The prevalence and patterns of pharyngoesophageal dysmotility in patients with early stage Parkinson's disease.
Dysphagia occurs in the majority of patients with Parkinson's disease (PD) and is known to correlate with abnormalities of oropharyngeal function. The aim of this study was to evaluate pharyngoesophageal activity in patients with early-stage PD. Newly diagnosed PD patients with a symptom duration not exceeding 3 years were included. All PD patients were questioned about symptoms of dysphagia and underwent combined multichannel intraluminal impedance manometry and multiple rapid swallow tests. Fifty-four patients (22 men and 32 women, 67.1 ± 10.3 years) were enrolled. The duration of Parkinsonian motor symptoms was 11.5 ± 8.8 months, the Hoehn and Yahr stage was 1.6 ± 0.4, and the total Unified Parkinson's Disease Rating Scale was 25.1 ± 18.6. Esophageal manometry in the liquid swallow and viscous swallow tests was abnormal in 22 (40.7%) and 31 (67.4%) patients, respectively. Although manometric abnormalities were more common in patients with more severe dysphagia symptoms, many patients with no or minimal symptoms also had manometric abnormalities. Repetitive deglutition significantly correlated with failed peristalsis and incomplete bolus transit. Abnormal responses to multiple rapid swallow tests were found in 33 out of 54 patients; 29 with incomplete inhibition (repetitive contraction) and 4 with failed peristalsis. These results suggest that the majority of patients with early-stage PD showed pharyngeal and esophageal dysfunction even before clinical manifestations of dysphagia, which may reflect selective involvement of either the brain stem or the esophageal myenteric plexus in early-stage PD.
Sung
Hye Young
HY
Division of Gastroenterology, Department of Internal Medicine, The Catholic University of Korea, Seoul, South Korea.
Kim
Joong-Seok
JS
Lee
Kwang-Soo
KS
Kim
Yeong-In
YI
Song
In-Uk
IU
Chung
Sung-Woo
SW
Yang
Dong-Won
DW
Cho
Yu Kyung
YK
Park
Jae Myung
JM
Lee
In Seok
IS
Kim
Sang Woo
SW
Chung
In-Sik
IS
Choi
Myung-Gyu
MG
D000368:Aged; D000704:Analysis of Variance; D003679:Deglutition / Q000502:physiology; D015154:Esophageal Motility Disorders / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology*; D004947:Esophagus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D013223:Statistics as Topic