Oropharyngeal freezing and its relation to dysphagia - An analogy to freezing of gait.

Published on May 8, 2020in Parkinsonism & Related Disorders4.36
· DOI :10.1016/J.PARKRELDIS.2020.05.002
Bendix Labeit1
Estimated H-index: 1
(WWU: University of Münster),
Inga Claus3
Estimated H-index: 3
+ 5 AuthorsTobias Warnecke24
Estimated H-index: 24
Abstract Introduction The pathophysiology of dysphagia in Parkinson's disease (PD) is heterogeneous and poorly understood at present. This study investigated the phenotypes, prevalence and pathophysiology of oropharyngeal freezing (OPF) in PD and its relation to dysphagia. Methods In a prospective study, 50 PD patients were systematically screened for OPF using flexible endoscopic evaluation of swallowing (FEES). In addition, FEES-videos of 50 patients with post-stroke dysphagia and 50 healthy subjects were retrospectively evaluated as control groups. In PD patients freezing was assessed with the “freezing of gait (FoG) questionnaire” and the relationship between OPF and FoG was analyzed. Results In analogy to FoG, signs for OPF presented as either temporarily missing or delayed swallowing reflex in combination with freezing associated movement abnormalities e.g. festination, trembling, or akinesia. Seventeen PD patients (34%) showed considerable signs for OPF (15 cases of festination, 3 cases of trembling, 3 cases of akinesia). In the patients with post-stroke dysphagia, OPF was detected in 2 patients (4%). The healthy subjects showed no signs for OPF. The distribution of OPF differed significantly between the investigated groups (p  Conclusion Swallowing in PD patients can be impaired by OPF. We suggest that OPF and FoG share common pathophysiologic mechanisms based on their association and similar semiologies.
  • References (29)
  • Citations (0)
📖 Papers frequently viewed together
1 Citations
10 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
#1Rainer DziewasH-Index: 1
Last. Tobias WarneckeH-Index: 24
view all 46 authors...
At present, the flexible endoscopic evaluation of swallowing (FEES) is one of the most commonly used methods for the objective assessment of swallowing. This multicenter trial prospectively collected data on the safety of FEES and also assessed the impact of this procedure on clinical dysphagia management. Patients were recruited in 23 hospitals in Germany and Switzerland from September 2014 to May 2017. Patient characteristics, professional affiliation of the FEES examiners (physicians or speec...
1 CitationsSource
#1Bendix LabeitH-Index: 1
#2Paul MuhleH-Index: 7
Last. Rainer DziewasH-Index: 34
view all 9 authors...
BACKGROUND: Intact pharyngeal sensation is essential for a physiological swallowing process, and conversely, pharyngeal hypesthesia can cause dysphagia. This study introduces and validates a diagnostic test to quantify pharyngeal hypesthesia. METHODS: A total of 20 healthy volunteers were included in a prospective study. Flexible endoscopic evaluation of swallowing (FEES) and a sensory test were performed both before and after pharyngeal local anesthesia. To test pharyngeal sensation, a small tu...
2 CitationsSource
#1Carsten Buhmann (UHH: University of Hamburg)H-Index: 23
#2Moritz Bihler (Augsburg College)H-Index: 2
Last. Christina Pflug (UHH: University of Hamburg)H-Index: 3
view all 11 authors...
Abstract Background This study evaluates the prevalence, characteristics, and predictors of the difficulty of swallowing medication in Parkinson's disease (PD). Methods In this prospective controlled, cross-sectional cohort study, the ability to swallow four different placebos was assessed using flexible endoscopic evaluation of swallowing (FEES) in 118 PD patients and 32 controls. The association between a patient's swallowing ability for each pill and water, patient characteristics and dopamin...
2 CitationsSource
#1Yoko Wakasugi (Tokyo Medical and Dental University)H-Index: 5
#2Toshiyuki YamamotoH-Index: 1
Last. Shunsuke Minakuchi (Tokyo Medical and Dental University)H-Index: 19
view all 6 authors...
Background and Objective We investigated the swallowing function in patients with Parkinson's disease (PD) using deteriorated tongue control because PD patients frequently exhibit an impaired oral stage of swallowing and the tongue movement affects to oral and pharyngeal stage. Methods In total, 201 PD patients (106 men, 95 women; mean age 70.6 ± 8.0 years; median Hoehn-Yahr Stage III) were studied. The patients swallowed 10 mL of liquid barium under videofluorography and their oral transit time...
