Journal of Neural Transmission

, Volume 122, Issue 11, pp 1553–1561 | Cite as

Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson’s disease

  • Kyung Duck Lee
  • Jung Hoi Koo
  • Sun Hong Song
  • Kwang Deog Jo
  • Moon Kyu Lee
  • Wooyoung JangEmail author
Neurology and Preclinical Neurological Studies - Original Article


Dysphagia is an important issue in the prognosis of Parkinson’s disease (PD). Although several studies have reported that oropharyngeal dysphagia may be associated with cognitive dysfunction, the exact relationship between cortical function and swallowing function in PD patients is unclear. Therefore, we investigated the association between an electrophysiological marker of central cholinergic function, which reflected cognitive function, and swallowing function, as measured by videofluoroscopic studies (VFSS). We enrolled 29 early PD patients. Using the Swallowing Disturbance Questionnaire (SDQ), we divided the enrolled patients into two groups: PD with dysphagia and PD without dysphagia. The videofluoroscopic dysphagia scale (VDS) was applied to explore the nature of the dysphagia. To assess central cholinergic dysfunction, short latency afferent inhibition (SAI) was evaluated. We analyzed the relationship between central cholinergic dysfunction and oropharyngeal dysphagia and investigated the characteristics of the dysphagia. The SAI values were significantly different between the two groups. The comparison of each VFSS component between the PD with dysphagia group and the PD without dysphagia group showed statistical significance for most of the oral phase components and for a single pharyngeal phase component. The total score on the VDS was higher in the PD with dysphagia group than in the PD without dysphagia group. The Mini-Mental State Examination and SAI values showed significant correlations with the total score of the oral phase components. According to binary logistic regression analysis, SAI value independently contributed to the presence of dysphagia in PD patients. Our findings suggest that cholinergic dysfunction is associated with dysphagia in early PD and that an abnormal SAI value is a good biomarker for predicting the risk of dysphagia in PD patients.


Parkinson’s disease Dysphagia Electrophysiology VFSS Short latency afferent inhibition 



This work was funded by the Gangneung Asan Hospital Biomedical Research Center Promotion Fund.

Compliance with ethical standards

Conflict of interest

The authors have reported no potential conflicts of interest concerning this article and have equally contributed to this study in a meaningful manner. None of the authors have anything to disclose.


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Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Kyung Duck Lee
    • 1
  • Jung Hoi Koo
    • 1
  • Sun Hong Song
    • 1
  • Kwang Deog Jo
    • 2
  • Moon Kyu Lee
    • 2
  • Wooyoung Jang
    • 2
    • 3
    Email author
  1. 1.Department of Rehabilitation MedicineGangneung Asan Hospital, University of Ulsan College of MedicineGangneungRepublic of Korea
  2. 2.Department of NeurologyGangneung Asan Hospital, University of Ulsan College of MedicineGangneungRepublic of Korea
  3. 3.Biomedical Research CenterGangneung Asan HospitalGangneungRepublic of Korea

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