Abstract
BackgroundParkinsonism (PD) is a common neurodegenerative disorders into which dysphagia occurs mainly in the late stage and to a lesser extent in an early stage. Diagnosis of dysphagia particularly in early idiopathic Parkinson’s disease (IPD) is important as dysphagia affects the quality of life of patients and most of the patients are unaware of this important symptom.MethodFifty-four patients were enrolled in this study presented with early IPD attending to the outpatient clinic of Sohag University Hospital. All PD patients were assessed by using Unified Parkinson’s Disease Rating Scale (UPDRS) and modified Hoehn and Yahr scale. IPD patients were classified into tremor dominant (TD) and postural instability/gait disorder (PIGD) phenotypes. Swallowing disturbance questionnaire (SDQ) and fiberoptic endoscopic evaluation of swallowing (FEES) were used to evaluate dysphagia.ResultsThirty-five percent of patients experienced dysphagia when the patients were questioned, and this percent rises to 40% on using FEES. The results of SDQ were significantly correlated to the results of more accurate FEES. The percentage of dysphagia was higher in patients with PIGD than TD phenotype. Dysphagia was significantly associated with the mean of the Mini-Mental State Examination (MMSE), UPDRS, and modified Hoehn and Yahr scale.ConclusionsDysphagia is a prevalent symptom in early IPD and significantly correlated with Parkinsonism phenotype, UPDRS, and modified Hoehn and Yahr scale.
Highlights
Parkinsonism (PD) is a common neurodegenerative disorders into which dysphagia occurs mainly in the late stage and to a lesser extent in an early stage
Dysphagia is a prevalent symptom in early idiopathic Parkinson’s disease (IPD) and significantly correlated with Parkinsonism phenotype, Unified Parkinson’s Disease Rating Scale (UPDRS), and modified Hoehn and Yahr scale
When the Parkinson’s disease (PD) patients were questioned, the percentage of dysphagia was 35.1% the oral phase which nearly doubles the percentage of the pharyngeal phase and this percentage increased to 40.7% when using the more accurate and objective method (FEES) (Table 1 and Fig. 1)
Summary
Parkinsonism (PD) is a common neurodegenerative disorders into which dysphagia occurs mainly in the late stage and to a lesser extent in an early stage. Diagnosis of dysphagia in early idiopathic Parkinson’s disease (IPD) is important as dysphagia affects the quality of life of patients and most of the patients are unaware of this important symptom. Dysphagia in IPD may occur in up to 100% of the patients in advanced disease stages [7, 8] which impairs the quality of life, interferes with medication intake, and. Fiberoptic endoscopic evaluation of swallowing (FEES) is considered one of the gold standard tests for the diagnosis of dysphagia, which can be replaced by a simple questionnaire like SDQ when FEES is not available [10]. To the best of our knowledge, most of the studies underestimate the frequency and severity of dysphasia in radiologically documented dysphagia, and the simple, sensitive, and specific bedside tests available for diagnosis of dysphagia in IPD are lacking [13,14,15,16]
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