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Prepharyngeal dysphagia in Parkinson's disease
1Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA.
Dysphagia
|January 1, 1996
Summary
Parkinson's disease (PD) patients often experience dysphagia. Advanced PD shows more prepharyngeal swallowing issues, while early stages have more complaints, indicating complex motor control deficits.
Area of Science:
- Neurology
- Gastroenterology
- Speech-Language Pathology
Background:
- Dysphagia is a common complication in Parkinson's disease (PD).
- Traditionally, pharyngeoesophageal dysfunction is considered the primary cause.
- This study investigates prepharyngeal swallowing abnormalities in idiopathic PD.
Purpose of the Study:
- To analyze prepharyngeal motor functions and ingestion abnormalities in Parkinson's disease patients.
- To correlate swallowing difficulties with disease severity using the Hoehn and Yahr scale.
Main Methods:
- Patients with idiopathic Parkinson's disease were divided into mild/moderate (subgroup I) and advanced (subgroup II) based on Hoehn and Yahr scale.
- Dysphagia symptoms were self-reported.
- Dynamic videofluoroscopy was used to assess oral preparatory and lingual movements during ingestion.
Main Results:
- 82% of all Parkinson's disease patients reported dysphagia symptoms, with more complaints in subgroup I.
- Advanced Parkinson's disease (subgroup II) showed significantly more prepharyngeal abnormalities, including jaw rigidity and impaired head/neck posture.
- Impaired mastication and oral preparatory lingual movements were the most frequent videofluoroscopy findings (48/71 patients).
Conclusions:
- Prepharyngeal motor abnormalities are prevalent in Parkinson's disease, particularly in advanced stages.
- Swallowing difficulties in Parkinson's disease result from the disintegration of volitional and automatic movements due to PD-related akinesia, bradykinesia, and rigidity.