Abstract
BackgroundParkinson’s disease (PD) is a neurodegenerative disorder characterized by a combination of motor and non-motor dysfunction. Dysphagia is a common symptom in PD, though it is still too frequently underdiagnosed. Consensus is lacking on screening, diagnosis, and prognosis of dysphagia in PD.ObjectiveTo systematically review the literature and to define consensus statements on the screening and the diagnosis of dysphagia in PD, as well as on the impact of dysphagia on the prognosis and quality of life (QoL) of PD patients.MethodsA multinational group of experts in the field of neurogenic dysphagia and/or PD conducted a systematic revision of the literature published since January 1990 to February 2021 and reported the results according to PRISMA guidelines. The output of the research was then analyzed and discussed in a consensus conference convened in Pavia, Italy, where the consensus statements were drafted. The final version of statements was subsequently achieved by e-mail consensus.ResultsEighty-five papers were used to inform the Panel’s statements even though most of them were of Class IV quality. The statements tackled four main areas: (1) screening of dysphagia: timing and tools; (2) diagnosis of dysphagia: clinical and instrumental detection, severity assessment; (3) dysphagia and QoL: impact and assessment; (4) prognostic value of dysphagia; impact on the outcome and role of associated conditions.ConclusionsThe statements elaborated by the Consensus Panel provide a framework to guide the neurologist in the timely detection and accurate diagnosis of dysphagia in PD.
Highlights
Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide [1]
The project was initiated by the Organizing Committee during the 2018 edition of the ‘Dysphagia Update’ Meeting, an international scientific event focused on neurogenic dysphagia that has been held biannually since 2008 under the patronage of the Italian Society of Neurology, the Italian Society of Neurorehabilitation, and the European Society for Swallowing Disorders
Questions on prognosis: a) Does dysphagia influence the prognosis of PD? b) What factors or associated conditions can influence the prognosis of dysphagia in PD?
Summary
Parkinson’s disease (PD) is the second most common neurodegenerative disorder worldwide [1]. There is an urgent need to identify standardized protocols for the clinical assessment and investigation of dysphagia in this population. An established and formal methodology to provide reliable guidance in complex health issues in the absence of high-quality evidence is represented by a consensus-based process. In this process, expert professionals reach a consensus on statements aimed at providing a guide for clinical practice on the basis of the best available evidence and the group’s expertise. (1) To define the appropriate timing for screening dysphagia in patients with PD and to identify reliable modalities;. (5) To identify unmet needs and highlight areas for future research
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