cMovement Disorders Clinic, London Health Sciences Centre, 339 Windemere Blvd, A 10-026, London, Ontario Canada.
Neurology. 2010 Apr 13;74(15):1198-202. doi: 10.1212/WNL.0b013e3181d9002b.
Reduced swallowing frequency affects secretion management in Parkinson disease (PD). Gum chewing increases saliva flow and swallow frequency. This study uses chewing gum to modify swallow frequency and latency between swallows in patients with PD.
Twenty participants were studied across 3 tasks, each of 5 minutes in duration: BL, GC, and PGC. Respiratory and laryngeal signals were continuously recorded using PowerLab (version 5.5.5; ADI Instruments, Castle Hill, Australia). Frequency and latency of swallow events were calculated.
Differences (analysis of variance) are reported for frequency (p < 0.000001) and latency (p < 0.000001). Swallow frequency (mean +/- SD) increased during GC (14.95 +/- 3.02) compared with BL (3.1 +/- 2.85) and PGC (7.0 +/- 2.57). Latency in seconds (mean +/- SD) decreased during GC (24.1 +/- 4.174) and increased with BL (131.8 +/- 59.52) and PGC (mean = 60.74 +/- 25.25). Intertask comparisons (t test) found differences in swallow frequency and latency between tasks: BL vs GC (p < 0.0001, p < 0.0001), BL vs PGC (p < 0.0011, p < 0.0009), and GC vs PGC (p < 0.0001, p < 0.0002), respectively. Post hoc analysis showed carryover to 5.317 minutes.
Modifying sensorimotor input by chewing gum alters frequency and latency of swallowing and may be an effective strategy for secretion management in Parkinson disease.
This study provides Class III evidence that chewing gum increases swallow frequency and decreases latency of swallowing in an experiment in patients with stage 2 to 4 Parkinson disease who are nonsymptomatic for significant prandial dysphagia.
吞咽频率降低会影响帕金森病（PD）患者的唾液分泌管理。咀嚼口香糖可以增加唾液流量和吞咽频率。本研究使用口香糖来改变 PD 患者（2-4 期）非进食性吞咽困难患者的吞咽频率和吞咽之间的潜伏期。
1）评估 PD 患者（无症状 2-4 期）在基线（BL）、咀嚼口香糖（GC）和咀嚼口香糖后（PGC）时吞咽的频率和潜伏期；2）评估口香糖吐出后的延续性。
20 名参与者参与了 3 项任务，每项任务持续 5 分钟：BL、GC 和 PGC。使用 PowerLab（版本 5.5.5；ADI 仪器公司，澳大利亚卡斯尔山）连续记录呼吸和喉部信号。计算吞咽事件的频率和潜伏期。
报告了频率（方差分析，p<0.000001）和潜伏期（方差分析，p<0.000001）的差异。与 BL（3.1±2.85）和 PGC（7.0±2.57）相比，GC 期间的吞咽频率（平均值±标准差）增加（14.95±3.02）。GC 期间的潜伏期（秒，平均值±标准差）缩短（24.1±4.174），BL 期间延长（131.8±59.52），PGC 期间延长（平均=60.74±25.25）。任务间比较（t 检验）发现任务间吞咽频率和潜伏期存在差异：BL 与 GC（p<0.0001，p<0.0001）、BL 与 PGC（p<0.0011，p<0.0009）、GC 与 PGC（p<0.0001，p<0.0002）。事后分析显示持续到 5.317 分钟。
通过咀嚼口香糖改变感觉运动输入会改变吞咽的频率和潜伏期，这可能是帕金森病患者分泌管理的有效策略。
本研究提供了 III 级证据，表明咀嚼口香糖可增加吞咽频率并缩短吞咽潜伏期，这在无症状 2-4 期帕金森病患者中进行的实验中是有效的，这些患者无明显的进食性吞咽困难。
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