Comparison of swallowing function in Parkinson's disease and progressive supranuclear palsy

Johnston, B. T.; Castell, June A.; Stumacher, Sharon; Colcher, Amy; Gideon, R. Matthew; Li, Qun; Castell, Donald O.

doi:10.1002/mds.870120310

Cited by 51 publications

(40 citation statements)

References 17 publications

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“…In PD patients, an impaired tongue movement for swallowing action and its hesitancy result in defective tongue pumping, which causes a delay in the swallowing reflex 4, 6, 8–11, 13, 38–41. Problems associated with the oral preparatory phase and lingual movements during ingestion and the delay of lingual pumping effect on the bolus in PD patients are all related to akinesia.…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson's disease

et al. 2002

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We studied the various physiological aspects of oropharyngeal swallowing in Parkinson's disease (PD). Fifty-eight patients with PD were investigated by clinical and electrophysiological methods that measured the oropharyngeal phase of swallowing. All patients except 1 had mild to moderate degree of disability score. Dysphagia was demonstrated in 53% of all patients in whom the test of dysphagia limit was abnormal. All PD patients with or without dysphagia displayed the following abnormalities: (1) the triggering of the swallowing reflex was prolonged probably due to inadequate bolus control in the mouth and tongue and/or a specific delay in the execution of the swallowing reflex; (2) the duration of the pharyngeal reflex time was extremely prolonged due to slowness of the sequential muscle movements, especially those of the suprahyoid-submental muscles; (3) cricopharyngeal muscle of the upper oesophageal sphincter was found to be electrophysiologically normal; and (4) the electrophysiological phenomena in PD patients could not be strongly correlated with the degree of the disability and clinical score of the PD. It was concluded that various motor disorders of PD have considerable influence on oropharyngeal swallowing: hypokinesia, reduced rate of spontaneous swallowing, and the slowness of segmented but coordinated sequential movements rather than any abnormalities in the central pattern generator of the bulbar center. Some compensatory mechanisms in the course of PD may explain the benign nature of swallowing disorder until the terminal stage of the disease. Similarly, the swallowing problems of PD are not only related with the dopamine deficiency; some other nondopaminergic mechanisms may also be involved.

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Section: Discussionmentioning

confidence: 99%

Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson's disease

et al. 2002

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“…7,22,23 In contrast with PD, in MSA-P or PSP neither the dysphagia scores nor the electrophysiologic scores were related to disease duration or to disease severity (UPDRS). These findings might be attributed to a shorter disease duration range with higher UPDRS values or to a smaller number of patients in both MSA-P and PSP groups.…”

Section: Figure 1 Recording Of Oral-pharyngeal Swallowing In a Normamentioning

confidence: 95%

“…This abnormality indicates that the bradykinesia may be responsible for swallowing difficulties also in PSP and MSA-P, in accordance with previous observations. [22][23][24] However, absence of the EMG silence of the cricopharyngeal muscle was the most frequent electrophysiologic alteration observed in both PSP and MSA-P (table 4, figure 4). We already reported this electrophysiologic finding in MSA.…”

