitoring and adjustment are necessary to avoid potential speech issues. ^{1 3 6 7 8}

How does this treatment for Parkinson's disease speech impairment differ from other treatments?

This treatment is unique because it focuses on monitoring brain activity to understand and address speech impairments in Parkinson's disease, using novel brain-imaging markers and task-free magnetoencephalography to identify affected brain systems, unlike traditional treatments that may not specifically target speech-related brain activity. ^{1 2 3 7 9}

Eligibility Criteria

This trial is for adults aged 18-85 with Parkinson's disease, essential tremor, or dystonia who are scheduled for Deep Brain Stimulation (DBS) implantation. Participants must be able to understand the study and follow instructions. People with hearing loss or those who do not speak English cannot join.

Inclusion Criteria

I am scheduled for DBS implantation for Parkinson's, essential tremor, or dystonia.

Subjects able to provide informed consent and comply with task instructions.

Exclusion Criteria

I have hearing loss.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Data Collection

Brain signal data collection at the time of deep brain stimulation (DBS) surgery

Duration of single DBS surgery

Follow-up

Participants are monitored for safety and effectiveness after data collection

4 weeks

Treatment Details

Interventions

• Electrophysiological data collection

Trial Overview The study aims to gather electrophysiological data on brain activity during speech perception and production in patients undergoing DBS surgery for movement disorders.

Participant Groups

Group I: Brain signal data collection Experimental Treatment 1 Intervention

Brain signal data collection at the time of deep brain stimulation (DBS) surgery.

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials

3,066

Recruited

13,430,000+

Findings from Research

Smartphone technology can effectively capture speech abnormalities in individuals at high risk of developing Parkinson's disease, demonstrating its potential as a tool for early detection.

Acoustic measurements of speech, such as frequency variability and pause duration, were able to distinguish between individuals with Parkinson's and healthy controls with high accuracy (area under curve of 0.85), suggesting that smartphone-collected speech data could enhance diagnostic processes for neurodegenerative diseases.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Smartphone Allows Capture of Speech Abnormalities Associated With High Risk of Developing Parkinson's Disease. Rusz, J., Hlavnicka, J., Tykalova, T., et al.[2019]

A study involving 59 patients with Parkinson's disease revealed that reliable scoring of speech impairments correlates more closely with motor and cognitive issues than with traditional acoustic measures.

Articulation difficulties in these patients are linked to abnormal activity in the left inferior frontal cortex, suggesting that this brain region's connectivity with motor areas plays a key role in how cognitive decline affects speech quality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Aberrant neurophysiological signaling associated with speech impairments in Parkinson's disease. Wiesman, AI., Donhauser, PW., Degroot, C., et al.[2023]

In a study involving 11 patients with Parkinson's disease, researchers found that high-gamma activity in the subthalamic nucleus (STN) is associated with speech production and can differentiate between articulators like the tongue and lips, indicating its role in encoding speech at a subcortical level.

The STN showed articulator-specific activity before the sensorimotor cortex during speech articulation, suggesting that the STN may play a crucial role in the timing and organization of speech production, which is not currently reflected in existing models of speech.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Subthalamic Nucleus and Sensorimotor Cortex Activity During Speech Production. Chrabaszcz, A., Neumann, WJ., Stretcu, O., et al.[2020]

Patients with Parkinson's disease showed abnormal auditory processing during speech, as evidenced by less suppression of brain activity in response to their own speech sounds compared to age-matched controls, indicating impaired self-monitoring of speech.

This study is the first to identify early electrophysiological changes in auditory processing related to speech in Parkinson's patients who do not report noticeable speech deficits, suggesting a potential mechanism for speech difficulties as the disease progresses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Deficits in monitoring self-produced speech in Parkinson's disease. Railo, H., Nokelainen, N., Savolainen, S., et al.[2021]

In patients with Parkinson's disease, performing speech and motor tasks leads to increased β oscillations in the subthalamic nucleus, which may explain the worsening of motor symptoms during these activities.

The study found that different behavioral tasks can switch β power states, suggesting that monitoring these changes could help in developing closed-loop neuromodulatory devices for better management of Parkinson's disease symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Transient and state modulation of beta power in human subthalamic nucleus during speech production and finger movement. Hebb, AO., Darvas, F., Miller, KJ.[2021]

The study evaluated the use of a portable voice accumulator (PVA) to assess treatment effects on speech and voice in 15 participants with mild-moderate Parkinson's disease, but only six provided sufficient data due to technical issues and handling difficulties.

Results indicated that daily life voice recordings captured different changes in voice sound levels compared to controlled studio recordings, suggesting that PVAs can offer valuable insights into real-world voice use, although improvements in usability and study protocols are needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Using Portable Voice Accumulators to Study Transfer of Speech Outcomes Following Intervention - A Feasibility Study. Steurer, H., Körner Gustafsson, J., Franzén, E., et al.[2021]

This review highlights the need for standardized methods in recording and analyzing speech in patients with movement disorders, focusing on factors like recording environment and vocal tasks to improve clinical assessments.

The study identified specific acoustic features that differentiate speech patterns in patients with hypokinetic and hyperkinetic dysarthria, suggesting that these features can be used for more accurate diagnosis and treatment evaluation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Guidelines for Speech Recording and Acoustic Analyses in Dysarthrias of Movement Disorders. Rusz, J., Tykalova, T., Ramig, LO., et al.[2022]

Levodopa and subthalamic nucleus (STN) stimulation can have varying effects on dysarthria in Parkinson's disease, with some patients experiencing speech improvement while others may see worsening due to factors like dyskinesias or improper stimulation parameters.

The study of four cases highlights that while some aspects of speech can improve with treatment, the complex coordination required for effective speech may not respond well to STN stimulation, suggesting a need for careful management of stimulation settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech. Pinto, S., Gentil, M., Krack, P., et al.[2013]

Individuals with mild Parkinson's disease (PD) show similar patterns of muscle coordination during speech as healthy controls, indicating that some motor functions may still be preserved.

However, PD participants have a reduced amplitude ratio in muscle activity, suggesting that their ability to generate strong motor commands for speech is impaired, which contributes to symptoms like bradykinesia and hypokinesia.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Polar-phase indices of perioral muscle reciprocity during syllable production in Parkinson's disease. Chu, SY., Barlow, SM., Lee, J., et al.[2018]

References

1. United States pubmed.ncbi.nlm.nih.gov

Smartphone Allows Capture of Speech Abnormalities Associated With High Risk of Developing Parkinson's Disease. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Aberrant neurophysiological signaling associated with speech impairments in Parkinson's disease. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Subthalamic Nucleus and Sensorimotor Cortex Activity During Speech Production. [2020]

4. Netherlands pubmed.ncbi.nlm.nih.gov

Deficits in monitoring self-produced speech in Parkinson's disease. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Transient and state modulation of beta power in human subthalamic nucleus during speech production and finger movement. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

Using Portable Voice Accumulators to Study Transfer of Speech Outcomes Following Intervention - A Feasibility Study. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

Guidelines for Speech Recording and Acoustic Analyses in Dysarthrias of Movement Disorders. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Changes induced by levodopa and subthalamic nucleus stimulation on parkinsonian speech. [2013]

9. England pubmed.ncbi.nlm.nih.gov

Polar-phase indices of perioral muscle reciprocity during syllable production in Parkinson's disease. [2018]