Disordered voluntary cough as freezing phenomenon in parkinsonism.
Mitsuaki Ishii, Hideaki Mashimo
PMID 28356654WHAT IT FOUND
In two people with parkinsonism, sequential cough showed delayed start, a rounded first cough, and progressively smaller and faster later coughs on the flow-volume curve, not just in peak cough flow.
Key findings
01Case 1 showed rounding of the first cough spike, decreased peak cough flow, and progressively smaller and faster later spikes at lower lung volume.
02Case 2 showed hesitation in cough initiation, rounding of the first spike, severely reduced second spike flow, and progressively smaller and faster later spikes at lower lung volume.
03In case 2, who was taking L-DOPA and a dopamine agonist, cough patterns were near normal about 120 minutes after L-DOPA administration, showed hesitation and reduced spike flow 15 minutes after administration, and gradually improved 25 to 30 minutes after administration.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study reports only two patients, so it cannot show how common this cough pattern is or whether it predicts aspiration. No treatment effect was tested, so it does not show that changing cough assessment improves outcomes. The authors' mechanistic explanations, including freezing phenomenon and bradykinesia, are interpretations from the case patterns, not measured findings. Case 2 was receiving L-DOPA and a dopamine agonist, so the timing of cough changes cannot be attributed to L-DOPA alone. No measured comparison group was reported.
The easy way to misread this
Do not treat this as evidence that cough freezing is common in parkinsonism or that flow-volume curve assessment prevents aspiration. Only two patients were studied, and the paper describes cough patterns without testing an intervention or following aspiration outcomes.