Hypokinetic dysarthria (HD) is a difficult-to-treat symptom affecting quality of life in patients with Parkinson's disease (PD). Levodopa may partially alleviate some symptoms of HD in PD, but the neural correlates of these effects are not fully understood. The aim of our study was to identify neural mechanisms by which levodopa affects articulation and prosody in patients with PD. Altogether 20 PD patients participated in a task fMRI study (overt sentence reading). Using a single dose of levodopa after an overnight withdrawal of dopaminergic medication, levodopa-induced BOLD signal changes within the articulatory pathway (in regions of interest; ROIs) were studied. We also correlated levodopa-induced BOLD signal changes with the changes in acoustic parameters of speech. We observed no significant changes in acoustic parameters due to acute levodopa administration. After levodopa administration as compared to the OFF dopaminergic condition, patients showed task-induced BOLD signal decreases in the left ventral thalamus (p = 0.0033). The changes in thalamic activation were associated with changes in pitch variation (R = 0.67, p = 0.006), while the changes in caudate nucleus activation were related to changes in the second formant variability which evaluates precise articulation (R = 0.70, p = 0.003). The results are in line with the notion that levodopa does not have a major impact on HD in PD, but it may induce neural changes within the basal ganglia circuitries that are related to changes in speech prosody and articulation.

1st Department of Neurology Faculty of Medicine Masaryk University and St Anne's University Hospital Brno Brno Czech Republic

Applied Neuroscience Research Group Central European Institute of Technology CEITEC Masaryk University Brno Brno Czech Republic

Department of Neurology Faculty of Medicine Masaryk University and Faculty Hospital Brno Brno Czech Republic

Department of Telecommunications Brno University of Technology Brno Czech Republic

Multimodal and Functional Neuroimaging Research Group Central European Institute of Technology CEITEC Masaryk University Brno Brno Czech Republic

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