Impact of Dysphagia Therapy in Parkinson's Disease

Abstract

Background: Dysphagia is a common symptom in Parkinson's disease (PD) which indicates a difficulty in swallowing. It has been accompanied with poor quality of life (QoL), anxiety and depression. Aim of the Study: to assess the effects of dysphagia treatment in Parkinson’s disease. Materials and methods: Studies published up to July 2017 were found via a systematic comprehensive electronic database search using PubMed, Embase, and The Cochrane Library.Two reviewers independently assessed the studies using strict inclusion criteria. Results: Thirteen studies were enrolled in the present study and qualitatively analyzed using critical appraisal items. The review includes rehabilitative (exercises, electrical stimulation, bolus modification etc.) and pharmacologic treatment. Some well-designed controlled trials were included. However, none of the included studies fulfilled all criteria for external and internal validity. Thus, a meta-analysis was not carried out as most of the studies were not of sufficient quality. Conclusion: Rehabilitative treatment including Expiratory Muscle Strength Training (EMST) may be effective for dysphagia treatment solely coupled with dopaminergic therapy for PD. Recently developed other treatment methods such as implant-prosthodontic treatment and percutaneous injection of botulinum neurotoxin type A in the cricopharyngeal muscle on dysphagia is rather promising. Nevertheless, these preliminary results warrant further investigation concerning their clinical applicability, and further research should be conducted.