Predictors of Residue and Airway Invasion in Parkinson's Disease.
James A Curtis, Sonja Molfenter, Michelle S Troche
PMID 31028481WHAT IT FOUND
In people with Parkinson’s disease being considered for deep brain stimulation, disease severity did not predict swallowing residue or airway invasion.
Reduced pharyngeal constriction and delayed airway closure were linked to these problems, and the links varied by swallow condition.
Key findings
01Disease severity did not significantly influence airway invasion, residue, or swallowing kinematics.
02Less pharyngeal constriction was significantly associated with more residue during cued thin liquid, non-cued thin liquid, and semisolid swallows.
03Airway invasion during thin liquids was significantly associated with delayed airway closure in non-cued swallows and with less complete closure plus shorter PES opening in cup sips.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The participants were people with Parkinson’s disease being considered for deep brain stimulation, described as early to mid-stage. The sample was small, and the authors noted it may have been underpowered to detect a small effect of disease severity. The Unified Parkinson’s Disease Rating Scale focuses more on appendicular than axial function, which may not capture swallowing-relevant severity. The 5 mL bolus was smaller than average for healthy older adults and may have been too small to reveal differences across disease severity. Oral kinematics were not analysed. Only three of the 38 semisolid trials had airway invasion, so that model was underpowered. Inter-rater reliability was not excellent for all measures.
Declared interests
The article is tagged as supported by N.I.H. extramural research. No author conflicts of interest are stated in the supplied text.
The easy way to misread this
Do not conclude that Parkinson’s disease severity predicts swallowing residue or airway invasion. The severity analyses were null. Also do not treat the kinematic links as evidence that a specific therapy works, because no treatment was tested.