Santos-García Diego, de Deus Fonticoba Teresa, Jesús Silvia, Cosgaya Marina, García Caldentey Juan, Caballol Nuria, Legarda Ines, Hernández Vara Jorge, Cabo Iria, López Manzanares Lydia, González Aramburu Isabel, Ávila Rivera Maria A, Gómez Mayordomo Víctor, Nogueira Víctor, Dotor García-Soto Julio, Borrué Carmen, Solano Vila Berta, Álvarez Sauco María, Vela Lydia, Escalante Sonia, Cubo Esther, Mendoza Zebenzui, Pareés Isabel, Sánchez Alonso Pilar, Alonso Losada Maria G, López Ariztegui Nuria, Gastón Itziar, Kulisevsky Jaime, Seijo Manuel, Valero Caridad, Alonso Redondo Ruben, Ordás Carlos, Menéndez-González Manuel, McAfee Darrian, Martinez-Martin Pablo, Mir Pablo
Department of Neurology, Hospital Universitario de A Coruña (HUAC), Complejo Hospitalario Universitario de A Coruña (CHUAC), C/ As Xubias 84, 15006, A Coruña, Spain.
Grupo de Investigación en Enfermedad de Parkinson y Otros Trastornos del Movimiento, INIBIC (Instituto de Investigación Biomédica de A Coruña), A Coruña, Spain.
Neurol Sci. 2025 Jun;46(6):2637-2653. doi: 10.1007/s10072-025-08027-8. Epub 2025 Feb 19.
Dysphagia at time of diagnosis suggests atypical parkinsonism instead Parkinson´s disease (PD). Our aim was to analyze the frequency of dysphagia in patients with early PD comparing with a control group and to identify related factors.
Patients with early PD (≤ 2 years from symptoms onset) who were recruited from January/2016 to November/2017 (baseline visit; V0) and evaluated annually for 5 years from the Spanish cohort COPPADIS were included in this prospective study. Controls were assessed at baseline and at 2-, 4-, and 5-year follow-up. Dysphagia was defined as a score ≥ 1 in the item 20 of the Non-Motor Symptoms Scale (NMSS).
Dysphagia was more frequent at baseline in PD patients (19.6% [36/184]; 62.3 ± 8.3 years old; 56.8% males) than in controls (5.3% [11/206]; 60.9 ± 8.3 years old; 50% males) (p < 0.0001) and in all visits as well (p < 0.0001). A worse quality of sleep (Parkinson´s Disease Sleep Scale; OR = 0.974; p = 0.005), a greater impulse-control behavior (ICB) (Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale; OR = 1.066; p = 0.014), and non-motor symptoms burden (Non-Motor Symptoms Scale; OR = 1.016; p = 0.021) were independent factors associated with dysphagia at baseline. In those subjects with dysphagia, no differences were observed between patients and controls in the mean NMSS-item 20 overtime, and it didn´t change throughout the follow-up.
Dysphagia was frequent in early PD patients compared to controls. However, it was minor and did not progress over time. Sleep, ICB, and non-motor symptoms burden were related to dysphagia.
诊断时出现吞咽困难提示为非典型帕金森综合征而非帕金森病（PD）。我们的目的是分析早期PD患者吞咽困难的发生率，并与对照组进行比较，同时确定相关因素。
本前瞻性研究纳入了2016年1月至2017年11月从西班牙COPPADIS队列中招募的早期PD患者（症状出现≤2年），并在5年内每年进行评估（基线访视；V0）。对照组在基线以及随访2年、4年和5年时进行评估。吞咽困难定义为非运动症状量表（NMSS）第20项得分≥1分。
PD患者在基线时吞咽困难的发生率（19.6%[36/184]；62.3±8.3岁；56.8%为男性）高于对照组（5.3%[11/206]；60.9±8.3岁；50%为男性）（p<0.0001），在所有访视中也是如此（p<0.0001）。睡眠质量较差（帕金森病睡眠量表；OR=0.974；p=0.005）、冲动控制行为（ICB）较强（帕金森病冲动控制障碍问卷-评定量表；OR=1.066；p=0.014）以及非运动症状负担较重（非运动症状量表；OR=1.016；p=0.021）是与基线时吞咽困难相关的独立因素。在有吞咽困难的受试者中，患者和对照组在NMSS第20项的平均随时间变化情况无差异，且在随访期间没有变化。
与对照组相比，早期PD患者吞咽困难较为常见。然而，程度较轻且不会随时间进展。睡眠、ICB和非运动症状负担与吞咽困难有关。
