期刊
PARKINSONISM & RELATED DISORDERS
卷 18, 期 7, 页码 847-853出版社
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2012.04.014
关键词
Parkinson; Deep-brain-stimulation; Dysphagia; Nucleus subthalamicus; Swallowing
资金
- Medtronic GmbH
- Medical Faculty of University of Tubingen [AKF 259-0-0]
- Novartis Pharma
- Federal Ministry of Education and Research (BMBF) (NGFN-Plus and ERA-Net NEURON)
- Helmholtz Association (HelMA, Helmholtz Alliance for Health in an Ageing Society)
- European Community (MeFoPa, Mendelian Forms of Parkinsonism)
- German Research Council (DFG) [KR2119/3-2]
- Michael J Fox Foundation
- Fritz Thyssen foundation [10.11.2.153]
- Federal Ministry for Education and Research [BMBF, NGFN-plus] [01GS08134]
- UCB Pharma
- Cephalon
- Abbott Pharmaceuticals
- Takeda Pharmaceuticals
- Medtronic
- Abbott Pharma
- Merz Pharmaceuticals
- Ipsen Pharma
- Pharm-Allergan
Objective: A large proportion of patients with Parkinson's disease develop dysphagia during the course of the disease. Dysphagia in Parkinson's disease affects different phases of deglutition, has a strong impact on quality of life and may cause severe complications, i.e. aspirational pneumonia. So far, little is known on how deep-brain-stimulation of the subthalamic nucleus influences deglutition in PD. Methods: Videofluoroscopic swallowing studies on 18 patients with Parkinson's disease, which had been performed preoperatively, and postoperatively with deep-brain-stimulation-on and deep-brain-stimulation-off, were analyzed retrospectively. The patients were examined in each condition with three consistencies (viscous, fluid and solid). The New Zealand Index for Multidisciplinary Evaluation of Swallowing (NZIMES) Subscale One' for qualitative and 'Logemann-MBS-Parameters' for quantitative evaluation were assessed. Results: Preoperatively, none of the patients presented with clinically relevant signs of dysphagia. While postoperatively, the mean daily levodopa equivalent dosage was reduced by 50% and deep-brain-stimulation led to a 50% improvement in motor symptoms measured by the UPDRS III, no clinically relevant influence of deep-brain-stimulation-on swallowing was observed using qualitative parameters (NZIMES). However quantitative parameters (Logemann scale) found significant changes of pharyngeal parameters with deep-brain-stimulation-on as compared to preoperative condition and deep-brain-stimulation-off mostly with fluid consistency. Conclusion: In Parkinson patients without dysphagia deep-brain-stimulation of the subthalamic nucleus modulates the pharyngeal deglutition phase but has no clinically relevant influence on deglutition. Further studies are needed to test if deep-brain-stimulation is a therapeutic option for patients with swallowing disorders. (C) 2012 Elsevier Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据