title: Esophageal dysfunction in different stages of Parkinson's disease.
abstract: BACKGROUND
  Dysphagia is a clinically relevant symptom in patients with Parkinson's disease (PD) leading to pronounced reduction in quality of life and other severe complications. Parkinson's disease-related dysphagia may affect the oral and pharyngeal, as well as the esophageal phase of swallowing.
  
  
  METHODS
  To examine the nature and extend of esophageal dysphagia in different stages of PD and their relation to oropharyngeal dysfunction, we examined 65 PD patients (mean age 66.3±9.7 years, mean disease duration 7.9±5.8 years, mean Hoehn & Yahr [H&Y] stage 2.89±0.91) and divided into three groups (early [H&Y I+II; n=21], intermediate [H&Y III; n=25], and advanced stadium [H&Y IV+V; n=19]), using esophageal high-resolution manometry (HRM) to detect esophageal motor disorders. Oropharyngeal impairment was assessed using fiberoptic endoscopic evaluation of swallowing.
  
  
  RESULTS
  Major esophageal motor disorders were detected in nearly one third of the PD patients. Minor impairment of the esophageal body was present in 95% of participants and throughout all disease stages with pathological findings especially in peristalsis and intrabolus pressure (IBP). The IBP was found to significantly increase in the advanced stadium. Although dysfunction of the upper and lower esophageal sphincters was observed in individual patients, alterations in these esophageal segments revealed no statistical significance compared with normative data. No clear association was found between the occurrence of oropharyngeal dysphagia and esophageal impairment.
  
  
  CONCLUSIONS
  Esophageal body impairment in PD is a frequent phenomenon during all disease stages, which possibly reflects α-synucleinopathy in the enteric nervous system.
authors.affiliation: Department of Neurology, University Hospital of Münster, Münster, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Suttrup
authors.affiliation: Social Brain Lab, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Suttrup
authors.affiliation: Department of Neurology, University Hospital of Münster, Münster, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Suntrup-Krueger
authors.affiliation: Department of Gastroenterology, University Hospital of Münster, Münster, Germany.
authors.forename: M-L
authors.initials: ML
authors.lastname: Siemer
authors.affiliation: Department of Gastroenterology, University Hospital of Münster, Münster, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Bauer
authors.affiliation: Department of Neurology, University Hospital of Münster, Münster, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Hamacher
authors.affiliation: Department of Neurology, University Hospital of Münster, Münster, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Oelenberg
authors.affiliation: Department of Gastroenterology, University Hospital of Münster, Münster, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Domagk
authors.affiliation: Department of Neurology, University Hospital of Münster, Münster, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Dziewas
authors.affiliation: Department of Neurology, University Hospital of Münster, Münster, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Warnecke
mesh_terms: D000368:Aged; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D018450:Disease Progression; D016099:Endoscopy, Gastrointestinal / Q000379:methods / Q000639:trends; D015154:Esophageal Motility Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods / Q000639:trends; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D011788:Quality of Life; D012189:Retrospective Studies
keywords: 
  FEES
  ; Parkinson's disease; esophageal dysphagia; high-resolution manometry