Section: Figure 1 Recording Of Oral-pharyngeal Swallowing In a Normamentioning

confidence: 97%

Cerebellar infarction after gamma knife radiosurgery of a vestibular schwannoma

Neuhaus¹,

Saleh²,

Oosterhout³

et al. 2007

Neurology

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Abstract-Objectives:To assess the presence, severity, and differences in dysphagia in Parkinson disease (PD), Parkinson variant of multiple system atrophy (MSA-P), and progressive supranuclear palsy (PSP), and to study the pathophysiology of swallowing abnormalities in these disorders. Methods: We applied an electrophysiologic method to evaluate oral-pharyngeal swallowing. We analyzed the following measures: duration of EMG activity of suprahyoid/submental muscles (SHEMG-D); duration of laryngeal-pharyngeal mechanogram (LPM-D); duration of the inhibition of the cricopharyngeal muscle activity (CPEMG-ID); interval between onset of EMG activity of suprahyoid/submental muscles and onset of laryngeal-pharyngeal mechanogram (I-SHEMG-LPM); and swallowing reaction time (SRT). Results: The prolongation of I-SHEMG-LPM was more typical in PD, whereas the most distinctive finding both in patients with PSP and MSA-P was the reduction or the absence of CPEMG-ID early in the course of the disease. Conclusions: Involvement of the peduncolo-pontine tegmental nucleus, with subsequent dysfunction of basal ganglia and of the medullary central pattern generator of swallowing, may account for the abnormalities detected in these parkinsonian syndromes. The method described was able to identify swallowing abnormalities also in patients without symptoms of dysphagia and to evaluate dysphagia severity in all patients. NEUROLOGY 2007;68:583-590 Parkinson disease (PD), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) are degenerative disorders of the CNS that share several common features, especially early in their course, so it is often difficult to differentiate one from the others. Swallowing abnormalities are a common problem in these disorders, and can manifest themselves as dysphagia or silent aspiration of food and liquids in the airways, conditions that can put the patient's life at risk.1,2 Radiologic and gastroenterologic dynamic procedures such as videofluoroscopy and manofluorography have been used to evaluate swallowing abnormalities in these disorders.2-4 Electrophysiologic investigations have also been proposed to study the functional aspects of the oral and pharyngeal phases of swallowing, in normal subjects 5 and in patients with PD. 6Dysphagia appears earlier in PSP and MSA than in PD, 7 but it is unclear whether each of these parkinsonian syndromes shows specific abnormalities of the oral or pharyngeal phases of swallowing.In the present study we used electrophysiologic techniques to examine the oral and pharyngeal phases of swallowing in patients with PD, Parkinson variant of MSA (MSA-P), and PSP. Our aims were to improve our knowledge of the pathophysiologic mechanisms of dysphagia in these parkinsonian syndromes; to examine differences in swallowing abnormalities between these disorders; and to assess the presence and the severity of swallowing abnormalities and to correlate them with clinical dysphagia.Methods. All patients and control subjects gave informed consent to all procedures of the...

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“…Individuals with PSP are thought to present an accurate awareness of their difficulty eating and drinking when assessed by questionnaire and verified by VFSS [78, 79]. The degree of cognitive impairment positively correlates to both individual reports of difficulty and clinician-observed swallow impairment [20, 83].…”

Section: Motor Disorders With Ftld Neuropathologymentioning

confidence: 99%

“…PSP is characterized by both oral and pharyngeal swallowing deficits occurring early in disease onset [78-80]. Dysphagia, often secondary to bradykinesia, is characterized by oral weakness, delayed swallow initiation, and reduced laryngeal elevation [20, 79, 81].…”

Section: Motor Disorders With Ftld Neuropathologymentioning

confidence: 99%

A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration

Lewis

Walterfang

Velakoulis

et al. 2018

Dement Geriatr Cogn Disord

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Background: Frontotemporal lobar degeneration (FTLD) can result in a decline in behavior, language, and motor function. Mealtime disturbances are a common and significant outcome of FTLD. Disturbances during mealtimes can arise from dysphagia or may occur secondary to behavioral changes such as rapid eating, mealtime rigidity, and altered diet preferences. Summary: Few studies have comprehensively evaluated eating behavior or dysphagia in individuals presenting with FTLD pathology despite the potential impact on medical safety and individual quality of life. Dysphagia is reported in the late stages of frontotemporal dementia and early in the motor subtypes of FTLD. The identification of dysphagia can alert individuals and medical teams to disease progression and provide insight into the nature and spread of the underlying neuropathology. Improved understanding of eating behaviors can improve individual care and may enhance diagnostic accuracy. Key Message: Aberrant eating behavior and swallowing difficulties are reported in the conditions associated with FTLD neuropathology. The consequences of mealtime disturbances include health risks associated with an increased BMI and aspiration, reduction of an individual’s independence, and an increase in caregiver stress and burden. Here we review and summarize the literature on eating behavior and swallow impairments (dysphagia) in each of the syndromes caused by FTLD.

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Comparison of swallowing function in Parkinson's disease and progressive supranuclear palsy

Cited by 51 publications

References 17 publications

Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson's disease

Electrophysiological evaluation of pharyngeal phase of swallowing in patients with Parkinson's disease

Cerebellar infarction after gamma knife radiosurgery of a vestibular schwannoma

A Review: Mealtime Difficulties following Frontotemporal Lobar Degeneration

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