Respiratory Muscle Dysfunction in Parkinson's Disease

Abstract

Patients with Parkinson's disease may have more difficulty performing repetitive motor acts than single motor acts because of bradykinesia and skeletal muscle rigidity. We thought that repetitive ventilatory tasks might be similarly limited and that this dysfunction would likely contribute to respiratory muscle fatigue. We studied 9 patients with Parkinson's disease who had no evidence of restrictive or obstructive lung disease and 5 normal age-matched control subjects who performed repetitive, forced inspiratory resistive-loaded tasks. The time a given mean airway opening pressure could be sustained, the incremental oxygen cost of breathing, and the work rate of breathing (W) were measured. Although maximal static inspiratory pressures were comparable in both groups, 8 of the 9 patients could not sustain as high a W in the resistive-loaded tasks as could the normal control subjects (41.0 +/- 23.0 versus 67.7 +/- 29.1 J/min; mean +/- SD, p less than 0.01) and the efficiency of breathing was reduced (2.0 +/- 0.8 versus 3.8 +/- 1.4%; p less than 0.01). These findings are similar to derangements of task performance by peripheral skeletal muscle groups in Parkinson's disease.

Respiratory changes in Parkinson's disease may be unrelated to dopaminergic dysfunction

“…Measuring maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) is useful to quantify the degree of respiratory impairment in individuals with PD 6,7 , and it is also a good method to assess the functional efficiency of respiratory muscles. Observations of respiratory muscle weakness are consistent with the reduced ability to generate normal forced expiratory maneuvers 8 . Muscle weakness in patients with PD restricts the ability to overcome rigidity and potentially contributes to reduced lung volume and respiratory pressure, which will impact on swallow, cough and speech functions 7 .…”

“…It is interesting that some investigations about respiratory pressure present in literature failed to find differences between patients with PD and values predicted for the general population or controls 8,12,13 . The discrepancy in results of different studies most likely reflects methodological issues: 1) Some of the studies 7,12 compared the values of variables with those predicted for the population, not including controls.…”

“…In some of these studies, authors have failed to find differences between these parameters in comparison with controls and/or predicted values. For instance, MIP values of nine patients with PD according to Hoehn and Yahr (HY) scores ranged from 1 to 3, and they did not differ from values of control subjects in one study 8 . In another study with 16 patients (HY 1 to 3), MIP and MEP were within the range predicted for their age and gender 12 .…”

Análise da função respiratória na doença de Parkinson

“…Análise dos percentuais de volume da curva expiratória forçada (%VEF 1 ) e da capacidade vital força-da que pode ser expirada em um segundo (%VEF 1 / CVF) como referenciais da permeabilidade de vias aéreas, quando relacionados entre si, não caracterizaram a presença de obstrução brônquica nos parkinsonianos [13][14][15] . O VEF 1 foi normal na doença relativamente severa 10,11 , com medidas de 88,7±23,8% 6 até 108,1±3,4% 2 .…”

Improvement of Sleep Hypopnea by Antiparkinsonian Drugs in a Patient with Parkinson's Disease: a Polysomnographic Study

“…There are several reports on respiratory function or the effects of antiparkinsonian drugs on respiratory dysfunction in Parkinson's disease (PD) patients (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”