Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

Kim, Ji Sun; Youn, Jinyoung; Suh, Mee Kyung; Kim, Tae‐Eun; Chin, Juhee; Park, Suyeon; Cho, Jin Whan

doi:10.1017/cjn.2015.304

Cited by 31 publications

(17 citation statements)

References 26 publications

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“…Like previous studies, the present study revealed that dysphagia is significantly correlated with UPDRS and modified Hoehn and Yahr scale [ 30 , 31 ] in contrast to the others [ 32 , 33 ] which showed that the disease stage (UPDRS total and Hoehn and Yahr rating) was not correlated to swallowing difficulties which may be explained by the relatively early stage of PD in our patients (H&Y scale< 3), the shorter duration of illness (4.7 ± 2.2) and the usage of different scores for evaluation of dysphagia.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of dysphagia in different phenotypes of early and idiopathic Parkinsonism

Mohamed

Elnady

et al. 2018

Egypt J Neurol Psychiatry Neurosurg

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BackgroundParkinsonism (PD) is a common neurodegenerative disorders into which dysphagia occurs mainly in the late stage and to a lesser extent in an early stage. Diagnosis of dysphagia particularly in early idiopathic Parkinson’s disease (IPD) is important as dysphagia affects the quality of life of patients and most of the patients are unaware of this important symptom.MethodFifty-four patients were enrolled in this study presented with early IPD attending to the outpatient clinic of Sohag University Hospital. All PD patients were assessed by using Unified Parkinson’s Disease Rating Scale (UPDRS) and modified Hoehn and Yahr scale. IPD patients were classified into tremor dominant (TD) and postural instability/gait disorder (PIGD) phenotypes. Swallowing disturbance questionnaire (SDQ) and fiberoptic endoscopic evaluation of swallowing (FEES) were used to evaluate dysphagia.ResultsThirty-five percent of patients experienced dysphagia when the patients were questioned, and this percent rises to 40% on using FEES. The results of SDQ were significantly correlated to the results of more accurate FEES. The percentage of dysphagia was higher in patients with PIGD than TD phenotype. Dysphagia was significantly associated with the mean of the Mini-Mental State Examination (MMSE), UPDRS, and modified Hoehn and Yahr scale.ConclusionsDysphagia is a prevalent symptom in early IPD and significantly correlated with Parkinsonism phenotype, UPDRS, and modified Hoehn and Yahr scale.Electronic supplementary materialThe online version of this article (10.1186/s41983-018-0031-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Evaluation of dysphagia in different phenotypes of early and idiopathic Parkinsonism

Mohamed

Elnady

et al. 2018

Egypt J Neurol Psychiatry Neurosurg

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“…In healthy participants, disruptive stimuli might alter feeding, but had little effect on oropharyngeal swallowing [ 29 ]. A study in Parkinson's disease patients suggested that there are significant correlations between frontal/executive or learning/memory functions and the oral phase of swallowing, whereas the pharyngeal phase showed weak correlations with frontal functions [ 30 ]. In Alzheimer's disease (AD), dysphagia has also been thought to be associated with cognitive impairment [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Cognitive Function and Dysphagia After Stroke

Hwang

Pyun

2017

Ann Rehabil Med

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ObjectiveTo investigate the characteristics of cognitive deficits in patients with post-stroke dysphagia, and to analyze the relationships between cognitive dysfunction and severity of dysphagia in supratentorial stroke.MethodsA total of 55 patients with first-ever supratentorial lesion stroke were enrolled retrospectively, within 3 months of onset. We rated dysphagia from 0 (normal) to 4 (severe) using the dysphagia severity scale (DSS) through clinical examinations and videofluoroscopic swallowing studies (VFSS). The subjects were classified either as non-dysphagic (scale 0) or dysphagic (scale 1 to 4). We compared general characteristics, stroke severity and the functional scores of the two groups. We then performed comprehensive cognitive function tests and investigated the differences in cognitive performance between the two groups, and analyzed the correlation between cognitive test scores, DSS, and parameters of oral and pharyngeal phase.ResultsFugl-Meyer motor assessment, the Berg Balance Scale, and the Korean version of the Modified Barthel Index showed significant differences between the two groups. Cognitive test scores for the dysphagia group were significantly lower than the non-dysphagia group. Significant correlations were shown between dysphagia severity and certain cognitive subtest scores: visual span backward (p=0.039), trail making tests A (p=0.042) and B (p=0.002), and Raven progressive matrices (p=0.002). The presence of dysphagia was also significantly correlated with cognitive subtests, in particular for visual attention and executive attention (odds ratio [OR]=1.009; 95% confidence interval [CI], 1.002–1.016; p=0.017). Parameters of premature loss were also significantly correlated with the same subtests (OR=1.009; 95% CI, 1.002–1.016; p=0.017).ConclusionOur results suggest that cognitive function is associated with the presence and severity of post-stroke dysphagia. Above all, visual attention and executive functions may have meaningful influence on the oral phase of swallowing in stroke patients with supratentorial lesions.

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“…The characteristic signs of Parkinson's disease—bradykinesia, rigidity, and tremor—have been linked to dopamine loss resulting from neuronal death in the substantia nigra [ 2 , 4 , 5 ]. However, it is becoming clear that damage occurs on a larger scale, throughout the nervous system in PD, and that many symptoms are not responsive to treatments targeting dopamine loss [ 6 ], including problems with eating and swallowing [ 7 , 8 ]. Such problems are frequent in patients with Parkinson's disease.…”

Section: Introductionmentioning

confidence: 99%

Evidence of Oropharyngeal Dysfunction in Feeding in the Rat Rotenone Model of Parkinson’s Disease

Gould

Gross

German

et al. 2018

Parkinson's Disease

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Swallowing disorders in Parkinson's disease are not responsive to dopamine depletion therapy and contribute to morbidity. They are poorly understood owing to a lack of adequate models. We present the first evidence of oropharyngeal changes in a rotenone toxicity model of Parkinson's disease. Rats were recorded while feeding before and after daily rotenone injections at two different doses (2.75 mg/kg and 3 mg/kg). The higher dose had a much more severe parkinsonian phenotype than the low dose. Timing and amplitude of chewing changed, as did the coordination of chewing and swallowing. Dose-dependent effects were evident. These preliminary results indicate that future research in toxicological models of Parkinson's disease should incorporate the study of oropharyngeal dysfunction. A better understanding of nongenetic models of Parkinson's disease in feeding may open new avenues for research into the neurological and behavioral bases for swallowing dysfunction in Parkinson's disease.

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Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

Cited by 31 publications

References 26 publications

Evaluation of dysphagia in different phenotypes of early and idiopathic Parkinsonism

Evaluation of dysphagia in different phenotypes of early and idiopathic Parkinsonism

Relationship Between Cognitive Function and Dysphagia After Stroke

Evidence of Oropharyngeal Dysfunction in Feeding in the Rat Rotenone Model of Parkinson’s Disease

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