Treatment of Dysphagia in Parkinson’s Disease: A Systematic Review

Abstract

The incidence of oropharyngeal dysphagia in Parkinson’s disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative approaches to dysphagia. We reviewed the scientific literature to describe the treatments of dysphagia in PD. A systematic review was performed in PubMed, Scopus, Elsevier, and Medline according to PRISMA standards in 2018. The articles that did not mention dysphagia secondary to PD or used surgical treatment were excluded. Eleven articles met the criteria with information from 402 patients. The review relates to different protocols, such as training in expiratory muscle strength, postural techniques, oral motor exercises, video-assisted swallowing therapy, surface electrical stimulation, thermal stimulation, touch, compensatory interventions, training regime for swallowing, neuromuscular electrical stimulation, Lee Silverman voice treatment, swallow maneuver, airway protection, and postural compensation maneuvers. This review identifies the rationing interventions in each trial, if they are efficient and equitable. Several rehabilitative therapies have been successful. An improvement was seen in the degenerative function (coordination, speed, and volume), quality of life, and social relationships of people with PD. Further investigations concerning the clinical applicability of these therapies based on well-designed randomized controlled studies are needed. Larger patient populations need to be recruited to evaluate the effectiveness, long-term effects, and new treatment techniques.

Global Trends in the Incidence, Prevalence, and Years Lived With Disability of Parkinson's Disease in 204 Countries/Territories From 1990 to 2019

“…Meanwhile, early onset PD with high genetic susceptibility ( 49 , 50 ), longer disease duration ( 51 ), and low adherence to treatment ( 52 , 53 ), could prolong the course of disability. Some PD is accompanied by stroke ( 54 ), dementia ( 55 ), and dysphagia ( 56 ), which also contributes to the increase in disability. The high prevalence of disability caused by PD was found in low- and middle-income countries, but increasing recognition should strengthen management and access to resources ( 57 ).…”

Does Etiology Matter? Comparative Analysis of a Singing-Enhanced Swallowing Protocol for Patients with Neurological Impairment versus Head and Neck Cancer

“…Since dysphagia is a frequent complaint among patients with neurological impairment, various approaches to rehabilitative treatment for this population have been developed [3,4]. Although such attempts are advancing, their outcomes remain mixed [5,6], and efforts to examine these interventions with specific populations of patients with neurological disorders, such as patients with Parkinson's disease (PD) [7], are only just beginning. Alongside patients with neurological impairment, patients with structural impairment (e.g., resulting from head and neck cancer [HNC]) are the most vulnerable to swallowing difficulties and resulting malnutrition [8].…”

Relationship between the Functional Oral Intake Scale (FOIS) and the Self-Efficacy Scale among Cancer Patients: A Cross-Sectional Study

“…Dysphagia, in general, can be caused by either (1) severe neurological impairment (e.g., stroke, myasthenia gravis, inflammatory myopathies, Parkinson’s disease, and amyotrophic lateral sclerosis), (2) structural damage (e.g., trauma caused by the intubation or treatment of malignancies, especially HNC), (3) medication or toxic/drug side-effects, (4) presbyphagia, or (5) phagophobia [ 9 , 10 , 11 ]. Dysphagia can not only lead to malnutrition, weight loss, and aspiration pneumonia, but also affect health-related quality of life (HRQoL), including psychological and social aspects [ 12 ].…”

“…(2) structural damage (e.g., trauma caused by the intubation or treatment of malignancies, especially HNC), (3) medication or toxic/drug side-effects, (4) presbyphagia, or (5) phagophobia [9][10][11]. Dysphagia can not only lead to malnutrition, weight loss, and aspiration pneumonia, but also affect health-related quality of life (HRQoL), including psychological and social aspects [12].…”