Pharyngeal Area Changes in Parkinson's Disease and Its Effect on Swallowing Safety, Efficiency, and Kinematics.
James A Curtis, Sonja M Molfenter, Michelle S Troche
PMID 31446478WHAT IT FOUND
People with Parkinson's disease had larger resting pharyngeal areas than healthy older adults.
Larger pharyngeal area was linked to poorer swallowing safety, efficiency, and pharyngeal constriction. Clinicians reviewing VFSS should consider this anatomical change.
Key findings
01After age, sex, and height were controlled, the Parkinson's disease group had an average resting pharyngeal area 21.1% larger than the healthy older adult group.
02In people with Parkinson's disease, larger pharyngeal area was associated with worse swallowing kinematics, including reduced pharyngeal constriction and shorter duration of airway closure.
03Larger pharyngeal area in Parkinson's disease was associated with worse swallowing efficiency, meaning more post-swallow residue, and with worse swallowing safety.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The two datasets were not matched, because the Parkinson's disease group was younger and taller than the healthy older adults, and age and height were controlled statistically rather than by matching. Pharyngeal muscle atrophy was inferred from larger pharyngeal area, not measured directly by biopsy or muscle testing. People with Parkinson's disease were tested about one hour after medication, so medication state may have influenced the swallowing measures. The study did not test whether pharyngeal resistance training improves swallowing, so it cannot support a treatment effect.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as proof that larger pharyngeal area causes dysphagia or that pharyngeal strength training improves swallowing. The study measured an association, and it did not test an intervention.