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Six-Year Follow-Up of Dysphagia in Patients with Parkinson’s Disease

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Abstract

The current study sought to examine longitudinal changes of dysphagia in Parkinson’s disease, identify predictors of dysphagia aggravation and elucidate the influence of dysphagia on other symptoms in Parkinson’s disease patients. Forty-eight patients with Parkinson’s disease were enrolled. All patients underwent videofluoroscopic study of swallowing evaluation and a battery of neuropsychological assessments at baseline in 2014 and at follow-up in 2020. We used t-tests or Wilcoxon tests for comparative analysis between patients with/without dysphagia and comparative analysis of longitudinal data. We used Spearman’s correlation analysis to examine predictors of dysphagia aggravation, and the Wilcoxon test to compare neuropsychological aggravation between patients with/without dysphagia at baseline. Swallowing function, cognitive function, depression, anxiety, and quality of life were aggravated at follow-up. Dysphagia prevalence increased from 27.08 at baseline to 39.58% at follow-up. Spearman’s correlation results showed that dysphagia was more likely to become aggravated in male patients compared with female patients (P = 0.0049). Cognitive impairment at baseline was significantly related to dysphagia aggravation (P = 0.042). Patients with dysphagia at baseline exhibited a significantly greater increase in anxiety scores than patients without dysphagia at baseline (P = 0.021). The results revealed that male sex and cognitive impairment predicted worsening dysphagia in Parkinson’s disease patients, and suggested that dysphagia may have a negative impact on anxiety in Parkinson’s disease patients. The results highlight the importance of swallowing function screening and necessary instrumental checks, such as videofluoroscopic study of swallowing, in Parkinson’s disease patients.

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References

  1. Chaudhuri KR, Martinez-Martin P, Schapira AH, et al. International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson’s disease: the NMSQuest study. Mov Disord. 2006;21(7):916–23. https://doi.org/10.1002/mds.20844.

    Article  PubMed  Google Scholar 

  2. Argolo N, Sampaio M, Pinho P, Melo A, Nóbrega AC. Videofluoroscopic predictors of penetration-aspiration in Parkinson’s disease patients. Dysphagia. 2015;30(6):751–8. https://doi.org/10.1007/s00455-015-9653-y.

    Article  PubMed  Google Scholar 

  3. Fukuoka T, Ono T, Hori K, et al. Tongue pressure measurement and videofluoroscopic study of swallowing in patients with Parkinson’s disease. Dysphagia. 2019;34(1):80–8. https://doi.org/10.1007/s00455-018-9916-5.

    Article  PubMed  Google Scholar 

  4. Curtis JA, Molfenter S, Troche MS. Predictors of residue and airway invasion in Parkinson’s disease. Dysphagia. 2020;35(2):220–30. https://doi.org/10.1007/s00455-019-10014-z.

    Article  PubMed  Google Scholar 

  5. Tomita S, Oeda T, Umemura A, et al. Video-fluoroscopic swallowing study scale for predicting aspiration pneumonia in Parkinson’s disease. PLoS ONE. 2018;13(6): e197608. https://doi.org/10.1371/journal.pone.0197608.

    Article  CAS  Google Scholar 

  6. Wang G, Li XJ, Hu YS, et al. Mortality from Parkinson’s disease in China: Findings from a five-year follow up study in Shanghai. Can J Neurol Sci. 2015;42(4):242–7. https://doi.org/10.1017/cjn.2015.49.

    Article  PubMed  Google Scholar 

  7. Auyeung M, Tsoi TH, Mok V, et al. Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson’s disease patients. J Neurol Neurosurg Psychiatry. 2012;83(6):607–11. https://doi.org/10.1136/jnnp-2011-301590.

    Article  PubMed  Google Scholar 

  8. Pflug C, Bihler M, Emich K, et al. Critical dysphagia is common in parkinson disease and occurs even in early stages: a prospective cohort study. Dysphagia. 2018;33(1):41–50. https://doi.org/10.1007/s00455-017-9831-1.

