Longitudinal change in swallow function in patients with Parkinson's disease (PD)

Area of Science:

• Neurology
• Gastroenterology
• Speech-Language Pathology

Background:

• Parkinson's disease (PD) commonly causes dysphagia, impacting quality of life.
• Limited longitudinal data exists on swallowing progression in treated PD patients.
• Previous studies often exclude treated individuals or use subjective/cross-sectional data.

Purpose of the Study:

• To investigate long-term changes in swallowing physiology and diet.
• To analyze data from a pragmatic, real-world population of treated PD patients.
• To assess the effectiveness of clinical care on swallowing function over time.

Main Methods:

• Retrospective review of PD patients with at least two videofluoroscopic swallow studies (VFSS) over one year apart.
• Exclusion of patients with comorbid neurologic or structural diseases.
• Standardized metrics included DIGEST, PAS, FOIS, IDDSI, and kinematic analysis (PCR, PESmax).

Main Results:

• Nineteen PD patients showed significant declines in PESmax (p < 0.001) and DIGEST Overall (p = 0.024) over a mean 2.6-year interval.
• Despite an average of 9.7 swallow therapy sessions per patient, swallowing efficiency (p = 0.039) and IDDSI solids (p = 0.041) also declined.
• Mild-to-moderate PD subgroups exhibited similar deterioration trends.

Conclusions:

• Swallowing function deteriorates progressively in Parkinson's disease, irrespective of treatment.
• Instrumental reassessment is crucial for monitoring swallowing changes in PD.
• Proactive, longitudinal management strategies are essential for real-world PD care.