早期帕金森病患者自我感知的言语和吞咽障碍进展:统一帕金森病评定量表的纵向分析
Progression of Self-Perceived Speech and Swallowing Impairment in Early Stage Parkinson's Disease: Longitudinal Analysis of the Unified Parkinson's Disease Rating Scale.
作者信息
Watts Christopher R, Zhang Yan
机构信息
Harris College of Nursing & Health Sciences, Texas Christian University, Fort Worth.
出版信息
J Speech Lang Hear Res. 2022 Jan 12;65(1):146-158. doi: 10.1044/2021_JSLHR-21-00216. Epub 2021 Dec 1.
PURPOSE
The purpose of this study was to investigate the presence and progression of self-perceived speech and swallowing impairments in newly diagnosed people with Parkinson's disease (PD) longitudinally across 6 years.
METHOD
Longitudinal data from the Parkinson's Progression Markers Initiative were analyzed across six consecutive years in a cohort of 269 newly diagnosed people with PD, and a subset of those ( = 211) who were assessed at every time point across the 6 years. Dependent variables included self-perceived ratings of speech and swallowing impairment severity from the Unified Parkinson's Disease Rating Scale. Patient-centered factors of age at diagnosis and motor phenotype were also assessed to determine if they were related to the change in self-perceived speech and swallowing impairments.
RESULTS
Overall, self-perceived speech and swallowing impairments were present in newly diagnosed people with PD, although over time, the degree of severity for both remained in the mild range. However, the rate of change over time was significant for perceived speech impairment, (5.5, 1158.8) = 21.1, < .001), and perceived swallowing impairment, (5.2, 1082.6) = 8.6, < .001. Changes for speech and swallowing impairment were both in the direction of progressive severity. There were no effects of age at diagnosis or motor phenotype on the degree of change for either speech or swallowing.
CONCLUSIONS
Self-perceptions of speech and swallowing impairment changed significantly over time in newly diagnosed people with PD (PWPD). Consistent with existing literature, self-perceptions of speech impairment were rated as more severe than those of swallowing impairment. These findings reveal that even in the early years postdiagnoses, PWPD are experiencing changes to speech and swallowing function, albeit within the mildly severe range. The presence of self-perceived mild speech and swallowing impairments in the initial years postdiagnosis may support the need for intervention to improve and or sustain function over time.
目的
本研究旨在纵向调查新诊断的帕金森病(PD)患者在6年期间自我感知的言语和吞咽障碍的存在情况及进展。
方法
对帕金森病进展标志物计划的纵向数据进行分析,该数据来自269名新诊断的PD患者队列,连续6年进行观察,其中一部分(n = 211)在这6年中的每个时间点都接受了评估。因变量包括统一帕金森病评定量表中自我感知的言语和吞咽障碍严重程度评分。还评估了以患者为中心的诊断时年龄和运动表型等因素,以确定它们是否与自我感知的言语和吞咽障碍变化有关。
结果
总体而言,新诊断的PD患者存在自我感知的言语和吞咽障碍,尽管随着时间推移,两者的严重程度仍处于轻度范围。然而,自我感知的言语障碍随时间的变化率具有统计学意义(F(5.5, 1158.8) = 21.1, p <.001),自我感知的吞咽障碍随时间的变化率也具有统计学意义(F(5.2, 1082.6) = 8.6, p <.001)。言语和吞咽障碍的变化均呈严重程度逐渐增加的趋势。诊断时年龄或运动表型对言语或吞咽障碍的变化程度均无影响。
结论
新诊断的PD患者自我感知的言语和吞咽障碍随时间发生了显著变化。与现有文献一致,自我感知的言语障碍比吞咽障碍的严重程度更高。这些发现表明,即使在诊断后的早期,PD患者的言语和吞咽功能也在发生变化,尽管仍处于轻度至中度范围内。诊断后最初几年存在自我感知的轻度言语和吞咽障碍可能支持需要进行干预,以随着时间推移改善和维持功能。