Objective: The goal of this study was to compare the effects of STN vs. GPi DBS on swallowing and cough outcomes in PD.

Background: Deep brain stimulation (DBS) surgery into the subthalamic nucleus (STN) and the globus pallidus interna (GPi) is quickly becoming a management option of choice for persons with Parkinson’s disease (PD). There have been no prospective studies investigating the differential effects of STN and GPi DBS on airway protective mechanisms in PD.

Methods: Twenty-five participants with mild to moderate PD who were undergoing DBS were recruited for this study. Study procedures were completed before surgery and six months post-DBS surgery. Sensory and motor measures of cough were assessed from a capsaicin challenge with three randomized blocks of 0, 50, 100 & 200 μM capsaicin. Following each presentation of capsaicin, participants rated their UTC using a modified Borg scale. Participants completed a videofluoroscopic evaluation of swallowing and swallowing safety was evaluated using the penetration-aspiration scale.

Results: There were no significant differences in age or PD severity between groups. Participants who received GPi DBS maintained swallowing safety outcomes, while participants who received STN DBS worsened (p=.029). Median UTC scores (median=3) for both groups were below norms for age-matched healthy participants. Sensory and motor measures of cough were differentially impaired in GPi and STN groups.

Conclusions: Understanding the differential effects of STN vs. GPi DBS on airway protection is important and timely as DBS continues to gain traction and given that aspiration pneumonia is a leading cause of morbidity and death in PD.

This abstract was presented at the 2015 International Dysphagia Research Society Annual Meeting in Chicago, IL, March 13, 2016.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/airway-protective-mechanisms-and-deep-brain-stimulation-in-parkinsons-disease/