Abstract
Objective: To measure the accuracy of DeglutiSom as an auxiliary method to assess swallowing in patients with Parkinson's disease (PD). Methodology: Accuracy study. Among 248 individuals, 91 participants met the inclusion criteria, with a mean age of 64.9 years (SD 7.7), 53.8% male and 46.2% female, with a mean disease duration of 12.6 years (SD 3.8 years). Two instrumental studies were performed: An acoustic analysis with Sonar Doppler via the DeglutiSom Software, and a videofluoroscopic swallow study. Three judges analyzed the swallowing sounds in the DeglutiSom software and the instrumental examination findings. Results: The inter-rater reliability was 90.1%, with 4.4% degree of partial agreement and 5.5% disagreement. Sensitivity resulted in 90.0% and specificity in 90.0%. A sensitivity of 97.0% and specificity of 91.0% are indicators of a high validity for the dysphagia screening method, with predictive value (+) of 97.0% and predictive value (-) of 91.0%, with an accuracy method of 96.0%. The validity indicator values for screening aspiration were also high, with a sensitivity of 90.0%, specificity of 90.0%, predictive value (+) of 82.0%, predictive value (-) of 95% , 0% and 90.0% accuracy. Conclusion: The method proposed is considered appropriate for oropharyngeal dysphagia and tracheal aspiration screening in patients with Parkinson's Disease.
Highlights
Parkinson's disease is a chronic and progressive disorder of the central nervous system, characterized by the degeneration of dopaminergic neurons, which may affect the dorsal nucleus of the vagus nerve
The present study aims to measure the accuracy of DeglutiSom as an auxiliary method to assess swallowing in patients with Parkinson's disease
In the pharyngeal phase - laryngeal elevation and cricopharyngeal opening – the results of the comparison between the frequencies of swallowing sounds between frequency 1 peak (F1p) and intensity 1 peak (1p) dB, final frequency (FF) in Hz and final intensity, showed significant changes in frequencies, means, minimum, maximum, and standard deviation
Summary
Parkinson's disease is a chronic and progressive disorder of the central nervous system, characterized by the degeneration of dopaminergic neurons, which may affect the dorsal nucleus of the vagus nerve. Authors estimate an incidence of 36,000 new cases per year in the Brazilian population, with a prevalence of 3.3% in individuals over 64 years of age (Souza et al, 2011). It is primarily a motor impairment disease, dysphagia can be present in Parkinson's disease, albeit not always correlated to the severity of the disease. Identification of dysphagia should be performed by a screening instrument. There is currently no consensus on the parameters that should make up a screening instrument and who should complete it. Many studies do not report the steps required to construct a measuring instrument, which includes obtaining evidence of instrument validity (Edmiaston et al, 2014)
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