title: Cognitive and Motor Aspects of Parkinson's Disease Associated with Dysphagia.
abstract: BACKGROUND
  Dysphagia is a common symptom and an important prognostic factor in Parkinson's disease (PD). Although cognitive and motor dysfunctions may contribute to dysphagia in patients with PD, any specific association between such problems and swallowing functions is unclear. Here, we examined the potential relationship between cognitive/motor components and swallowing functions in PD. We evaluated the contributions of cognition and motor function to the components of swallowing via video fluoroscopic swallowing (VFS) experiments.
  
  
  METHODS
  We prospectively enrolled 56 patients without dementia having PD. Parkinson's disease severity was assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). All participants received neuropsychological tests covering general mental status, visuospatial function, attention, language, learning and memory, and frontal executive function. The well-validated "modified barium swallow impairment profile" scoring system was applied during VFS studies to quantify swallowing impairments. Finally, correlations between neuropsychological or motor functions and impairment in swallowing components were calculated.
  
  
  RESULTS
  The most significant correlations were found between the frontal/executive or learning/memory domains and the oral phase of swallowing, though a minor component of the pharyngeal phase correlated with frontal function as well. Bradykinesia and the UPDRS total score were associated with both the pharyngeal and oral phases.
  
  
  CONCLUSIONS
  Our findings suggest that cognitive dysfunctions are associated with the oral phase of swallowing in patients with early stage PD while the severity of motor symptoms may be associated with overall swallowing function.
authors.affiliation: 1Department of Neurology,Soonchunhyang University Hospital,Soonchunhyang University School of Medicine,Seoul,Korea.
authors.forename: Ji Sun
authors.initials: JS
authors.lastname: Kim
authors.affiliation: 3Department of Neurology,Sungkyunkwan University School of Medicine,Samsung Medical Center,Seoul,Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Youn
authors.affiliation: 3Department of Neurology,Sungkyunkwan University School of Medicine,Samsung Medical Center,Seoul,Korea.
authors.forename: Mee Kyung
authors.initials: MK
authors.lastname: Suh
authors.affiliation: 5Department of Neurology,Gwangmyeong Seongae Hospital,Gwangmyeong,Korea.
authors.forename: Tae-Eun
authors.initials: TE
authors.lastname: Kim
authors.affiliation: 3Department of Neurology,Sungkyunkwan University School of Medicine,Samsung Medical Center,Seoul,Korea.
authors.forename: Juhee
authors.initials: J
authors.lastname: Chin
authors.affiliation: 2Department of Biostatistics,Soonchunhyang University Hospital,Soonchunhyang University School of Medicine,Seoul,Korea.
authors.forename: Suyeon
authors.initials: S
authors.lastname: Park
authors.affiliation: 3Department of Neurology,Sungkyunkwan University School of Medicine,Samsung Medical Center,Seoul,Korea.
authors.forename: Jin Whan
authors.initials: JW
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001288:Attention / Q000502:physiology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D003680:Deglutition Disorders / Q000150:complications* / Q000503:physiopathology; D003704:Dementia / Q000150:complications / Q000503:physiopathology; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000503:physiopathology
keywords: Dysphagia; Parkinson’s disease; neuropsychology; oral phase