Characterization of Corticobulbar Pharyngeal Neurophysiology in Dysphagic Patients With Parkinson's Disease

Michou, Emilia; Hamdy, Shaheen; Harris, Mary L.; Vania, Adil; Dick, Jeremy; Kellett, Mark; Rothwell, John C.

doi:10.1016/j.cgh.2014.03.020

Cited by 30 publications

(52 citation statements)

References 32 publications

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“…Our lack of detecting a consistent relationship between pre-and post-stimulation MEPs is consistent with previous research. Others have found both positive and negative relationships between treatmentrelated changes in pharyngeal MEPs and swallowing function in patients following stroke [19,20] and those with Parkinson disease [21]. The lack of consistent outcomes indicates the complexity of underlying neural mechanisms associated with adequate swallowing function [22].…”

Section: Discussionmentioning

confidence: 99%

Pharyngeal Stimulation in Head and Neck Cancer Patients with Dysphagia: Functional Outcomes and Transcranial Magnetic Stimulation Motor Evoked Potentials

Harris¹

2014

Int J Neurorehabilitation Eng

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Purpose: Head and neck cancer patients often experience swallowing disorders, impacting health and quality of life. This study examined effects of electrical stimulation to the pharynx on swallowing outcomes in post-surgical head and neck cancer patients.Methods: Swallowing was assessed using video fluoroscopy before, and 30 minutes after, a ten-minute application of electrical stimulation to the pharynx in five patients experiencing moderate-severe dysphagia. Corticopharyngeal motor projections were measured before and after stimulation of the pharynx using transcranial magnetic stimulation of motor cortex and measurements of motor evoked potentials (MEPs) in the striated muscle of the posterior pharyngeal wall.Results: Short-term changes in swallowing function were observed post-stimulation in: pharyngeal transit time, cricopharyngeal opening duration, total number of swallows, penetration/aspiration score, and duration of contact between the base of tongue and posterior pharyngeal wall. MEPs could not be measured in two participants. In the remaining participants, the MEP measures were not strongly associated with changes in observed swallowing function as has been found for neurogenic dysphagia.Conclusions: These findings indicated that somatosensory input, generated by electrical stimulation of the pharynx, changes swallowing function in head and neck cancer patients. These changes are not strongly correlated with alterations of corticopharyngeal excitability as previously observed in acutely dysphagic stroke patients.

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Section: Discussionmentioning

confidence: 99%

Pharyngeal Stimulation in Head and Neck Cancer Patients with Dysphagia: Functional Outcomes and Transcranial Magnetic Stimulation Motor Evoked Potentials

Harris¹

2014

Int J Neurorehabilitation Eng

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“…Five other studies, [12][13][14][15][16] that used the VFSS to assess the swallowing in PD patient, were found in this literature review. Kim et al [12] evaluated 33 patients and observed that 78.8% had clinical sign of penetration or aspiration.…”

Section: Prevalence Of Dysphagia In Parkinson's Diseasementioning

confidence: 99%

“…However, we do not have scientific evidences of the benefits of this approach [56] thus, studies are reinforced. More recently, studies discuss the transcranial magnetic stimulation in cerebral cortex [16] neuromuscular electrical stimulation [39] deepbrain-stimulations in subthalamics nucleus [57,58] and surface electrical stimulation in sub mental region [59]. To date, none of these studies reported a significant improvement of swallowing with only one type of stimulation.…”

Section: Management Of Dysphagia In Pdmentioning

confidence: 99%

“…In the study by Monteiro et al [15] the prevalence of swallowing complaints was of 40.0% in PD patients. Lastly, one other study by Michou et al [16] also reported prevalence of swallowing disturbances in eleven (50.0%) of the PD patients evaluated. Thus, the prevalence of dysphagia in Parkinson disease still needs to be investigated.…”

Section: Prevalence Of Dysphagia In Parkinson's Diseasementioning

confidence: 99%

“…In the last 5 years, the prevalence of dysphagia in Parkinson's disease (PD) has been reported with a wide range, from 11% to 100% [4][5][6][7][8][9][10][11][12][13][14][15][16]. The procedures used to assess the presence of dysphagia and its severity it also differs in studies.…”

Section: Prevalence Of Dysphagia In Parkinson's Diseasementioning

confidence: 99%

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Dysphagia in Parkinson’s disease: Prevalence, Impact and Management Challenges

Luchesi¹,

Toledo²,

Mourão³

2017

JOENTR

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The aim of this review is to present an update of the prevalence, impact and management challenges of dysphagia in Parkinson's disease. In the last 5 years, the prevalence of dysphagia in Parkinson's disease (PD) has been reported with a wide range of values in the literature. The dysphagia prevalence ranged from 11% to 100% of the patients with PD. This variation, generally, depended on the disease stage and the procedure of swallowing assessment. In the management of dysphagia, compensatory techniques, rehabilitation exercises and deep-brain stimulation have been conducted. Despite of the lack of high scientific evidences of efficiency of the majority of these interventions, the positive aspects and benefits are described in the actual literature. Moreover, this review paper discuss about the importance of the dysphagia assessment and treatment in the best timing to prevent complications, as pulmonary and nutritional impairment, and to improve quality of life.

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Lung Function Testing On and Off Dopaminergic Medication in Parkinson's Disease Patients With and Without Dysphagia

Sawan

Harris

Kobylecki

et al. 2015

Movement Disord Clin Pract

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Background: Swallowing function in individuals with Parkinson's disease (PD) can be negatively affected by dopaminergic medication with associated inhibition of brainstem reflexes. Three different "swallowing-safety" profiles of PD patients were previously observed, classified according to swallowing safety on and off levodopa. Methods: Here, we investigated the effects of L-dopa on pulmonary function tests (PFTs) on 26 individuals with PD from the three different swallowing-safety profiles. PFTs results were compared to predicted values and direct comparisons between the groups with or without dysphagia were performed with nonparametric statistical tests (i.e., Kruskal-Wallis). Results: A short (12-hour) withdrawal from L-dopa did not result in any significant changes in PFTs, and no differences on PFTs results were observed between the different dysphagic groups the on and off L-dopa state. No correlation was observed between the PFTs results with swallowing safety profiles of PD patients. Conclusions: Although deglutition seems to be at least partially affected by dopaminergic repletion, dopaminergic mechanisms do not seem to be responsible for PD patients' performance in PFTs.Parkinson's disease (PD) is the most common neurodegenerative disorder after Alzheimer's disease and its prevalence increases with age.

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Characterization of Corticobulbar Pharyngeal Neurophysiology in Dysphagic Patients With Parkinson's Disease

Cited by 30 publications

References 32 publications

Pharyngeal Stimulation in Head and Neck Cancer Patients with Dysphagia: Functional Outcomes and Transcranial Magnetic Stimulation Motor Evoked Potentials

Pharyngeal Stimulation in Head and Neck Cancer Patients with Dysphagia: Functional Outcomes and Transcranial Magnetic Stimulation Motor Evoked Potentials

Dysphagia in Parkinson’s disease: Prevalence, Impact and Management Challenges

Lung Function Testing On and Off Dopaminergic Medication in Parkinson's Disease Patients With and Without Dysphagia

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