Effect of Intestinal Levodopa-Carbidopa Infusion on Pharyngeal Dysphagia: Results from a Retrospective Pilot Study in Patients with Parkinson's Disease.
Journal
Parkinson's disease
ISSN: 2090-8083
Titre abrégé: Parkinsons Dis
Pays: United States
ID NLM: 101539877
Informations de publication
Date de publication:
2020
2020
Historique:
received:
02
01
2020
accepted:
15
02
2020
entrez:
8
4
2020
pubmed:
8
4
2020
medline:
8
4
2020
Statut:
epublish
Résumé
Pharyngeal dysphagia is a common symptom of Parkinson's disease (PD) leading to severe complications. PD-related pharyngeal dysphagia (PDrPD) may significantly improve in up to half of patients following acute oral levodopa challenge. The aim of this study was to investigate the effects of levodopa-carbidopa intestinal gel (LCIG) on PDrPD. Forty-five PD patients under LCIG treatment were available for retrospective analysis. In all patients with PDrPD who underwent flexible endoscopic evaluation of swallowing (FEES) in the clinical "on-state" both before and after implementation of LCIG treatment, FEES videos were systematically reassessed. PDrPD was characterized using a PD-specific FEES score evaluating premature bolus spillage, penetration/aspiration, and pharyngeal residue. Further, the duration of white-out was assessed, as a parameter for pharyngeal bradykinesia. Eleven patients with PDrPD (mean age 74.6 ± 4.4 years; mean Hoehn and Yahr stage 3.8 ± 0.6) received FEES both before and after the onset of LCIG treatment. The mean swallowing score improved from 14.9 ± 7.3 to 13.0 ± 6.9 after implementation of LCIG; however, this difference was not significant ( LCIG may affect PDrPD and reduce premature bolus spillage and pharyngeal bradykinesia. Future studies with larger sample sizes are required to follow-up on these pilot results and identify which factors predict a good response of PDrPD to LCIG treatment.
Sections du résumé
BACKGROUND
BACKGROUND
Pharyngeal dysphagia is a common symptom of Parkinson's disease (PD) leading to severe complications. PD-related pharyngeal dysphagia (PDrPD) may significantly improve in up to half of patients following acute oral levodopa challenge.
OBJECTIVE
OBJECTIVE
The aim of this study was to investigate the effects of levodopa-carbidopa intestinal gel (LCIG) on PDrPD.
METHODS
METHODS
Forty-five PD patients under LCIG treatment were available for retrospective analysis. In all patients with PDrPD who underwent flexible endoscopic evaluation of swallowing (FEES) in the clinical "on-state" both before and after implementation of LCIG treatment, FEES videos were systematically reassessed. PDrPD was characterized using a PD-specific FEES score evaluating premature bolus spillage, penetration/aspiration, and pharyngeal residue. Further, the duration of white-out was assessed, as a parameter for pharyngeal bradykinesia.
RESULTS
RESULTS
Eleven patients with PDrPD (mean age 74.6 ± 4.4 years; mean Hoehn and Yahr stage 3.8 ± 0.6) received FEES both before and after the onset of LCIG treatment. The mean swallowing score improved from 14.9 ± 7.3 to 13.0 ± 6.9 after implementation of LCIG; however, this difference was not significant (
CONCLUSIONS
CONCLUSIONS
LCIG may affect PDrPD and reduce premature bolus spillage and pharyngeal bradykinesia. Future studies with larger sample sizes are required to follow-up on these pilot results and identify which factors predict a good response of PDrPD to LCIG treatment.
Identifiants
pubmed: 32257098
doi: 10.1155/2020/4260501
pmc: PMC7086436
doi:
Types de publication
Journal Article
Langues
eng
Pagination
4260501Informations de copyright
Copyright © 2020 Bendix Labeit et al.
Déclaration de conflit d'intérêts
Tobias Warnecke has received honoraria from AbbVie. This could be perceived as conflicting since AbbVie distributes LCIG devices.
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