Reference : Deep-brain-stimulation does not impair deglutition in Parkinson's disease.
Scientific journals : Article
Life sciences : Genetics & genetic processes
Deep-brain-stimulation does not impair deglutition in Parkinson's disease.
Lengerer, Sabrina [> >]
Kipping, Judy [> >]
Rommel, Natalie [> >]
Weiss, Daniel [> >]
Breit, Sorin [> >]
Gasser, Thomas [> >]
Plewnia, Christian [> >]
Krüger, Rejko mailto [University of Luxembourg > Faculty of Science, Technology and Communication (FSTC) > Life Science Research Unit]
Wachter, Tobias [> >]
Parkinsonism and Related Disorders
Yes (verified by ORBilu)
[en] Activities of Daily Living ; Adult ; Deep Brain Stimulation ; Deglutition/physiology ; Deglutition Disorders/complications/physiopathology ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/complications/physiopathology/therapy ; Retrospective Studies ; Severity of Illness Index ; Subthalamic Nucleus/physiopathology ; Treatment Outcome
[en] 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.
Luxembourg Centre for Systems Biomedicine (LCSB): Clinical & Experimental Neuroscience (Krüger Group)
Copyright (c) 2012 Elsevier Ltd. All rights reserved.

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