Swallowing problems in Parkinson disease: frequency and clinical correlates

Miller, Nick; Allcock, Liesl M.; Hildreth, Anthony; Jones, Diana; Noble, Emma; Burn, David J.

doi:10.1136/jnnp.2008.157701

Cited by 138 publications

(124 citation statements)

References 23 publications

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“…Discrepancy between self-perception and objective findings regarding swallowing function has been seen in dysphagic patients (8,14,15,32,33). In this study the discrepancy could have several explanations.…”

Section: Discussioncontrasting

confidence: 38%

Deep brain stimulation - effects on swallowing function in Parkinson's disease

et al. 2012

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ObjectiveIn patients with Parkinson's disease (PD), deep brain stimulation of the subthalamic nucleus (STN DBS) is well recognized in improving limb function, but the outcome on swallowing function has rarely been studied. The aim of this work was to evaluate the effect of STN DBS on pharyngeal swallowing function in PD patients using self-estimation and fiberoptic endoscopic evaluation of swallowing. MethodsEleven patients (aged 41-72, median 61 years) were evaluated preoperatively and at 6 and 12 months after STN DBS surgery. All patients were evaluated with self-estimation on a visual analogue scale and eight of them with a fiberoptic endoscopic examination with a predefined swallowing protocol including Rosenbek's Penetration-Aspiration Scale, Secretion Severity Scale, preswallow spillage, pharyngeal residue and pharyngeal clearance. ResultsThe self-assessments of swallowing function revealed a swallowing improvement with STN DBS stimulation whereas the data from the swallowing protocol did not show any significant effect of the STN DBS treatment itself. The prevalence of aspiration was not affected by the surgery. ConclusionsThe results show that swallowing function was neither improved nor negatively affected by STN DBS and the risk of aspiration did not increase. Self-estimation of swallowing function showed an improvement due to stimulation.

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Section: Discussioncontrasting

confidence: 38%

Deep brain stimulation - effects on swallowing function in Parkinson's disease

et al. 2012

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“…This supports the hypothesis that swallowing may be associated with more axial motor disturbances. 6 Our study identified that bradykinesia was significantly associated with oral residue, as was the total UPDRS score (which was also associated with impaired tongue base retraction). These changes would be likely to produce hypokinesia of the oropharyngeal muscles.…”

Section: Discussionmentioning

confidence: 62%

“…26 Another study exploring the relationship between swallowing and cognitive function revealed a moderate positive correlation between swallowing speed and cognition, although cognitive function was measured by a simple screening tool. 6 Thus, cognitive decline is associated with, and may contribute to, dysphagia in in patients with PD. However, the association between individual aspects of cognition, defined by detailed neuropsychological profiles, and swallowing functions had not been adequately studied.…”

Section: Discussionmentioning

confidence: 99%

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Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

Kim

Youn

Suh

et al. 2015

Can. J. Neurol. Sci.

