Department of Rehabilitation, Hyogo College of Medicine Hospital, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, 555-36 Kurose-Gakuendai, Higashi-Hiroshima, Hiroshima, 739-2695, Japan.
Dysphagia. 2019 Feb;34(1):80-88. doi: 10.1007/s00455-018-9916-5. Epub 2018 Jun 8.
This study investigated the relationship between tongue pressure during swallowing and dysphagia in patients with Parkinson's disease (PD). A total of 24 patients with PD (12 men and 12 women, mean age 70.4 years) were studied. Their mean Hoehn and Yahr scale was 3.0 ± 1.3 (range 1-5). All participants underwent tongue pressure measurement and videofluorography during swallowing. Tongue pressure when swallowing 5 mL of barium on videofluorography was measured using a sensor sheet with five sensors. Based on the findings of videofluorography, the patients were divided into two groups: dysphagic PD group (n = 9) and non-dysphagic PD group (n = 15). The maximal magnitude (kPa), duration (s), time to peak pressure (s), and pressure gradient (kPa/s) of tongue pressure were analyzed for each part. For duration, time to peak pressure, and pressure gradient, similar values were calculated from the total waveform. There was no significant difference in maximal tongue pressure between the groups. The dysphagic PD group had prolonged duration of tongue pressure and time to peak pressure and a reduced pressure gradient compared with the non-dysphagic PD group. These results indicate that there is a clear difference in the temporal aspects of tongue pressure between the non-dysphagic and dysphagic PD patients. These differences provide the characteristics of tongue movement during swallowing in PD patients with dysphagia, which may be useful for the diagnosis and treatment of dysphagia.
本研究探讨了帕金森病(PD)患者吞咽时舌压与吞咽困难之间的关系。共纳入 24 例 PD 患者(男 12 例,女 12 例,平均年龄 70.4 岁)。他们的平均 Hoehn 和 Yahr 量表评分为 3.0±1.3(范围 1-5)。所有参与者均在吞咽时接受舌压测量和视频透视检查。在视频透视检查中,通过带有五个传感器的传感器片测量吞咽 5ml 钡时的舌压。根据视频透视检查的结果,将患者分为两组:吞咽困难 PD 组(n=9)和非吞咽困难 PD 组(n=15)。分析了每个部位舌压的最大幅度(kPa)、持续时间(s)、达峰时间(s)和压力梯度(kPa/s)。对于持续时间、达峰时间和压力梯度,从总波形中计算出相似的值。两组之间最大舌压无显著差异。吞咽困难 PD 组的舌压持续时间、达峰时间延长,压力梯度降低,与非吞咽困难 PD 组相比。这些结果表明,非吞咽困难和吞咽困难 PD 患者的舌压在时间方面存在明显差异。这些差异提供了吞咽困难 PD 患者吞咽时舌运动的特征,这可能有助于吞咽困难的诊断和治疗。