Objective: Patients with Parkinson’s disease (PD) encounter various swallowing disorders. This study aimed to assess the effects of cervical percutaneous interferential current stimulation on pharyngeal and laryngeal sensory nerves using the 1% citric acid cough test. Additionally, we comprehensively examined the effects using videofluoroscopic examination (VF).

Background: Aspiration pneumonia is a leading cause of death in PD patients, often due to increased rates of silent aspiration resulting from decreased pharyngeal and laryngeal sensation. Interventions targeting this condition may aid in pneumonia prevention.

Method: We targeted PD patients at Hoehn–Yahr stages 2–4. The intervention involved twice-weekly sessions of 20-minute cervical percutaneous interferential current stimulation over 8 weeks. The primary outcome measure was the proportion of patients exhibiting a normal cough reflex post 1% citric acid ingestion, compared to baseline. VF analysis included assessment of aspiration/laryngeal penetration, oral cavity residue, vallecular residue, and pharyngeal residue, alongside temporal analysis.

Results: Twenty-five patients were assessed. Following 1% citric acid ingestion, the proportion of patients with a normal cough reflex significantly increased (p=0.001). However, parameters such as tongue pressure, peak expiratory flow, and VF-detected aspiration or penetration remained unchanged. Longer disease duration, higher Unified Parkinson’s Disease Rating Scale scores, and higher levodopa equivalent daily doses correlated significantly with improved cough test outcomes. Baseline VF revealed notable proportions of laryngeal penetration/aspiration, oral cavity residue, vallecular residue, and pharyngeal residue. Cervical percutaneous interferential current stimulation improved only oral cavity residue, reducing it from 88.0% to 56.0%.

Conclusion: Cervical percutaneous interferential current stimulation significantly improved cough reflexes, potentially ameliorating silent aspiration. High frequencies of residues in oral and pharyngeal regions were observed in PD patients. This intervention showed partial efficacy solely in reducing oral cavity residue, highlighting the need for further case accumulation and knowledge expansion to address PD’s diverse symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cervical-percutaneous-interferential-current-stimulation-improves-cough-reflex-and-oral-residue-in-patients-with-parkinsons-disease/