Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
Department of Rehabilitation, Zhejiang University School of Medicine Second Affiliated Hospital, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
Dysphagia. 2022 Oct;37(5):1271-1278. doi: 10.1007/s00455-021-10387-0. Epub 2021 Nov 26.
The current study sought to examine longitudinal changes of dysphagia in Parkinson's disease, identify predictors of dysphagia aggravation and elucidate the influence of dysphagia on other symptoms in Parkinson's disease patients. Forty-eight patients with Parkinson's disease were enrolled. All patients underwent videofluoroscopic study of swallowing evaluation and a battery of neuropsychological assessments at baseline in 2014 and at follow-up in 2020. We used t-tests or Wilcoxon tests for comparative analysis between patients with/without dysphagia and comparative analysis of longitudinal data. We used Spearman's correlation analysis to examine predictors of dysphagia aggravation, and the Wilcoxon test to compare neuropsychological aggravation between patients with/without dysphagia at baseline. Swallowing function, cognitive function, depression, anxiety, and quality of life were aggravated at follow-up. Dysphagia prevalence increased from 27.08 at baseline to 39.58% at follow-up. Spearman's correlation results showed that dysphagia was more likely to become aggravated in male patients compared with female patients (P = 0.0049). Cognitive impairment at baseline was significantly related to dysphagia aggravation (P = 0.042). Patients with dysphagia at baseline exhibited a significantly greater increase in anxiety scores than patients without dysphagia at baseline (P = 0.021). The results revealed that male sex and cognitive impairment predicted worsening dysphagia in Parkinson's disease patients, and suggested that dysphagia may have a negative impact on anxiety in Parkinson's disease patients. The results highlight the importance of swallowing function screening and necessary instrumental checks, such as videofluoroscopic study of swallowing, in Parkinson's disease patients.
本研究旨在探讨帕金森病吞咽障碍的纵向变化，识别吞咽障碍恶化的预测因素，并阐明吞咽障碍对帕金森病患者其他症状的影响。共纳入 48 例帕金森病患者。所有患者均于 2014 年基线期和 2020 年随访期行吞咽电视透视检查和一系列神经心理学评估。我们使用 t 检验或 Wilcoxon 检验进行有/无吞咽障碍患者间的比较分析和纵向数据的比较分析。我们使用 Spearman 相关分析来检验吞咽障碍恶化的预测因素，并使用 Wilcoxon 检验来比较基线时有/无吞咽障碍患者的神经心理学恶化情况。吞咽功能、认知功能、抑郁、焦虑和生活质量在随访时均加重。吞咽障碍的患病率从基线时的 27.08%增加到随访时的 39.58%。Spearman 相关结果显示，与女性患者相比，男性患者更有可能出现吞咽障碍恶化（P=0.0049）。基线时的认知障碍与吞咽障碍恶化显著相关（P=0.042）。基线时有吞咽障碍的患者焦虑评分的增加明显大于基线时无吞咽障碍的患者（P=0.021）。结果表明，男性和认知障碍预测帕金森病患者吞咽障碍恶化，提示吞咽障碍可能对帕金森病患者的焦虑产生负面影响。这些结果强调了对帕金森病患者吞咽功能筛查和必要的仪器检查（如吞咽电视透视检查）的重要性。
