Dysphagia, Parkinson Disease
Conditions
Keywords
Parkinson's Disease, dysphagia
Brief summary
We recruited 116 patients with idiopathic PD who were from the Neurology clinic of the Second Affiliated Hospital of Zhejiang University, School of Medicine from January 2014 to November 2014. Perform videofluroscopic swallowing study and psychiatric and neurological evaluations and followed up after 6 years.
Detailed description
In baseline, 116 patients with idiopathic PD were recruited from the Neurology Clinic of the Second Affiliated Hospital of Zhejiang University School of Medicine according to the United Kingdom PD Society Brain Bank Clinical Diagnostic Criteria. They were admitted from January 2014 to November 2014, and were followed up after 6 years. Perform psychiatric and neurological evaluations. And use Videofluoroscopic swallowing study (VFSS) to assess the swallowing function of PD patients. Added 200mg of barium sulfate to 286ml water to achieve a concentration of 60%. Add a thickener (Ourdiet Swallow, Ourdiet Biotech Co. Ltd, Guangzhou, China) to prepare juice and pudding viscosities, No thickener was added to the liquid viscosity. The patients were advised to have boluses of 3, 5 and 10 ml of the liquid, juice, pudding viscosities in sequence according to the clinician's instructions under X-ray fluoroscopy. The patients ware sitting or standing, The lateral view of the patients' swallow was recorded by a camera (30 frames per second). The radiologist, the clinician, and the rehabilitation therapist completed this examination. Two person analyzed the video in slow motion and frame - by - frame, and record abnormal results. The VFSS inspection parameters are Penetration/aspiration score and Residue score. In order to reduce the influence of drugs on dysphagia, all patients were in the off - period. The patients stopped taking anti-Parkinson's disease drugs from 9 o'clock the night before the examination, and were tested in the morning (free of medicine for more than 12 hours). The patients had completed the above tests in 2014 and were asked to perform the above assessments again.
Interventions
PROCEDUREdeep brain stimulation
performing deep brain stimulation if needed
DRUGAnti-Parkinsonian Drugs
Using anti-parkinsonian drugs if needed
Sponsors
Second Affiliated Hospital, School of Medicine, Zhejiang University
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* idiopathic PD according to the United Kingdom PD Society Brain Bank Clinical Diagnostic Criteria.
Exclusion criteria
* (1) Parkinsonian syndromes;(2) with severe lung disease, severe liver insufficiency and cardiac insufficiency; (3) Kubota water drinking test grade ≥3; (4) have had or combined other diseases that affect swallowing function; (5) Nasal feeding, gastric reflux or gastrostomy; (6) Mental disorders Or patients with low intelligence and cognitive function, unable to understand and cooperate with the examination.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| penetration - aspiration score | in the morning, before taking anti-parkinson drugs | according to the 8-Point Penetration-Aspiration Scale, PAS ≥ 6 means that material enters below the vocal cords. |
| residue score | in the morning, before taking anti-parkinson drugs | evaluate the residue in the oral cavity and pharynx (vallecula, pyriform sinuses) after the first swallowing. Residue amount was rated on a scale from 0 to 3: no residue visible, 0 score; mild residue (less than 25% of the level of the height of the structure), 1 score; moderate residue (25% to 50% of the height of the structure), 2 score; severe residue (high than 50% of the structure height), 3 score. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| water swallow test | in the morning, before taking anti-parkinson drugs | The patient is asked to sit in a chair, and is handed a cup containing 30 mL of water at normal temperature. The patient is then asked to Please drink this water as you usually do. Time to empty a cup is measured, and the drinking profile and episodes are monitored and assessed. |
| SDQ-C | in the morning, before taking anti-parkinson drugs | The Chinese version of the Swallowing Disturbance Questionnaire |
Other
| Measure | Time frame | Description |
|---|---|---|
| PDQ-39 | in the morning, before taking anti-parkinson drugs | Parkinson Disease Quality of Life Measure |
| MMSE | in the morning, before taking anti-parkinson drugs | Mini-mental State Examination (MMSE)； |
| NMSQ | in the morning, before taking anti-parkinson drugs | Non-Motor Symptoms Quest |
| HAMD | in the morning, before taking anti-parkinson drugs | Hamilton Depression Scale |
| HAMA | in the morning, before taking anti-parkinson drugs | Hamilton Anxiety Scale |
| H&Y | in the morning, before taking anti-parkinson drugs | Hoehn-Yahr stage |
Outcome results
None listed