Perceived changes to swallowing in people with Parkinson's disease

Noble, Emma; Jones, Diana; Miller, Nick

doi:10.12968/ijtr.2015.22.12.573

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…rate-accuracy tradeoffs, stressed-unstressed syllable tradeoffs, increased attention to effort), especially those who are aware of their speech imprecision. This has been observed in other areas of motor control in PD, such as swallowing (Noble et al, 2015;Suntrup et al, 2013). The phenomenon has been linked to apparently sudden rapid decline when spontaneous neural reorganization reaches its limits, as well as paradoxical improvement for a period once individuals become aware of their impairment and employ compensatory techniques.…”

Section: Discussionmentioning

confidence: 93%

Is there an order of loss of sounds in speakers with Parkinson’s disease?

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Miller

Kitsou

2018

Clinical Linguistics & Phonetics

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Influential reports on speech changes in people with Parkinson's disease (Logemann et al, 1978(Logemann et al, , 1981 reported a posterior to anterior pattern of loss of speech sound accuracy. These claims have never been examined. In a partial replication of Logemann et al's work we examined whether posterior lingual sounds are most affected in people with Parkinson's disease, followed by anterior lingual sounds then labial sounds. Ninety-nine people with PD (age mean 70.7, SD 8.46; time since diagnosis mean 6.97, SD 6.2) with mild to severe overall motor symptoms (Hoehn and Yahr stages 1-5, median 2.5) completed a diagnostic intelligibility test. This was scored by 60 listeners unfamiliar with PD and dysarthric speech.We calculated the proportion of posterior vs anterior lingual vs labial sounds misrecognized by the listeners. We compared profiles of misperceived sounds within and across Hoehn and Yahr stages of severity, and in relation to Unified Parkinson's Disease Rating Scale and speech intelligibility scores. Speech accuracy declined significantly in relation to overall motor impairment for labial and anterior lingual sounds but not for velar sounds. Speech sound accuracy was strongly associated with intelligibility outcomes (p = <0.01). Contrary to previous assertions, there was no evidence supporting the existence of a posterior to anterior order of 'loss' of oral speech sounds in people with PD, nor an interaction of anteriorposterior speech profile changes with Hoehn and Yahr stage. Findings support the notion that a common underlying impairment of movement downscaling affects all sounds similarly and simultaneously in PD from the start.

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Section: Discussionmentioning

confidence: 93%

Is there an order of loss of sounds in speakers with Parkinson’s disease?

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Miller

Kitsou

2018

Clinical Linguistics & Phonetics

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“…Dysphagia is very common and a major clinical concern in patients with PD from the early stage of the disease. Poor self-awareness of the symptoms may hamper early detection and proper management in these patients [1,2,10-12]. Therefore, early intervention employing validated screening tools and instruments would be recommended from the initial stage of the disease to improve the quality of life and mortality rate of the patients.…”

Section: Resultsmentioning

confidence: 99%

“…Poor correlation between self-report and the water swallow test for dysphagia demonstrated that the subjective measure is not a good indicator for detecting dysphagia in patients with PD [2]. Other studies using a questionnaire or instrumental test, such as a videofluoroscopic swallowing study (VFSS) or fiberoptic endoscopic evaluation of swallowing (FEES), also showed that oro-pharyngeal dysphagia emerged in more than 50% of patients with PD who reported no problem with swallow [10-12]. Therefore, a patients’ self-report or response to a simple question whether or not they have any swallowing problem can lead to an underestimation of dysphagia in patients with PD.…”

Section: Parkinson’s Diseasementioning

confidence: 99%

Oro-Pharyngeal Dysphagia in Parkinson’s Disease and Related Movement Disorders

Kwon¹,

Lee

2019

JMD

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Oro-pharyngeal dysphagia is a common symptom in patients with Parkinson’s disease (PD) and related disorders, even in their early stage of diseases. Dysphagia in these patients has been underdiagnosed, probably due to poor the self-awareness of the conditions and the underuse of validated tools and objective instruments for assessment. The early detection and intervention of dysphagia are closely related to improving the quality of life and decreasing the mortality rate in these patients. The purpose of this paper is to give an overview of the characteristics of dysphagia, including the epidemiology, pathophysiology, and clinical symptomatology, in patients with PD compared with other parkinsonian disorders and movement disorders. The management of dysphagia and future research directions related to these disorders are also discussed.

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“…Dysphagia in patients with early stages of PD can be ameliorated by implementing dopaminergic treatment during the first few years after disease onset [22]. However, dysphagia is usually underdiagnosed in these patients due to poor self-awareness of the symptoms [81,82]. Therefore, early detection and individualised intervention are crucial for improving quality of life in patients.…”

Section: Dysphagiamentioning

confidence: 99%

Gastrointestinal Dysfunction in Parkinson’s Disease: Current and Potential Therapeutics

Han

Finkelstein

McQuade

et al. 2022

JPM

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Abnormalities in the gastrointestinal (GI) tract of Parkinson’s disease (PD) sufferers were first reported over 200 years ago; however, the extent and role of GI dysfunction in PD disease progression is still unknown. GI dysfunctions, including dysphagia, gastroparesis, and constipation, are amongst the most prevalent non-motor symptoms in PD. These symptoms not only impact patient quality of life, but also complicate disease management. Conventional treatment pathways for GI dysfunctions (i.e., constipation), such as increasing fibre and fluid intake, and the use of over-the-counter laxatives, are generally ineffective in PD patients, and approved compounds such as guanylate cyclase C agonists and selective 5-hyroxytryptamine 4 receptor agonists have demonstrated limited efficacy. Thus, identification of potential targets for novel therapies to alleviate PD-induced GI dysfunctions are essential to improve clinical outcomes and quality of life in people with PD. Unlike the central nervous system (CNS), where PD pathology and the mechanisms involved in CNS damage are relatively well characterised, the effect of PD at the cellular and tissue level in the enteric nervous system (ENS) remains unclear, making it difficult to alleviate or reverse GI symptoms. However, the resurgence of interest in understanding how the GI tract is involved in various disease states, such as PD, has resulted in the identification of novel therapeutic avenues. This review focuses on common PD-related GI symptoms, and summarizes the current treatments available and their limitations. We propose that by targeting the intestinal barrier, ENS, and/or the gut microbiome, may prove successful in alleviating PD-related GI symptoms, and discuss emerging therapies and potential drugs that could be repurposed to target these areas.

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Perceived changes to swallowing in people with Parkinson's disease

Abstract: This document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher's website (a subscription may be required.)

Cited by 6 publications

References 39 publications

Is there an order of loss of sounds in speakers with Parkinson’s disease?

Is there an order of loss of sounds in speakers with Parkinson’s disease?

Oro-Pharyngeal Dysphagia in Parkinson’s Disease and Related Movement Disorders

Gastrointestinal Dysfunction in Parkinson’s Disease: Current and Potential Therapeutics

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