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Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents

1
Medical School of Ribeirao Preto, University of São Paulo, São Paulo 14049-900, Brazil
2
Gastrointestinal Physiology Laboratory, CIBERehd CSdM-UAB, Hospital de Mataró, 08404 Mataró, Spain
3
Centro de Investigación Biomédica en Red, Enfermedades Hepato-Digestivas (CIBERehd) Instituto de Salud Carlos III, 28029 Madrid, Spain
4
Neurology Department, Hospital de Mataró, Universitat Autònoma de Barcelona, 08404 Mataró, Spain
5
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Near East University, Nicosia 99138, Cyprus
6
Department of Speech Language Pathology: Communication Disorders and Dysphagia, University of Patras, 26334 Patras, Greece
*
Author to whom correspondence should be addressed.
Brain Sci. 2020, 10(9), 609; https://doi.org/10.3390/brainsci10090609
Received: 31 July 2020 / Revised: 27 August 2020 / Accepted: 3 September 2020 / Published: 4 September 2020
(1) Background: The effect of dopaminergic treatment on swallowing response in patients with Parkinson’s disease (PD) suffering oropharyngeal dysphagia (OD) is not understood. Aim: To characterize OD pathophysiology in PD and to assess whether dopaminergic states affect swallow function and the effect of thickeners. (2) Methods: Fifty patients with PD (40 evaluated in OFF/ON states) and 12 healthy volunteers (HVs) were evaluated with videofluoroscopy (VFS) to assess the swallowing biomechanics and kinematics of the swallowing response at three different shear-viscosities (<50, 120, and 4000 mPa·s); (3) Results: Patients presented a mean age of 70.46 ± 10.03 years. Disease evolution was 5.09 ± 3.86 year and Hoehn-Yahr stage was 2.32 ± 0.81. For HVs, mean age was 40.20 ± 2.50 year. Penetrations were present in 37.50% of PD patients and were associated with delayed laryngeal vestibule closure (LVC = 293.33 ± 90.07 ms). In contrast, HVs presented a LVC = 164.00 ± 39.78 ms (p < 0.05). An LVC ≥ 260 ms cutoff predicted unsafe swallow (sensitivity ≥ 0.83, specificity ≥ 0.57, AUC = 0.80) in PD. Increasing bolus viscosity improved deglutition safety but increased oropharyngeal residue. There were no differences in swallowing between the OFF/ON states. (4) Conclusions: In initial PD stages, oropharyngeal swallow response is severely delayed, while mildly impaired swallow safety improves with increasing bolus viscosity, which increases residue. Dopaminergic treatment does not affect swallowing or the therapeutic effect of thickeners. View Full-Text
Keywords: oropharyngeal dysphagia; Parkinson’s disease; oropharyngeal swallow response; thickening agents; dopamine; shear viscosity; OFF/ON states oropharyngeal dysphagia; Parkinson’s disease; oropharyngeal swallow response; thickening agents; dopamine; shear viscosity; OFF/ON states
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MDPI and ACS Style

Nascimento, W.V.; Arreola, V.; Sanz, P.; Necati, E.; Bolivar-Prados, M.; Michou, E.; Ortega, O.; Clavé, P. Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents. Brain Sci. 2020, 10, 609. https://doi.org/10.3390/brainsci10090609

AMA Style

Nascimento WV, Arreola V, Sanz P, Necati E, Bolivar-Prados M, Michou E, Ortega O, Clavé P. Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents. Brain Sciences. 2020; 10(9):609. https://doi.org/10.3390/brainsci10090609

Chicago/Turabian Style

Nascimento, Weslania V.; Arreola, Viridiana; Sanz, Pilar; Necati, Ediz; Bolivar-Prados, Mireia; Michou, Emilia; Ortega, Omar; Clavé, Pere. 2020. "Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents" Brain Sci. 10, no. 9: 609. https://doi.org/10.3390/brainsci10090609

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