Abstract
Objective: The goal of this study is to evaluate pulmonary function and respiratory center drive in patients with early-stage idiopathic Parkinson's disease (IPD) to facilitate early diagnosis of Parkinson's Disease (PD).Methods: 43 IPD patients (Hoehn and Yahr scale of 1) and 41 matched healthy individuals (e.g., age, sex, height, weight, BMI) were enrolled in this study. Motor status was evaluated using the Movement Disorders Society-Unified PD Rating Scale (MDS-UPDRS). Pulmonary function and respiratory center drive were measured using pulmonary function tests (PFT). All IPD patients were also subjected to a series of neuropsychological tests, including Non-Motor Symptoms Questionnaire (NMSQ), REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Beck Depression Inventory (BDI) and Mini Mental State Examination (MMSE).Results: IPD patients and healthy individuals have similar forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), forced expiratory volume in 1s/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and carbon monoxide diffusion capacity (DLCOcSB). Reduced respiratory muscle strength, maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) was seen in IPD patients (p = 0.000 and p = 0.002, respectively). Importantly, the airway occlusion pressure after 0.1 s (P0.1) and respiratory center output were notably higher in IPD patients (p = 0.000) with a remarkable separation of measured values compared to healthy controls.Conclusion: Our findings suggest that abnormal pulmonary function is present in early stage IPD patients as evidenced by significant changes in PImax, PEmax, and P0.1. Most importantly, P0.1 may have the potential to assist with the identification of IPD in the early stage.
Highlights
Parkinson’s disease (PD) is the second most common chronic and progressive neurodegenerative disease in the elderly [1]
Consistent with the early clinical stage of these idiopathic Parkinson’s disease (IPD) patients, we found no significant changes in ventilation function in IPD patients (FVC: 105.51 ± 17.24%; FEV1: 102.67 ± 18.50%; FVC/FEVF1: 79.27 ± 9.46%; PEF: 103.19 ± 20.67%; RV: 94.26 ± 17.09%; TLC: 92.04 ± 9.67%; DLCOcSB: 83.57 ± 15.55%; n = 43) compared to healthy controls (FVC: 104.38 ± 15.90%, p = 0.76; FEV1: 102.12 ± 13.93%, p = 0.88; FVC/FEVF1: 79.71 ± 6.10%, p = 0.80; PEF: 109.01 ± 13.99%, p = 0.13; RV: 97.64 ± 16.65%, p = 0.36; TLC: 93.21 ± 11.26 %, p = 0.61; DLCOcSB: 88.63 ± 14.09%, p = 0.12; n = 41)
We evaluated respiratory muscle strength by assessing muscle strength index PImax and PEmax in both early-stage IPD patients and healthy controls
Summary
Parkinson’s disease (PD) is the second most common chronic and progressive neurodegenerative disease in the elderly [1]. Pulmonary function impairment has been studied in idiopathic Parkinson’s disease (IPD), the most common type of Parkinsonism whereby the cause is unknown [4]. Abnormalities involving obstructive, restrictive and mixed-type pulmonary dysfunction increases disability in PD patients [5]. Respiratory complications, such as aspiration pneumonia and pulmonary embolism are associated with mortality of PD patients [6]. Based on the experimental designs and conclusions, these studies can be classified into four main topics: first is the effect of Levodopa (combined with different formulation) on pulmonary dysfunction in PD; the second is about dysregulated lung function, especially ventilatory dysfunction, diffusion impairment, obstructive, and restrictive disorders in PD; the third is the potential relationship between swallowing impairment and respiratory dysfunction in PD; the last is the therapeutic effect of rehabilitation (e.g., YOGA, Qigong) on pulmonary function in patients with PD [8,9,10,11,12]. Whether pulmonary function is affected in early stage IPD patients remains elusive
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