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帕金森病的气道躯体感觉缺陷和吞咽困难。

Airway somatosensory deficits and dysphagia in Parkinson's disease.

机构信息

Division of Otolaryngology, Department of Surgery, University of Wisconsin, Madison, WI 53792, USA.

出版信息

J Parkinsons Dis. 2013;3(1):39-44. doi: 10.3233/JPD-120161.

Abstract

BACKGROUND

Individuals with Parkinson's disease (PD) often experience substantial impairment of swallow control, and are typically unaware of the presence or severity of their impairments suggesting that these individuals may also experience airway sensory deficits. However, the degree to which impaired swallow function in PD may relate to airway sensory deficits has yet to be formally tested.

OBJECTIVE

The purpose of this study was to examine whether airway sensory function is associated with swallow impairment in PD.

METHODS

Eighteen PD participants and 18 healthy controls participated in this study and underwent endoscopic assessment of airway somatosensory function, endoscopic assessment of swallow function, and clinical ratings of swallow and disease severity.

RESULTS

PD participants exhibited abnormal airway somatosensory function and greater swallow impairment compared with healthy controls. Swallow and sensory deficits in PD were correlated with disease severity. Moreover, PD participants reported similar self-rated swallow function as healthy controls, and swallow deficits were correlated with sensory function suggesting an association between impaired sensory function and poor self-awareness of swallow deficits in PD.

CONCLUSIONS

These results suggest that control of swallow is influenced by airway somatosensory function, that swallow-related deficits in PD are related to abnormal somatosensation, and that swallow and airway sensory function may degrade as a function of disease severity. Therefore, the basal ganglia and related neural networks may play an important role to integrate airway sensory input for swallow-related motor control. Furthermore, the airway deficits observed in PD suggest a disintegration of swallow-related sensory and motor control.

摘要

背景

帕金森病(PD)患者常出现明显的吞咽控制障碍,且通常无法感知到自身吞咽障碍的存在或严重程度,这提示 PD 患者可能还存在气道感觉缺陷。然而,PD 患者吞咽功能障碍与气道感觉缺陷的相关程度尚未得到正式验证。

目的

本研究旨在探讨气道感觉功能是否与 PD 患者的吞咽障碍有关。

方法

18 名 PD 患者和 18 名健康对照者参与了本研究,他们接受了气道躯体感觉功能内镜评估、吞咽功能内镜评估和吞咽及疾病严重程度的临床评分。

结果

PD 患者表现出异常的气道躯体感觉功能和更严重的吞咽障碍,与健康对照组相比。PD 患者的吞咽和感觉缺陷与疾病严重程度相关。此外,PD 患者自我报告的吞咽功能与健康对照组相似,吞咽缺陷与感觉功能相关,这表明 PD 患者的感觉功能受损与对吞咽缺陷的自我意识差之间存在关联。

结论

这些结果表明,吞咽的控制受到气道躯体感觉功能的影响,PD 患者的吞咽相关缺陷与异常躯体感觉有关,并且随着疾病严重程度的增加,吞咽和气道感觉功能可能会下降。因此,基底神经节和相关神经网络可能在整合与吞咽相关的感觉输入以进行运动控制方面发挥重要作用。此外,PD 中观察到的气道缺陷表明与吞咽相关的感觉和运动控制的分离。

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