5 CitationsSource
#1Lucia Ricciardi (St George's, University of London)H-Index: 19
#2Michela EbreoH-Index: 1
Last. Francesca Morgante (UNIME: University of Messina)H-Index: 28
view all 7 authors...
Abstract Introduction Speech disturbances in Parkinson's disease (PD) are heterogeneous, ranging from hypokinetic to hyperkinetic types. Repetitive speech disorder has been demonstrated in more advanced disease stages and has been considered the speech equivalent of freezing of gait (FOG). We aimed to verify a possible relationship between speech and FOG in patients with PD. Methods Forty-three consecutive PD patients and 20 healthy control subjects underwent standardized speech evaluation using...
10 CitationsSource
#1Tobias WarneckeH-Index: 24
#2Inga SuttrupH-Index: 7
Last. Rainer DziewasH-Index: 34
view all 8 authors...
Abstract Background It is still controversially discussed whether central dopaminergic stimulation improves swallowing ability in Parkinson's disease (PD). We evaluated the effect of oral levodopa application on dysphagia in advanced PD patients with motor fluctuations. Methods In 15 PD patients (mean age 71.93 ± 8.29 years, mean disease duration 14.33 ± 5.94 years) with oropharyngeal dysphagia and motor fluctuations endoscopic swallowing evaluation was performed in the off state and on state co...
24 CitationsSource
More than 80 % of patients with Parkinson’s disease (PD) develop dysphagia during the course of their disease. Swallowing impairment reduces quality of life, complicates medication intake and leads to malnutrition and aspiration pneumonia, which is a major cause of death in PD. Although the underlying pathophysiology is poorly understood, it has been shown that dopaminergic and non-dopaminergic mechanisms are involved in the development of dysphagia in PD. Clinical assessment of dysphagia in PD ...
56 CitationsSource
#1Natalie Argolo (UFBA: Federal University of Bahia)H-Index: 5
#2Marília Sampaio (UFBA: Federal University of Bahia)H-Index: 6
Last. Ana Caline Nóbrega (UFBA: Federal University of Bahia)H-Index: 10
view all 5 authors...
Background Lingual pumping (LP) is a repetitive, involuntary, anteroposterior movement of the tongue on the soft palate that is executed prior to transferring the food bolus to the pharynx, but we also observed LP when multiple swallows were taken. LP may be associated with rigidity and bradykinesia in patients with Parkinson's disease (PD). This phenomenon tends to be more prevalent in dysphagic PD patients, and its impact on swallowing dynamics remains poorly understood. Objective To evaluate ...
14 CitationsSource
#1Thais Jacóe Soares (USP: University of São Paulo)H-Index: 1
#2Danielle Pedroni Moraes (USP: University of São Paulo)H-Index: 6
Last. Claudia Regina Furquim de Andrade (USP: University of São Paulo)H-Index: 15
view all 6 authors...
Introducao: O tempo de trânsito oral e um dos parâmetros observados na avaliacao clinica da degluticao. A importância se deve ao seu impacto na duracao total da refeicao, o que pode ter como consequencia prognostico nutricional desfavoravel. Objetivo: Documentar os textos cientificos internacionais que abordem o tempo de trânsito oral em sujeitos saudaveis. Metodo: Estudo de revisao critica que segue os preceitos do Cochrane Handbook. Os artigos foram selecionados por meio da base de dados PubMe...
7 CitationsSource
#1Anina VoglerH-Index: 1
#2Jorina JanssensH-Index: 2
Last. Tim Vanbellingen (University of Bern)H-Index: 16
view all 5 authors...
Background. Freezing of Gait (FOG) is a disabling parkinsonian symptom. The Freezing of Gait Questionnaire (FOG-Q) reliably detects FOG in patients with Parkinson’s disease (PD). Objectives. The aim of this study was to develop a German translated version of the FOG-Q and to assess its validity. Methods. The translation was accomplished using forward-backward-translation. The construct validity of the FOG-Q was examined in twenty-seven German native speaking PD patients. Convergent validity was ...
2 CitationsSource
Cited By0