Leopold N A, Kagel M C
Department of Medicine, Crozer-Chester Medical Center, Upland, PA 19013, USA.
Neurology. 1997 Feb;48(2):373-6. doi: 10.1212/wnl.48.2.373.
Laryngeal muscle function is defective in Parkinson's disease (PD) patients; the intrinsic group (vocal cords) is defective during phonation and the extrinsic group (laryngeal strap muscles) is slow during deglutition. There are no studies of vocal cord motility during deglutition in PD. We investigated laryngeal motility during deglutition in 71 patients with PD in a videofluoroscopic swallowing study. Patients were subdivided into two groups by the Hoehn and Yahr disability scale, stages II and III (n = 38) and stages IV and V (n = 33). At least one abnormality of laryngeal movement was present in 68 of 71 patients (95.8%); most patients had multiple abnormalities. There was statistically significant slowing of vertical laryngeal excursion; true vocal cord closure; or delayed, incomplete, or absent opening of the true vocal cords. Patients with more advanced disease manifested more deficits of laryngeal movement. Laryngeal dysmotility in PD may be related to defective descending basal ganglionic control of medullary deglutory and phonatory motor functions.
帕金森病（PD）患者存在喉肌功能缺陷；发声时内在肌群（声带）功能缺陷，吞咽时外在肌群（喉带肌）运动迟缓。目前尚无关于PD患者吞咽时声带运动的研究。我们通过电视荧光吞咽造影研究，对71例PD患者吞咽时的喉部运动进行了调查。根据Hoehn和Yahr残疾量表，将患者分为两组，II期和III期（n = 38）以及IV期和V期（n = 33）。71例患者中有68例（95.8%）存在至少一种喉部运动异常；大多数患者有多种异常。垂直喉移位、真性声带闭合或真性声带延迟开放、不完全开放或未开放在统计学上有显著减慢。疾病进展较严重的患者表现出更多的喉部运动缺陷。PD患者的喉运动障碍可能与基底神经节对延髓吞咽和发声运动功能的下行控制缺陷有关。