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Background: Dysphagia is a common symptom and an important prognostic factor in Parkinson's disease (PD). Although cognitive and motor dysfunctions may contribute to dysphagia in patients with PD, any specific association between such problems and swallowing functions is unclear. Here, we examined the potential relationship between cognitive/motor components and swallowing functions in PD. We evaluated the contributions of cognition and motor function to the components of swallowing via video fluoroscopic swallowing (VFS) experiments. Methods: We prospectively enrolled 56 patients without dementia having PD. Parkinson's disease severity was assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). All participants received neuropsychological tests covering general mental status, visuospatial function, attention, language, learning and memory, and frontal executive function. The well-validated "modified barium swallow impairment profile" scoring system was applied during VFS studies to quantify swallowing impairments. Finally, correlations between neuropsychological or motor functions and impairment in swallowing components were calculated. Results: The most significant correlations were found between the frontal/executive or learning/memory domains and the oral phase of swallowing, though a minor component of the pharyngeal phase correlated with frontal function as well. Bradykinesia and the UPDRS total score were associated with both the pharyngeal and oral phases. Conclusions: Our findings suggest that cognitive dysfunctions are associated with the oral phase of swallowing in patients with early stage PD while the severity of motor symptoms may be associated with overall swallowing function.RÉSUMÉ: Aspects cognitifs et moteurs de la maladie de Parkinson qui sont associés à la dysphagie. Contexte : La dysphagie est un symptôme fréquent de la maladie de Parkinson (MP) et constitue un facteur de prédiction important dans cette maladie. Bien que les dysfonctions cognitives et motrices puissent contribuer à la dysphagie chez les patients atteints de la MP, une association spécifique entre ces problèmes et la déglutition demeure incertaine. Nous avons examiné une relation potentielle entre les composantes cognitives/motrices et la déglutition dans la MP. Nous avons évalué la contribution de la fonction cognitive et de la fonction motrice aux différentes composantes de la déglutition au moyen de la vidéofluoroscopie (DVF). Méthode : Nous avons recruté prospectivement 56 patients atteints de la MP, sans démence. La sévérité de la MP a été évaluée au moyen de la Unified Parkinson's Disease Rating Scale (UPDRS). Tous les participants ont subi des tests neuropsychologiques évaluant l'état mental général, la fonction visuospatiale, l'attention, le langage, l'apprentissage, la mémoire ainsi que les fonctions exécutives frontales. Le système « modified barium swallow impairment profile », un système d'évaluation validé, a été utilisé au cours des études de DVF pour quantifier l'atteinte de la fonction de d...

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“…In Parkinson's disease, the prevalence of dysphagia is estimated to be from 32% to 70% (28) . Nevertheless, the risk posed by dysphagia is neglected or underestimated until the patient suffers the first episode of pneumonia (17,20) , despite the known high risk of aspiration and pneumonia associated with oropharyngeal dysphagia in PD patients (10,26) . In association with dysphagia, because of the difficulty of clearing the oral saliva, sialorrhea or at least sialostasis, can be observed.…”

Section: Introductionmentioning

confidence: 99%

Dysphagia and Sialorrhea:

Nicaretta¹,

Rosso

Mattos

et al. 2013

Arq. Gastroenterol.

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-Context -Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease. Objective -The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease. Method -Two Parkinson's diseases groups from the same outpatients' population were studied. Patients in the first group, with dysphagia, were studied by videofluoroscopy. The second, with sialorrhea, were studied by the scintigraphic method, Results -Videofluoroscopic examination of the oral, pharyngeal and esophageal phases of swallowing showed that 94% of Parkinson's diseases patients present, structural causes, not related to Parkinson's diseases, able to produce or intensify the observed disphagia. The scintigraphic examination of Parkinson's diseases patients with sialorrhea showed that there is no increase of serous saliva production. Nevertheless, showed a significantly higher velocity of saliva excretion in the Parkinson's diseases patients.Conclusions -Dysphagia can be due to the muscular rigidity often present in the Parkinson's diseases patient, or more usually by non Parkinson's disease associated causes. In Parkinson's diseases patients, sialorrhea is produced by saliva retention. Nevertheless, sialorrhea can produce discomfort in swallowing, although without a formal complaint of dysphagia. In this case, subclinical dysphagia must be considered. Sialorrhea is indicative of dysphagia or at least of subclinical dysphagia. As final conclusion, Parkinson's diseases can be an isolated cause of dysphagia and/or sialorrhea, but frequently, a factor unrelated to Parkinson's diseases is the main cause of or at least aggravates the dysphagia.

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Swallowing problems in Parkinson disease: frequency and clinical correlates

Abstract: Swallowing problems are frequent in PD. Self-report of 'no difficulty' is not a reliable indicator of swallowing ability. Studies employing more-objective assessment of aspiration risk to compare with water swallow test performance are advocated.

Cited by 138 publications

References 23 publications

Deep brain stimulation - effects on swallowing function in Parkinson's disease

Deep brain stimulation - effects on swallowing function in Parkinson's disease

Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

Dysphagia and Sialorrhea:

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