Objective: To characterize the swallow function in Parkinson patients with or without bilateral STN DBS.

Background: Although aspiration is one of the major causes of mortality in patients with Parkinson’s disease (PD), the impact of different oral textures on aspiration and the characteristics of the swallow function across oral and pharyngeal phases with or without STN DBS have not been well studied.

Method: Videofluoroscopic swallow studies were conducted in eleven PD patients with bilateral STN DBS (130Hz, 60Hz, and DBS Off) in medication On state at the initial and follow up visits of 14-month apart. Analyses were made to assess the frequency of aspiration of liquid boluses compared to solid boluses, and to quantify twenty parameters of oropharyngeal swallowing function under the DBS On and Off conditions in a randomized double-blind manner. 

Results: At both the initial and follow-up visits of 14-month apart, there was greater frequency of aspiration with liquids compared to solids, regardless of the DBS conditions. There was no significant difference amongst the DBS conditions on various parameters of the swallow profile, except that there was less aspiration events at 60Hz compared to 130Hz stimulation at the initial but not the follow up visits. Many swallow parameters were slowly but significantly worse, with or without DBS, across the study period.

Conclusion: There is a higher risk of aspiration with liquids compared to solids, regardless of the DBS conditions (130Hz, 60Hz or DBS Off) or the length of the follow up, which highlights the importance of the early screening for difficulty swallowing liquids. There is no statistical difference in various swallowing parameters across the oropharyngeal phases among DBS conditions, except that there are less aspiration events at 60Hz compared to 130Hz at the initial visit. Swallowing function slowly gets worse over time.

References: n/a

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MDS Abstracts - https://www.mdsabstracts.org/abstract/characterization-of-the-swallow-function-in-parkinson-patients-with-or-without-stn-dbs/