Validation of a new scale for the evaluation of sialorrhea in patients with Parkinson's disease

Abstract

Sialorrhea is common in Parkinson disease (PD), affecting approximately 70% to 75% of patients. Several tools for measuring saliva volume or production exist, but none are designed specifically for assessing sialorrhea-related discomfort. The objective of this study was to develop and validate a clinical scale for subjective evaluation of sialorrhea in PD. In Phase I, internal consistency of the Sialorrhea Clinical Scale for PD (SCS-PD) was established in 39 PD patients. In Phase II, scale validity was proven through saliva volume measurements obtained in 49 PD patients and 27 healthy volunteers. Internal consistency estimated using Cronbach's alpha was 0.78, indicating none of the original seven items tested needed to be removed. Twenty-one patients complaining of sialorrhea (63%) studied during Phase II, showed higher SCS-PD scores but no differences in saliva volume. SCS-PD scores showed significant correlation with saliva volume (r = 0.41; P = 0.004) and with total Unified Parkinson's Disease Rating Scale Part III (UPDRS III) scores (r = 0.70). Furthermore, saliva volume showed inverse relation to age in PD patients as well as in controls (r = -0.3 and r = -0.4; P < 0.05), but SCS-PD scores did not. The SCS-PD scale showed good internal consistency and validity, providing support for its use in routine clinical sialorrhea-related discomfort evaluation.

Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease

“…Concept Model : The Sialorrhea Clinical Scale for PD (SCS‐PD) was recently developed to address the lack of validated tools for the evaluation of drooling in PD 14. The SCS‐PD consists of seven questions assessing drooling severity and frequency as well as social and functional impairment.…”

Gastrointestinal Dysfunctions in Parkinson’s Disease: Symptoms and Treatments

“…Furthermore, excessive salivary production may sometimes lead to serious complications, including saliva-induced asphyxiation and aspiration pneumonia [31, 45]. Different scales, such as Drooling Severity and Frequency Scales, Drooling Rating Scale, and Sialorrhea Clinical Scale for PD, have been proposed to assess sialorrhea according to standard criteria [52, 54, 55]. However, drooling is rarely due to overproduction of saliva but is rather more common due to dysphagia, which itself is essentially a manifestation of bradykinesia [50, 56].…”

Dental health of patients with Parkinson's disease in Iceland

“…One of the frequently observed features of the disease is hypersalivation, usually termed sialorrhea. This apparent increase in salivary flow has recently been shown to be dependent on medication and the stage of the disease 5,6 and is probably because of difficulties in swallowing and the loss of facial muscle tone than any actual increase in salivary flow 7 Indeed, hyposalivation has also been reported in some patients with PD 5,7 probably caused by medication.…”