Objective: The clinical and neuroimaging factors associated with dysphagia were investigated in this retrospective data of Parkinson’s disease (PD) patients.

Background: PD can cause dysphagia that usually worsens the prognosis. The clinical characteristics, especially factors associated with dysphagia are poorly understood. The problem is that it is not easy to assess swallowing function in outpatient clinics.

Method: A total of 104 patients, the patients with Hoehn and Yahr’s (HY) stage III or higher who visited our hospital in 2017 were included and those who underwent DBS and those with a family history were excluded. The degree of dysphagia was classified into six stages. Multiple regression analysis was performed between the degree of dysphagia and the following factors including age, sex, duration of illness, cognitive impairment, autonomic nervous symptoms, depression, hallucinations, HY stage, ADL, modified Rankin scale (mRS) score, respiratory dysfunction, and initial symptoms. In the subgroup analysis of the patients who underwent brain dopamine transporter single-photon emission computed tomography (DaT-SPECT) using 123I-ioflupane, the specific binding ratio (SBR) values were statistically compared between the patients who require to change in diet and others. Similarly, patients who received 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy and 123I-IMP SPECT were subgrouped and analyzed for differences between those two groups.

Results: Severe respiratory disorders, high severity on the HY classification, and cognitive impairment were highly correlated with the severity of dysphagia. The SBR in the group requiring a change in dietary form in the basal ganglia was low on DaT-SPECT, but there was no significant difference in H/M ratio in the early and late phases. 123I-IMP SPECT showed no significant difference in cerebral blood flow between the two groups.

Conclusion: High HY stage, low SBR, and cognitive impairment were important factors in causing dysphagia in PD patients. In such patients, it is important to consider swallowing function assessment, swallowing rehabilitation, and dietary changes. The lack of a significant difference between the two groups on 123I-IMP SPECT might suggest that the role of the cerebral cortex in the swallowing function in PD patients is relatively small.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-nuclear-neuroimaging-features-of-parkinsons-disease-with-dysphagia/