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15
Brocha Stimulator: Possible Target For Dyarthria In Post Left Middle Cerebral Artery Stroke

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Brocha Stimulator:  Possible Target Dsyarthria In Post Left Middle Cerebral Artery Stroke

Introduction:  Deep brain stimulation (DBS) has been widely accepted as an effective surgical treatment for medication-refractory movement disorders. DBS has been utilized for Parkinson’s disease, dyskinesia, and dystonia. With regards to dystonia, numerous studies have demonstrated that targeting the Globus Pallidus internus for deep brain stimulation can improve motor function. Likewise, the authors suggest that the dysarthria that left middle cerebral artery (MCA) stroke patients may suffer is primarily a motor issue. As such, the authors believe, in these cases the dysarthria may be improved with DBS; in similar fashion to other movement disorders. Several studies have begun to investigate the use of non-invasive brain stimulation techniques to promote recovery by stimulating the lesion and contralateral areas. Here, the possible use of a stimulator in Brocha’s area for patients with dysarthria is reviewed, primarily post left (MCA) stroke. 

Methods: An exhaustive search using PubMed and MedLine were conducted of English literature using search terms of dysarthria, left middle cerebral artery stroke, dysarthria intervention, deep brain stimulation, neuromodulation of dysarthria, treatment of dysarthria.

Results:  The authors found that the majority of the literature was focused and contributed by Speech Language Pathologist and the different modalities in which they try to assess and improve a variety of dysarthrias, with different etiologies.  There is a paucity of literature related to the actual treatment of dysarthria, especially post left MCA stroke. Currently, the authors have yet to find any literature that discusses or describes possible intervention for dysarthria. 

Conclusions: In conclusion, the authors suggest that the evaluation of using Brocha’s area as a possible target for treatment of post left MCA stroke for dysarthria is reasonable and could be of great benefit to patients and society.  Because of the opportunity to improve quality of life for patients and reduce cost burdens associated with the care for those who suffer from dysarthria, we feel that studies and investigations should be done to evaluate for safety and feasibility of DBS in Brocha’s area for post left MCA stroke for dysarthria.

 

key words: Dysarthria, stroke, dbs, treatment