Wet Voice as a Sign of Penetration/Aspiration in Parkinson’s Disease: Does Testing Material Matter?
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Wet voice is a perceptual vocal quality that is commonly used as an indicator of penetration and/or aspiration in clinical swallowing assessments and bedside screening tests. Our aim was to describe the clinimetric characteristics of this clinical sign using various fluid materials and one solid food in the Parkinson’s disease (PD) population. Consecutive PD individuals were submitted for simultaneous fiberoptic endoscopic evaluation of swallowing (FEES) and voice recording. Speech therapists rated the presence or absence of wetness and other voice abnormalities. Two binary endpoints of FEES were selected for comparison with an index test: low penetration (LP) and low penetration and/or aspiration (LP/ASP). The accuracy of wet voice changed according to the testing material in PD patients. Overall, the specificity of this indicator was better than its sensitivity, and the wafer cookie and yogurt drink yielded the best indices. Our data show that wet voice is clearly indicative of LP or LP/ASP in PD patients in case of positive test. However, in the case of a negative result, the wet voice test should be repeated or combined with other clinical tests to include or exclude the risk of LP or LP/ASP.
KeywordsDeglutition Deglutition disorders Parkinson disease Diagnostic techniques and procedures Evaluation studies Validation studies
The authors would like to thank Rui Lima, coordinator of the Laboratory of Petroleum and Gas (LAPEG), for allowing us to use the Brookfield rheology equipment, and Alana Almeida, for helping us in the viscosity tests. The authors also thank speech-language pathologists Carla Steinberg, Catarina Torres and Vanessa Neves for their contributions as judges of the voice samples.
Conflict of interest
For this article, no Grants or other financial support was received or supplied. There are no financial relationships or conflicts of interest to disclose.
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