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帕金森病中的吞咽困难:第二部分——当前的治疗选择及动物研究见解

Dysphagia in Parkinson Disease: Part II-Current Treatment Options and Insights from Animal Research.

作者信息

Krasko Maryann N, Rudisch Denis Michael, Burdick Ryan J, Schaen-Heacock Nicole E, Broadfoot Courtney K, Nisbet Alex F, Rogus-Pulia Nicole, Ciucci Michelle R

机构信息

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin-Madison, 1300 University Ave, Madison, WI 53706, USA.

Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI 53706, USA.

出版信息

Curr Phys Med Rehabil Rep. 2023 Jun;11(2):188-198. doi: 10.1007/s40141-023-00393-8. Epub 2023 Apr 24.

Abstract

PURPOSE OF REVIEW

Dysphagia is highly prevalent in Parkinson disease (PD) but is not typically identified nor treated until later in the disease process. This review summarizes current pharmacological, surgical, and behavioral treatments for PD-associated dysphagia and contributions from translational animal research.

RECENT FINDINGS

Swallowing is a complex physiologic process controlled by multiple brain regions and neurotransmitter systems. As such, interventions that target nigrostriatal dopamine dysfunction have limited or detrimental effects on swallowing outcomes. Behavioral interventions can help target PD-associated dysphagia in stages. Animal research is necessary to refine treatments and useful in studying dysphagia.

SUMMARY

Dysphagia is an early, common, and debilitating sign of PD. Current pharmacological and surgical interventions are not effective in ameliorating swallowing dysfunction; behavioral intervention remains the most effective approach for dysphagia treatment. Animal research has advanced our understanding of mechanisms underlying PD and PD-associated dysphagia, and continues to show translational promise for the study of dysphagia treatment options.

摘要

综述目的

吞咽困难在帕金森病(PD)中非常普遍,但通常在疾病进程较晚时才被识别和治疗。本综述总结了目前针对PD相关性吞咽困难的药物、手术和行为治疗方法,以及转化动物研究的贡献。

最新发现

吞咽是一个由多个脑区和神经递质系统控制的复杂生理过程。因此,针对黑质纹状体多巴胺功能障碍的干预措施对吞咽结果的影响有限或具有不利影响。行为干预可以分阶段帮助解决PD相关性吞咽困难。动物研究对于完善治疗方法很有必要,并且在吞咽困难研究中很有用。

总结

吞咽困难是PD早期常见且使人衰弱的症状。目前的药物和手术干预在改善吞咽功能障碍方面无效;行为干预仍然是治疗吞咽困难最有效的方法。动物研究增进了我们对PD及PD相关性吞咽困难潜在机制的理解,并继续显示出在吞咽困难治疗选项研究中的转化前景。

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