Early occurrence of inspiratory muscle weakness in Parkinson’s disease

Abstract

IntroductionIn Parkinson’s disease (PD), respiratory insufficiency (including functional and muscle disorders) can impact dysarthria and swallowing. Most studies of this topic have been performed retrospectively in populations of patients with advanced PD. The objective of the present study was to characterize lung function (under off-drug conditions) in early-stage PD patients at baseline and then again two years later.MethodsForty-one early-stage PD patients (mean ± SD age: 61.7 ± 7.7; mean ± SD disease duration: 1.9 ± 1.7 years) were prospectively enrolled and compared with 36 age-matched healthy controls. Neurological evaluations and pulmonary function testing were performed in the off-drug condition at the inclusion visit and then two years later.ResultsPulmonary function testing did not reveal any restrictive or obstructive disorders; at baseline, inspiratory muscle weakness was the only abnormality observed in the PD group (in 53.7% of the patients, vs. 25% in controls; p = 0.0105). The PD patients had a lower mean maximal inspiratory mouth pressure than controls and a lower sniff nasal inspiratory pressure. Two years after the initiation of chronic treatment with antiparkinsonian medications, the maximal inspiratory mouth pressure and the sniff nasal inspiratory pressure tended to be higher. Lastly, overall motor outcomes were not significantly worse in patients with inspiratory muscle weakness than in patients without inspiratory muscle weakness.ConclusionInspiratory muscle weakness seems to be common in patients with early-stage PD, and was seen to be stable over a two-year period. Additional long-term follow-up studies are required to specify the impact of this new feature of PD.

Respiratory disturbances in a mouse model of Parkinson's disease

“…In one of the recent studies, by Baille et al. (), it was observed that PD patients exhibited inspiratory muscle weakness during the early stages of the disease. Thus, the mechanical changes observed in our study might also be correlated with stiffening of the lung and ribcage, which have also been observed in these previous studies.…”

“…Parkinson's disease patients can experience an impairment in the tone, contractility and coordination of the thoracic musculature, affecting both respiratory mechanics and pulmonary functions (Baille et al., ; Owolabi et al., ; Reyes, Ziman, & Nosaka, ). Therefore, studies that evaluate the respiratory mechanics in a model of PD might lead to greater understanding of the effects of the disease.…”

“…Breathing problems are recognized as a cause of morbidity and mortality in patients with Parkinson's disease (PD), caused by neural damage in specific regions of the ventral medulla that are responsible for rhythm generation and chemoreception, such as the preBötzinger complex (preBötC) and retrotrapezoid nucleus (RTN), respectively (Baille et al., ; Benarroch, Schmeichel, Low, & Parisi, ; Owolabi, Nagoda, & Babashani, ; Seccombe et al., ; Torsney & Forsyth, ). Previous studies have also found that PD patients showed a reduction of pulmonary volumes and stiffening of respiratory muscles, indicating an impairment directly in the lung, ribcage and/or the muscles responsible for breathing (Baille et al., ; LeWitt et al., ; Owolabi et al., ; Seccombe et al., ). Additionally, clinical reports describe a predisposition to development of lung infections by PD patients, and to embolism and allergic reactions, compared with the general population (Hampson, Kieburtz, LeWitt, Leinonen, & Freed, ; Letsiou et al., ; Owolabi et al., ).…”

“…The lungs are one of the most sensitive organs in the body; however, few studies have described the negative changes and impact on the lungs during the development of PD (Baille et al, 2018;Seccombe et al, 2011;Torsney & Forsyth, 2017).…”

Brainstem Ventilatory Dysfunction: A Plausible Mechanism for Dyspnea in Parkinson's Disease?

“…Although there have been numerous studies of pulmonary function in PD, few have investigated the contributions of central and peripheral respiratory mechanisms using functional respiratory testing in patients with dyspnea. Table summarizes the key studies addressing pulmonary dysfunction in PD and shows the frequency of restrictive and obstructive patterns . Review of these studies shows a lack of consistent findings, which is likely due to the fact that they included diverse cohorts of patients at different stages of disease and used variable outcome measures.…”