Dysphagia in Parkinson's disease patients prior to deep brain stimulation: Is screening accurate?
| Autor: | Deanna Britton, Shannon Anderson, Jessica Pietrowski, Andrew D. Palmer, Linda Bryans, Donna J. Graville, Sara Charney |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Parkinson's disease Deep brain stimulation medicine.medical_treatment Deep Brain Stimulation Aspiration pneumonia 03 medical and health sciences 0302 clinical medicine Swallowing Clinical Protocols Predictive Value of Tests Internal medicine medicine Prevalence Humans Cause of death Aged Aged 80 and over business.industry Age Factors Parkinson Disease General Medicine Middle Aged medicine.disease Dysphagia Pneumonia 030220 oncology & carcinogenesis Fluoroscopy Surgery Female Neurology (clinical) medicine.symptom Airway business Deglutition Disorders 030217 neurology & neurosurgery |
| Zdroj: | Clinical neurology and neurosurgery. 203 |
| ISSN: | 1872-6968 |
| Popis: | Background Swallowing problems are common in Parkinson’s Disease (PD) and aspiration pneumonia is the leading cause of death. Deep brain stimulation (DBS) surgery can successfully manage the motor symptoms of PD when pharmacological management begins to fail. Before DBS it is important to identify baseline dysfunction, but no consensus regarding swallowing screening exists. Objectives This study was undertaken to: 1) identify the prevalence of dysphagia prior to DBS; and 2) determine if screening measures or other characteristics were predictive for reduced airway protection. Methods A standardized protocol was performed for 137 consecutive patients with idiopathic PD and no confounding medical conditions, including those referred for work-up of dysphagia (n = 57) and those prior to DBS (n = 80). Three validated screening measures were completed before videofluoroscopic evaluation. Results On videofluoroscopy, there were significant differences in reduced airway protection by group (dysphagia group: 44 %; pre-DBS group: 21 %). Aspiration also differed by group (dysphagia group: 18 %; pre-DBS group: 8 %) although not significantly. Although there were significant between-group differences, none of the screening measures was predictive of reduced airway protection or aspiration in the sample overall. Male gender, previous videofluoroscopic evaluation, history of pneumonia, and previous DBS surgery were associated with increased aspiration-risk. Age also showed a modest correlation. Conclusions Dysphagia is not uncommon prior to DBS. No screening measure accurately predicted reduced airway protection on videofluoroscopy. Abnormal findings on clinical assessment prior to DBS, particularly in patients that are older, male, or have a history of pneumonia, may identify individuals requiring an objective dysphagia evaluation. |
| Databáze: | OpenAIRE |
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