    Article  PubMed  Google Scholar 

  9. Kalf JG, de Swart BJ, Bloem BR, et al. Prevalence of oropharyngeal dysphagia in Parkinson’s disease: a meta-analysis. Parkinsonism Relat Disord. 2012;18(4):311–5. https://doi.org/10.1016/j.parkreldis.2011.11.006.

    Article  CAS  PubMed  Google Scholar 

  10. Nienstedt JC, Bihler M, Niessen A, et al. Predictive clinical factors for penetration and aspiration in Parkinson’s disease. Neurogastroenterol Motil. 2019;31(3): e13524. https://doi.org/10.1111/nmo.13524.

    Article  CAS  PubMed  Google Scholar 

  11. Claus I, Muhle P, Suttrup J, et al. Predictors of pharyngeal dysphagia in patients with Parkinson’s disease. J Parkinsons Dis. 2020;10(4):1727–35. https://doi.org/10.3233/JPD-202081.

    Article  CAS  PubMed  Google Scholar 

  12. Troche MS, Schumann B, Brandimore AE, et al. Reflex cough and disease duration as predictors of swallowing dysfunction in Parkinson’s disease. Dysphagia. 2016;31(6):757–64. https://doi.org/10.1007/s00455-016-9734-6.

    Article  PubMed  Google Scholar 

  13. Kim JS, Youn J, Suh MK, et al. Cognitive and motor aspects of Parkinson’s disease associated with dysphagia. Can J Neurol Sci. 2015;42(6):395–400. https://doi.org/10.1017/cjn.2015.304.

    Article  PubMed  Google Scholar 

  14. Massimo M, Deepak G, Francesco M, et al. Excessive daytime sleepiness is associated to the development of swallowing impairment in a cohort of early stage drug naïve Parkinson’s disease patients. J Neurol Sci. 2020;410: 116626. https://doi.org/10.1017/cjn.2015.304.

    Article  Google Scholar 

  15. Ding X, Gao J, Xie C, et al. Prevalence and clinical correlation of dysphagia in Parkinson disease: a study on Chinese patients. Eur J Clin Nutr. 2018;72(1):82–6. https://doi.org/10.1038/ejcn.2017.100.

    Article  CAS  PubMed  Google Scholar 

  16. Manor Y, Giladi N, Cohen A, Fliss DM, Cohen JT. Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson’s disease. Mov Disord. 2007;22(13):1917–21. https://doi.org/10.1002/mds.21625.

    Article  PubMed  Google Scholar 

  17. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8. https://doi.org/10.1007/BF00417897.

    Article  CAS  PubMed  Google Scholar 

  18. Liancai M, Stanislaw S, Jingming C, et al. Altered pharyngeal muscles in Parkinson disease. J Neuropathol Exp Neurol. 2012;71(6):520–30. https://doi.org/10.1097/NEN.0b013e318258381b.

    Article  Google Scholar 

  19. Liancai M, Stanislaw S, Jingming C, et al. Parkinson disease affects peripheral sensory nerves in the pharynx. J Neuropathol Exp Neurol. 2013;72(7):614–23. https://doi.org/10.1097/NEN.0b013e3182965886.

    Article  Google Scholar 

  20. Taira K, Fujiwara K, Fukuhara T, et al. Evaluation of the pharynx and upper esophageal sphincter motility using high-resolution pharyngeal manometry for Parkinson’s disease. Clin Neurol Neurosurg. 2021;201: 106447. https://doi.org/10.1016/j.clineuro.2020.106447.

    Article  PubMed  Google Scholar 

  21. Vilardell N, Rofes L, Arreola V, et al. Videofluoroscopic assessment of the pathophysiology of chronic poststroke oropharyngeal dysphagia. Neurogastroenterol Motil. 2017;29(10):1–8. https://doi.org/10.1111/nmo.13111.

