Department of Speech, Language, and Hearing Sciences, University of Florida, USA; Center for Movement Disorders and Neurorestoration, University of Florida, USA; Brain Rehabilitation Research Center, Malcom Randall VA, Gainesville, FL, USA.
Department of Neurology, University of Florida, USA; Center for Movement Disorders and Neurorestoration, University of Florida, USA.
Parkinsonism Relat Disord. 2014 Apr;20(4):439-43. doi: 10.1016/j.parkreldis.2013.12.011. Epub 2014 Jan 8.
Aspiration pneumonia is a leading cause of death in persons with Parkinson's disease (PD). Despite this, the mechanisms underlying dysphagia in this population are unclear. To date, researchers have not investigated the effects of varying cognitive demand on objective measures of swallowing safety. This study assessed whether swallowing safety could be disrupted by increasing cognitive demands during the task of swallowing.
Twenty participants with moderate PD and dysphagia were tested while completing a novel dual task experimental paradigm under videofluoroscopy. In the dual task condition, participants swallowed 10 cc of thin liquid barium while completing a digits forward task.
Four females and 16 males completed the study. Results revealed differential effects to swallowing safety based on baseline measures of cognitive flexibility and attention. Participants with mild impairment in cognitive flexibility and attention demonstrated cognitive-motor interference with worsening of both swallowing and cognitive performance. In contrast, participants who were most impaired in the domains of cognitive flexibility and attention improved swallowing safety in the dual task condition. Additionally, decreased swallow timing durations existed in the dual task condition compared to the single task condition.
The results of this study support the hypothesis that supramedullary drive can influence the swallowing plan. Additionally, this study highlights the need for cognitive taxing during swallowing evaluations.
吸入性肺炎是帕金森病（PD）患者死亡的主要原因。尽管如此，该人群吞咽困难的机制仍不清楚。迄今为止，研究人员尚未研究增加认知需求对吞咽安全性的客观测量的影响。本研究评估了在吞咽任务期间增加认知需求是否会破坏吞咽安全性。
在透视检查下，20 名伴有中度 PD 和吞咽困难的参与者在完成新的双重任务实验方案时接受了测试。在双重任务条件下，参与者在完成数字向前任务的同时吞咽 10 毫升稀薄的钡液。
四名女性和 16 名男性完成了研究。结果显示，基于认知灵活性和注意力的基线测量，吞咽安全性存在差异影响。认知灵活性和注意力轻度受损的参与者表现出认知运动干扰，吞咽和认知表现均恶化。相比之下，在认知灵活性和注意力方面受损最严重的参与者在双重任务条件下改善了吞咽安全性。此外，与单一任务条件相比，双重任务条件下的吞咽时间持续时间减少。
本研究的结果支持了这样一种假设，即延髓以上的驱动力可以影响吞咽计划。此外，本研究强调了在吞咽评估期间进行认知负荷的必要性。
