Predictive clinical factors for penetration and aspiration in Parkinson's disease
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Predictive clinical factors for penetration and aspiration in Parkinson's disease. / Nienstedt, Julie Cläre; Bihler, Moritz; Niessen, Almut; Plaetke, Rosemarie; Pötter-Nerger, Monika; Gerloff, Christian; Buhmann, Carsten; Pflug, Christina.
In: NEUROGASTROENT MOTIL, Vol. 31, No. 3, 03.2019, p. e13524.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Predictive clinical factors for penetration and aspiration in Parkinson's disease
AU - Nienstedt, Julie Cläre
AU - Bihler, Moritz
AU - Niessen, Almut
AU - Plaetke, Rosemarie
AU - Pötter-Nerger, Monika
AU - Gerloff, Christian
AU - Buhmann, Carsten
AU - Pflug, Christina
N1 - © 2018 John Wiley & Sons Ltd.
PY - 2019/3
Y1 - 2019/3
N2 - BACKGROUND: Do the current swallow-specific subquestions of neurological diagnostic tools reflect the objective swallowing function in Parkinson's disease (PD) patients or are clinical factors superior to predict critical aspiration?METHODS: In a cross-sectional, observational study a total of 119 Parkinson outpatients were examined clinically and by flexible-endoscopic evaluation of swallowing (FEES). Self-reported dysphagia by subquestions of the MDS-UPDRS and NMS questionnaire and history of subjective aspiration signs were collected.KEY RESULTS: Nearly, all PD patients showed deglutition abnormalities in FEES (113/119) while only 12%-27% of them reported swallowing problems in the swallow-specific subquestions of neurological standard diagnostic tools (MDS-UPDRS and NMS-Quest), and the answers were heterogeneous and poorly reproducible. With a sensitivity of up to a maximum of 50%, self-reported dysphagia is therefore no reliable tool for identifying dysphagia in PD. While most clinical parameters were linked to dysphagia to some extent, logistic regression analysis revealed high age (Odds Ratio (OR) 1.1 in years, 95% CI 1.03-1.18, P < 0.01), gender (OR 0.3 for females, 95% CI 0.08-0.97, P = 0.04), and affirmed subjective aspiration signs (OR 8.6, 95% CI 3.05-26.52, P < 0.001) as the most significant predictors for critical dysphagia.CONCLUSIONS AND INFERENCES: Self-perception of swallowing is no reliable tool for identifying dysphagia and questionnaires are insufficient for detecting previous aspiration. Consequent and specific asking for previous subjective aspiration signs is the single most important measure for identifying PD patients at risk for critical aspiration.
AB - BACKGROUND: Do the current swallow-specific subquestions of neurological diagnostic tools reflect the objective swallowing function in Parkinson's disease (PD) patients or are clinical factors superior to predict critical aspiration?METHODS: In a cross-sectional, observational study a total of 119 Parkinson outpatients were examined clinically and by flexible-endoscopic evaluation of swallowing (FEES). Self-reported dysphagia by subquestions of the MDS-UPDRS and NMS questionnaire and history of subjective aspiration signs were collected.KEY RESULTS: Nearly, all PD patients showed deglutition abnormalities in FEES (113/119) while only 12%-27% of them reported swallowing problems in the swallow-specific subquestions of neurological standard diagnostic tools (MDS-UPDRS and NMS-Quest), and the answers were heterogeneous and poorly reproducible. With a sensitivity of up to a maximum of 50%, self-reported dysphagia is therefore no reliable tool for identifying dysphagia in PD. While most clinical parameters were linked to dysphagia to some extent, logistic regression analysis revealed high age (Odds Ratio (OR) 1.1 in years, 95% CI 1.03-1.18, P < 0.01), gender (OR 0.3 for females, 95% CI 0.08-0.97, P = 0.04), and affirmed subjective aspiration signs (OR 8.6, 95% CI 3.05-26.52, P < 0.001) as the most significant predictors for critical dysphagia.CONCLUSIONS AND INFERENCES: Self-perception of swallowing is no reliable tool for identifying dysphagia and questionnaires are insufficient for detecting previous aspiration. Consequent and specific asking for previous subjective aspiration signs is the single most important measure for identifying PD patients at risk for critical aspiration.
KW - Journal Article
U2 - 10.1111/nmo.13524
DO - 10.1111/nmo.13524
M3 - SCORING: Journal article
C2 - 30548367
VL - 31
SP - e13524
JO - NEUROGASTROENT MOTIL
JF - NEUROGASTROENT MOTIL
SN - 1350-1925
IS - 3
ER -