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沙芬酰胺对帕金森病吞咽困难的影响。

The effects of safinamide on dysphagia in Parkinson's disease.

机构信息

Department of Neurology, Kindai University Faculty of Medicine, Ohnohigashi, Osakasayama, Osaka, Japan.

Department of Rehabilitation Medicine, Kindai University Faculty of Medicine, Ohnohigashi, Osakasayama, Osaka, Japan.

出版信息

PLoS One. 2023 May 25;18(5):e0286066. doi: 10.1371/journal.pone.0286066. eCollection 2023.

Abstract

Dysphagia is a potentially fatal symptom of Parkinson's disease (PD) and is characterized by frequent silent aspiration, a risk factor for aspiration pneumonia. The transdermal dopamine agonist rotigotine alleviates dysphagia in patients with PD and is more effective than oral levodopa, suggesting the importance of continuous dopaminergic stimulation (CDS) in swallowing. Safinamide is a monoamine oxidase B (MAOB) inhibitor that facilitates CDS. In this retrospective open-label evaluator-blinded research, swallowing functions in nine patients with PD were examined using a video fluoroscopic swallowing study (VFSS) before and after treatment with 50 mg of oral safinamide. The VFSS results showed that safinamide significantly improved some swallowing measures during oral and pharyngeal phases, including oral transit time and pharyngeal transit time, without worsening of any measures. Notably, improvements in lip closure, an oral phase component, seemed to be most attributable to improvements in oral phase scores. In conclusion, a medicine for CDS may effectively improve swallowing functions in patients with PD. This is the first study to show that the MAOB inhibitor safinamide partly but significantly improves swallowing function in patients with PD.

摘要

吞咽困难是帕金森病(PD)的一种潜在致命症状,其特征是频繁的无声吸入,这是吸入性肺炎的一个危险因素。透皮多巴胺激动剂罗替高汀可缓解 PD 患者的吞咽困难,且比口服左旋多巴更有效,这表明持续多巴胺能刺激(CDS)在吞咽中的重要性。沙芬酰胺是一种单胺氧化酶 B(MAOB)抑制剂,可促进 CDS。在这项回顾性、开放性、评价者盲法研究中,在 9 名 PD 患者接受 50mg 口服沙芬酰胺治疗前后,使用视频荧光透视吞咽研究(VFSS)检查了吞咽功能。VFSS 结果表明,沙芬酰胺可显著改善口服和咽期的一些吞咽指标,包括口腔通过时间和咽通过时间,且没有任何指标恶化。值得注意的是,口腔期评分的改善似乎与口唇闭合(口腔期成分)的改善最为相关。总之,一种用于 CDS 的药物可能会有效地改善 PD 患者的吞咽功能。这是第一项表明 MAOB 抑制剂沙芬酰胺可部分但显著改善 PD 患者吞咽功能的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/014d/10212188/561eb6b4a636/pone.0286066.g001.jpg

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