Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents
Nascimento, Weslania Viviane (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Arreola, Viridiana (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Sanz, Pilar (Hospital de Mataró. Consorci Sanitari del Maresme)
Necati, Ediz (Near East University (Xipre))
Bolivar-Prados, Mireia (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Michou, Emilia (University of Patras (Grècia))
Ortega, Omar (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Clavé i Civit, Pere (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)
Universitat Autònoma de Barcelona

Data:	2020
Resum:	(1) Background: The effect of dopaminergic treatment on swallowing response in patients with Parkinson's disease (PD) suffering oropharyngeal dysphagia (OD) is not understood. Aim: To characterize OD pathophysiology in PD and to assess whether dopaminergic states affect swallow function and the effect of thickeners. (2) Methods: Fifty patients with PD (40 evaluated in OFF/ON states) and 12 healthy volunteers (HVs) were evaluated with videofluoroscopy (VFS) to assess the swallowing biomechanics and kinematics of the swallowing response at three different shear-viscosities (<50, 120, and 4000 mPa·s); (3) Results: Patients presented a mean age of 70. 46 ± 10. 03 years. Disease evolution was 5. 09 ± 3. 86 year and Hoehn-Yahr stage was 2. 32 ± 0. 81. For HVs, mean age was 40. 20 ± 2. 50 year. Penetrations were present in 37. 50% of PD patients and were associated with delayed laryngeal vestibule closure (LVC = 293. 33 ± 90. 07 ms). In contrast, HVs presented a LVC = 164. 00 ± 39. 78 ms (p < 0. 05). An LVC ≥ 260 ms cutoff predicted unsafe swallow (sensitivity ≥ 0. 83, specificity ≥ 0. 57, AUC = 0. 80) in PD. Increasing bolus viscosity improved deglutition safety but increased oropharyngeal residue. There were no differences in swallowing between the OFF/ON states. (4) Conclusions: In initial PD stages, oropharyngeal swallow response is severely delayed, while mildly impaired swallow safety improves with increasing bolus viscosity, which increases residue. Dopaminergic treatment does not affect swallowing or the therapeutic effect of thickeners.
Ajuts:	Instituto de Salud Carlos III PI18/00241
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Oropharyngeal dysphagia ; Parkinson's disease ; Oropharyngeal swallow response ; Thickening agents ; Dopamine ; Shear viscosity ; OFF/ON states
Publicat a:	Brain sciences, Vol. 10 (september 2020) , ISSN 2076-3425

DOI: 10.3390/brainsci10090609
PMID: 32899758

16 p, 1.5 MB

El registre apareix a les col·leccions:
Articles > Articles de recerca
Articles > Articles publicats