The association between saliva control, silent saliva penetration, aspiration, and videofluoroscopic findings in Parkinson's disease patients

Authors
Ali Rajaei 1
Fereshteh Ashtari 2
Seyed Abolfazl Azargoon 3
Ahmad Chitsaz 2
Mohammad Hussein Nilforoush 4
Masoud Taheri 5
Saba Sadeghi 3
1 Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
2 Isfahan Neurosciences Research Center, Alzahra Hospital; Department of Neurology, Isfahan University of Medical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
3 Mahoor Clinic of Speech and Language Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
4 Department of Audiology, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
5 Department of Radiology, Isfahan Health Management of Social Security Organization, Isfahan, Iran
Abstract
Background: Dysphagia is a common disorder among patients with Parkinson's disease (PD). It occurs in up to 80% of all (PD) patients during the early stages of the disease and up to 95% in the advanced stages; but professionals may not hear from the patients about dysphagia symptoms until these symptoms reach an advanced stage and lead to medical complications.
Materials and Methods: Thirty-three PD patients (mean age 66.09 ± 9.4 years; 24 men, nine women) participated in this study at our Neurology Institute, between April 20, 2013, and October 26, 2013. They were asked two questions; one about saliva control and the other about silent saliva penetration and aspiration. Next, they underwent the videofluoroscopic swallowing study (VFSS).
Results: The Pearson Correlation coefficient between the Penetration-Aspiration Scale (PAS) scores and question 1 scores was 0.48 (P < 0.05, =0.25), and there was a significant correlation between the PAS scores and question 2 scores, and also question 1 scores + question 2 scores (r = 0.589, P < 0.05, =0 and r = 0589, P < 0.05, =0).
Conclusions: This study showed a significant correlation between the questions about saliva control, silent saliva penetration, and aspiration, and laryngeal penetration and aspiration during VFSS. Therefore, by using these two questions, the potential silent laryngeal penetration and aspiration during meals could be detected before it led to aspiration pneumonia. Taking the benefit of these questions, as a part of the swallowing assessment of PD patients, is recommended.

Keywords

1.
Braak H, Rüb U, Gai WP, Del Tredici K. Idiopathic Parkinson's disease: Possible routes by which vulnerable neuronal types may be subject to neuroinvasion by an unknown pathogen. J Neural Transm 2003;110:517-36.  Back to cited text no. 1
    
2.
Samii A, Nutt JG, Ransom BR. Parkinson's disease. Lancet 2004;363:1783-93.  Back to cited text no. 2
    
3.
Nagaya M, Kachi T, Yamada T, Igata A. Videofluorographic study of swallowing in Parkinson's disease. Dysphagia 1998;13:95-100.  Back to cited text no. 3
    
4.
Wintzen AR, Bradrising UA, Roos RA, Vielvoye J, Liauw L, Pauwels EK. Dysphagia in ambulant patients with Parkinson's disease: Common, not dangerous. Can J Neurol Sci 1994;21:53-6.  Back to cited text no. 4
    
5.
Plowman-Prine EK, Sapienza CM, Okun MS, Pollock SL, Jacobson C, Wu SS, et al. The relationship between quality of life and swallowing in Parkinson's disease. Mov Disord 2009;24:1352-8.  Back to cited text no. 5
    
6.
Troche MS, Sapienza CM, Rosenbek JC. Effects of bolus consistency on timing and safety of swallow in patients with Parkinson's disease. Dysphagia 2008;23:26-32.  Back to cited text no. 6
    
7.
Beyer MK, Herlofson K, Arsland D, Larsen JP. Causes of death in a community-based study of Parkinson's disease. Acta Neurol Scand 2001;103:7-11.  Back to cited text no. 7
    
8.
Mehanna R, Jankovic J. Respiratory problems in neurologic movement disorders. Parkinsonism Relat Disord 2010;16:628-38.  Back to cited text no. 8
    
9.
Monte FS, da Silva-Júnior FP, Braga-Neto P, Nobre e Souza MA, de Bruin VM. Swallowing abnormalities and dyskinesia in Parkinson's disease. Mov Disord 2005;20:457-62.  Back to cited text no. 9
    
10.
Clavé P, Terré R, de Karaa M, Serra M. Approaching oropharyngeal dysphagia. Rev Esp Enferm Dig 2004;96:119-31.  Back to cited text no. 10
    
11.
Cook IJ, Kahrilas PJ. AGA technical review on management of oropharyngeal dysphagia. Gastroenterology 1999;116:455-78.  Back to cited text no. 11
    
12.
Calne DB, Snow BJ, Lee C. Criteria for diagnosing Parkinson's disease. Ann Neurol 1992;32(Suppl):S125-7.  Back to cited text no. 12
    
13.
Malandraki GA, Hind JA, Gangnon R, Logemann JA, Robbins J. The utility of pitch elevation in the evaluation of oropharyngeal dysphagia: Preliminary findings. Am J Speech Lang Pathol 2011;20:262-8.  Back to cited text no. 13
    
14.
Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia 1996;11:93-8.  Back to cited text no. 14
    
15.
Bondi MW, Kaszniak AW, Rapcsak SZ, Butters MA. Implicit and explicit memory following anterior communicating artery aneurysm rupture. Brain Cogn 1993;22:213-29.  Back to cited text no. 15
    
16.
Stocchi F, Brusa L. Cognition and emotion in different stages and subtypes of Parkinson's disease. J Neurol 2000;247(Suppl 2):II114-21.  Back to cited text no. 16
    
17.
Ali GN, Wallace KL, Schwartz R, DeCarle DJ, Zagami AS, Cook IJ. Mechanisms of oral-pharyngeal dysphagia in patients with Parkinson's disease. Gastroenterology 1996;110:383-92.  Back to cited text no. 17
Advanced Biomedical Research
Volume 2015, May
May 2015
Pages 1-4