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Dysphagia Pattern in Early to Moderate Parkinson’s Disease Caused by Abnormal Pharyngeal Kinematic Function

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Abstract

Airway invasion is common in patients with Parkinson’s disease (PD) and can cause serious complications. However, a PD-related dysphagic pattern has not been clearly elucidated. In this study, 53 patients with early to moderate PD were enrolled to undergo a videofluoroscopic study of swallowing evaluation (VFSS) and a battery of neuropsychological assessments. A set of VFSS variables (three visuoperceptual, nine temporal, and six spatial) were measured. The main effects of bolus viscosity and volume on airway invasion were calculated. Statistical analyses were performed to determine key kinematic factors of airway invasion for swallowing each bolus type. Airway invasion frequency was significantly higher for liquid boluses (liquid vs. pudding P < 0.001; liquid vs. honey P = 0.006). Laryngeal vestibule closure reaction time (LVCrt) was the key kinematic factor of airway invasion for 3 ml liquid swallow (P = 0.040), anterior displacement of hyoid bone was the key kinematic factor for both 5 ml and 10 ml liquid swallows (P = 0.010, 0.034, respectively). Male sex and advanced Hoehn and Yahr stage were significantly related to reduced anterior displacement of hyoid bone. These results reveal the dysphagic pattern related to PD, demonstrating that prolonged LVCrt and reduced anterior displacement of hyoid bone are two crucial kinematic factors contributing to airway invasion during the liquid swallow. In addition, hyoid bone dysfunction was correlated with disease severity and male sex. Our findings warrant further investigation of the pathophysiological mechanism of dysphagia in PD and would guide clinical intervention.

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Data will be made available on reasonable request.

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Acknowledgements

We sincerely thank the patients participated in our study. We also acknowledge the support of the National Natural Science Foundation of China (82201393) and the Foundation of Zhejiang Rehabilitation Medical Center (ZKYJ2316).

Funding

This study was supported by the National Natural Science Foundation of China (82201393) and the Foundation of Zhejiang Rehabilitation Medical Center (ZKYJ2316).

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Authors and Affiliations

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

    Ping Wang, Xinhui Chen, Sheng Wu, Yanhong Pan,  Bo Wang &  Wei Luo

  2. Department of Rehabilitation, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China

    Ping Wang, Leilei Gao, Bing Xiong, Qian Shen, Yuanqing Shen & Jinhui Li

  3. Department of Neurology, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China

    Miao Chen

  4. Center for Rehabilitation Assessment and Therapy, Zhejiang Rehabilitation Medical Center, Hangzhou, China

    Changmeng Ji

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  1. Ping Wang
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Correspondence to Bo Wang or Wei Luo.

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Ping Wang and Xinhui Chen contributed equally to this work.

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Wang, P., Chen, X., Chen, M. et al. Dysphagia Pattern in Early to Moderate Parkinson’s Disease Caused by Abnormal Pharyngeal Kinematic Function. Dysphagia (2024). https://doi.org/10.1007/s00455-024-10672-8

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