Non-invasive assessment of swallowing and respiration in Parkinson's disease

Oro-pharyngeal dysphagia is well recognised but often underestimated in peo ple with Parkinson's disease. Asymptomatic patients may fail to receive tim ely advice or therapy, thus placing them at risk. The aim of this study was to determine whether subclinical abnormalities in swallowing and discrete changes in function such as those produced by prompting can be detected by non-invasive methods. We examined 12 people with idiopathic Parkinson's dis ease and 14 elderly comparison subjects. Five components of respiratory syn chronisation and swallowing efficiency were monitored using the Exeter Dysp hagia Assessment Technique. Ten feeding trials were administered under stan dard quiet conditions. The patients were then restudied using verbal prompt s when the spoon was presented to the mouth. The duration of two ore-pharyn geal events and the frequency of respiratory variables were compared for un related and related samples. Results showed the oral and pharyngeal parts o f the swallow to be significantly slower in those with Parkinson's dis ease . These patients required significantly more swallows to clear a 5-ml bolus , and fewer swallows were followed by expiration. When the patients were ve rbally prompted, there was a significant reduction in the duration of the o ral part. This study demonstrates that non-invasive methods can be used to detect subclinical difficulties with swallowing amongst a group of asymptom atic patients with PD and that these methods are sensitive to small changes in function produced by a verbal cue.