Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents
(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 effe...
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| Format: | Article |
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MDPI AG
2020-09-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/10/9/609 |
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| author | Weslania Viviane Nascimento Viridiana Arreola Pilar Sanz Ediz Necati Mireia Bolivar-Prados Emilia Michou Omar Ortega Pere Clavé |
| author_facet | Weslania Viviane Nascimento Viridiana Arreola Pilar Sanz Ediz Necati Mireia Bolivar-Prados Emilia Michou Omar Ortega Pere Clavé |
| author_sort | Weslania Viviane Nascimento |
| collection | DOAJ |
| description | (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 (<i>p</i> < 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. |
| first_indexed | 2024-03-10T16:33:52Z |
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| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T16:33:52Z |
| publishDate | 2020-09-01 |
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| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-53b734a232d04023bff5f2bc31bacc3d2023-11-20T12:37:32ZengMDPI AGBrain Sciences2076-34252020-09-0110960910.3390/brainsci10090609Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening AgentsWeslania Viviane Nascimento0Viridiana Arreola1Pilar Sanz2Ediz Necati3Mireia Bolivar-Prados4Emilia Michou5Omar Ortega6Pere Clavé7Medical School of Ribeirao Preto, University of São Paulo, São Paulo 14049-900, BrazilGastrointestinal Physiology Laboratory, CIBERehd CSdM-UAB, Hospital de Mataró, 08404 Mataró, SpainNeurology Department, Hospital de Mataró, Universitat Autònoma de Barcelona, 08404 Mataró, SpainDepartment of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Near East University, Nicosia 99138, CyprusGastrointestinal Physiology Laboratory, CIBERehd CSdM-UAB, Hospital de Mataró, 08404 Mataró, SpainDepartment of Speech Language Pathology: Communication Disorders and Dysphagia, University of Patras, 26334 Patras, GreeceGastrointestinal Physiology Laboratory, CIBERehd CSdM-UAB, Hospital de Mataró, 08404 Mataró, SpainGastrointestinal Physiology Laboratory, CIBERehd CSdM-UAB, Hospital de Mataró, 08404 Mataró, Spain(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 (<i>p</i> < 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.https://www.mdpi.com/2076-3425/10/9/609oropharyngeal dysphagiaParkinson’s diseaseoropharyngeal swallow responsethickening agentsdopamineshear viscosity |
| spellingShingle | Weslania Viviane Nascimento Viridiana Arreola Pilar Sanz Ediz Necati Mireia Bolivar-Prados Emilia Michou Omar Ortega Pere Clavé Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents Brain Sciences oropharyngeal dysphagia Parkinson’s disease oropharyngeal swallow response thickening agents dopamine shear viscosity |
| title | Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents |
| title_full | Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents |
| title_fullStr | Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents |
| title_full_unstemmed | Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents |
| title_short | Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents |
| title_sort | pathophysiology of swallowing dysfunction in parkinson disease and lack of dopaminergic impact on the swallow function and on the effect of thickening agents |
| topic | oropharyngeal dysphagia Parkinson’s disease oropharyngeal swallow response thickening agents dopamine shear viscosity |
| url | https://www.mdpi.com/2076-3425/10/9/609 |
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