    Article  CAS  PubMed  Google Scholar 

  22. Audag N, Goubau C, Toussaint M, Reychler G. Screening and evaluation tools of dysphagia in adults with neuromuscular diseases: a systematic review. Ther Adv Chronic Dis. 2019;10:2040622318821622. https://doi.org/10.1177/2040622318821622.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Iwaki H, Blauwendraat C, Leonard HL, et al. Differences in the presentation and progression of Parkinson’s disease by sex. Mov Disord. 2021;36(1):106–17. https://doi.org/10.1002/mds.28312.

    Article  PubMed  Google Scholar 

  24. Curtis JA, Molfenter SM, Troche MS. Pharyngeal area changes in Parkinson’s disease and its effect on swallowing safety, efficiency, and kinematics. Dysphagia. 2020;35(2):389–98. https://doi.org/10.1007/s00455-019-10052-7.

    Article  PubMed  Google Scholar 

  25. Mohsenin V. Gender differences in the expression of sleep-disordered breathing: role of upper airway dimensions. Chest. 2001;120(5):1442–7. https://doi.org/10.1378/chest.120.5.1442.

    Article  CAS  PubMed  Google Scholar 

  26. Jo SY, Hwang JW, Pyun SB. Relationship between cognitive function and dysphagia after stroke. Ann Rehabil Med. 2017;41(4):564–72. https://doi.org/10.5535/arm.2017.41.4.564.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Labeit B, Claus I, Muhle P, et al. Effect of cognitive and motor dual-task on oropharyngeal swallowing in Parkinson’s disease. Eur J Neurol. 2021;28(3):754–62. https://doi.org/10.1111/ene.14603.

    Article  PubMed  Google Scholar 

  28. Prediger RD, Matheus FC, Schwarzbold ML, et al. Anxiety in Parkinson’s disease: a critical review of experimental and clinical studies. Neuropharmacology. 2012;62(1):115–24. https://doi.org/10.1016/j.neuropharm.2011.08.039.

    Article  CAS  PubMed  Google Scholar 

  29. Broen MP, Narayen NE, Kuijf ML, et al. Prevalence of anxiety in Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2016;31(8):1125–33. https://doi.org/10.1002/mds.26643.

    Article  PubMed  Google Scholar 

  30. Rutten S, van der Ven PM, Weintraub D, et al. Predictors of anxiety in early-stage Parkinson’s disease—results from the first two years of a prospective cohort study. Parkinsonism Relat Disord. 2017;43:49–55. https://doi.org/10.1016/j.parkreldis.2017.06.024.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Zhu K, van Hilten JJ, Marinus J. Onset and evolution of anxiety in Parkinson’s disease. Eur J Neurol. 2017;24(2):404–11. https://doi.org/10.1111/ene.13217.

    Article  CAS  PubMed  Google Scholar 

  32. Ekberg O, Hamdy S, Woisard V, et al. Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia. 2002;17(2):139–46. https://doi.org/10.1007/s00455-001-0113-5.

    Article  PubMed  Google Scholar 

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Acknowledgements

We sincerely thank the patients and caregivers who participated in our study. We also acknowledge the support of the Science Technology Department of Zhejiang Province (2019C03017).

Funding

This study was supported by the Science Technology Department of Zhejiang Province (2019C03017).

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Authors and Affiliations

  1. Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China

    Ping Wang BD, Bo Wang, Xinhui Chen, Sheng Wu, Shuqi Chen, Peng Liu & Wei Luo

  2. Department of Rehabilitation, Zhejiang University School of Medicine Second Affiliated Hospital, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China

    Ping Wang BD, Bing Xiong, Fangyao Xie & Yinshan Tang

  3. Department of Neurology, Haining Chinese Medical Hospital, 177 Changdai Road, Haining, 314400, Zhejiang, China

    Xueping Ding MD

Authors
  1. Ping Wang BD
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  2. Bo Wang
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  3. Xinhui Chen
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Correspondence to Wei Luo.

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Wang, P., Wang, B., Chen, X. et al. Six-Year Follow-Up of Dysphagia in Patients with Parkinson’s Disease. Dysphagia 37, 1271–1278 (2022). https://doi.org/10.1007/s00455-021-10387-0

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  • DOI: https://doi.org/10.1007/s00455-021-10387-0

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