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Vol. 68. Issue 1.
Pages 15-22 (January - February 2017)
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Vol. 68. Issue 1.
Pages 15-22 (January - February 2017)
Original Article
Swallowing Disorders in Parkinson's Disease
Trastornos de la deglución en la enfermedad de Parkinson
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Sandra Mamolar Andrésa, María Liliana Santamarina Rabanala,b,c, Carla María Granda Membielaa, María José Fernández Gutiérreza,c, Paloma Sirgo Rodrígueza,c, César Álvarez Marcosa,b,d,
Corresponding author
alvarezmarcos@telefonica.net

Corresponding author.
a Universidad de Oviedo, Oviedo, Asturias, Spain
b Unidad de Disfagia, Servicio de Rehabilitación, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain
c Unidad de Foniatría y Logopedia, Servicio de Rehabilitación, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain
d Servicio de Otorrinolaringología, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, Spain
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Tables (2)
Table 1. Variables Which Change the Efficacy of Swallowing the Final Sample (n=19).
Table 2. Variables Which Change the Safety of Swallowing in the Final Sample (n=19).
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Abstract
Introduction

Parkinson's disease is a type of chronic neurodegenerative pathology with a typical movement pattern, as well as different, less studied symptoms such as dysphagia. Disease-related disorders in efficacy or safety in the process of swallowing usually lead to malnutrition, dehydration or pneumonias.

The aim of this study was identifying and analyzing swallowing disorders in Parkinson's disease.

Subjects and methods

The initial sample consisted of 52 subjects with Parkinson's disease to whom the specific test for dysphagia SDQ was applied. Nineteen participants (36.5%) with some degree of dysphagia in the SDQ test were selected to be evaluated by volume-viscosity clinical exploration method and fibreoptic endoscopic evaluation of swallowing.

Results

Disorders in swallowing efficiency and safety were detected in 94.7% of the selected sample. With regards to efficiency, disorders were found in food transport (89.5%), insufficient labial closing (68.4%) and oral residues (47.4%), relating to duration of ingestion. Alterations in security were also observed: pharynx residues (52.7%), coughing (47.4%), penetration (31.64%), aspiration and decrease of SaO2 (5.3%), relating to the diagnosis of respiratory pathology in the previous year.

Conclusion

The SDQ test detected swallowing disorders in 36.5% of the subjects with Parkinson's disease. Disorders in swallowing efficiency and safety were demonstrated in 94.7% of this subset. Disorders of efficiency were more frequent than those of safety, establishing a relationship with greater time in ingestion and the appearance of respiratory pathology and pneumonias.

Keywords:
Dysphagia
Parkinson's disease
Volume-viscosity examination
Pneumonia aspiration
Fibreoptic endoscopic swallowing
Resumen
Introducción

La enfermedad de Parkinson es una patología neurodegenerativa crónica, con síntomas motores característicos y otros menos estudiados como la disfagia. Suele relacionarse con desnutrición, deshidratación o neumonías por aspiración por trastornos en la eficacia y seguridad en la deglución.

El objetivo de este trabajo es identificar y analizar los trastornos deglutorios en la enfermedad de Parkinson.

Sujetos y métodos

Muestra inicial de 52 sujetos con enfermedad de Parkinson a los que se aplicó el test SDQ, específico para la disfagia. Se seleccionaron 19 (36,5%) participantes con algún grado de disfagia en dicho test para ser evaluados con el método de exploración clínica volumen-viscosidad y la videoendoscopia de la deglución.

Resultados

Se detectaron trastornos de eficacia y seguridad de la deglución en el 94,7%, siendo las alteraciones de la eficacia: dificultad en el transporte de alimento (89,5%), deglución fraccionada (78,9%), mal sello labial (68,4%) y residuos orales (47,4%), relacionándose con el tiempo que dura la ingesta. Se observaron también alteraciones en la seguridad como residuos faríngeos (52,7%), tos (47,4%), penetración (31,64%), aspiración y descenso de SaO2 (5,3%), relacionándose con el diagnóstico de patología respiratoria en el último año.

Conclusiones

El test SDQ detectó trastornos deglutorios en el 36,5% de los pacientes con enfermedad de Parkinson. Las alteraciones en la eficacia y seguridad de la deglución se demostraron en el 94,7% de ellos, siendo más frecuentes los trastornos de eficacia que los de seguridad, estableciendo relación con el mayor tiempo en la ingesta y la aparición de patología respiratoria y neumonías.

Palabras clave:
Disfagia
Enfermedad de Parkinson
Método volumen-viscosidad
Neumonía aspirativa
Videoendoscopia deglución

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