Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography

Abstract

ObjectiveTo compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD).MethodsHealthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation.ResultsA total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048).ConclusionUltrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.

Hand Pronation–Supination Movement as a Proxy for Remotely Monitoring Gait and Posture Stability in Parkinson’s Disease

“…In addition to GP correlations, our results further emphasized a correlation between P/S speed and BA-related UPDRS III in both forearms. It is worth noting that BA functions provide insight into the control of bulbar center CPGs [30,31]. The BA subscore of the UPDRS reflects dysphagia-and dysarthria-related dysfunctions, including swallowing and speech impairments, which are coordinated sequential movements.…”

“…The BA subscore of the UPDRS reflects dysphagia-and dysarthria-related dysfunctions, including swallowing and speech impairments, which are coordinated sequential movements. BA functions themselves are believed to be controlled by the CPGs [30,31], which is considered highly active and sophisticated in primates [32]. CPGs are proposed as key players in enabling bipedals to use quadrupedal coordination to control their gait [15,16].…”

Kinematic measures of swallowing obtained with ultrasound: a scoping review protocol

“…US is a technological imaging resource for the analysis of muscle morphometry and kinematics of swallowing in individuals with and without disorders 1,7,8,[10][11][12][13][14] . Concerning the kinematics of swallowing, various US parameters are considered; the most evident findings are related to hyoid bone elevation and tongue movements 18 .…”

“…US has been used to investigate swallowing in the oropharynx of individuals with and without disorders to assess the muscle morphometry and kinematics of the function, observe qualitative and quantitative measures, and complement the diagnosis of dysphagia 1,7,8,[11][12][13][14] . Despite such benefits, US has still been little explored in clinical practice due to little reliance on data acquisition and image selection for interpretation and the lack of consensus on assessment parameters.…”

Medidas cinemáticas da deglutição obtidas por ultrassonografia: um protocolo de revisão de escopo

“…Na investigação da deglutição em região orofaríngea, a USG tem sido realizada em indivíduos com ou sem distúrbios para avaliar a morfometria muscular e cinemática da função, observar medidas qualitativas e quantitativas, bem como para complementar o diagnóstico da disfagia 1,7,8,[11][12][13][14] . Apesar dos benefícios apresentados, a ultrassonografia ainda é um recurso pouco explorado na prática clínica devido à falta de confiabilidade no que se refere à aquisição de dados e seleção de imagens para interpretação, além da ausência de consenso sobre os parâmetros avaliados.…”