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Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson’s disease

  • Neurology and Preclinical Neurological Studies - Original Article
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Abstract

Dysphagia is an important issue in the prognosis of Parkinson’s disease (PD). Although several studies have reported that oropharyngeal dysphagia may be associated with cognitive dysfunction, the exact relationship between cortical function and swallowing function in PD patients is unclear. Therefore, we investigated the association between an electrophysiological marker of central cholinergic function, which reflected cognitive function, and swallowing function, as measured by videofluoroscopic studies (VFSS). We enrolled 29 early PD patients. Using the Swallowing Disturbance Questionnaire (SDQ), we divided the enrolled patients into two groups: PD with dysphagia and PD without dysphagia. The videofluoroscopic dysphagia scale (VDS) was applied to explore the nature of the dysphagia. To assess central cholinergic dysfunction, short latency afferent inhibition (SAI) was evaluated. We analyzed the relationship between central cholinergic dysfunction and oropharyngeal dysphagia and investigated the characteristics of the dysphagia. The SAI values were significantly different between the two groups. The comparison of each VFSS component between the PD with dysphagia group and the PD without dysphagia group showed statistical significance for most of the oral phase components and for a single pharyngeal phase component. The total score on the VDS was higher in the PD with dysphagia group than in the PD without dysphagia group. The Mini-Mental State Examination and SAI values showed significant correlations with the total score of the oral phase components. According to binary logistic regression analysis, SAI value independently contributed to the presence of dysphagia in PD patients. Our findings suggest that cholinergic dysfunction is associated with dysphagia in early PD and that an abnormal SAI value is a good biomarker for predicting the risk of dysphagia in PD patients.

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Acknowledgments

This work was funded by the Gangneung Asan Hospital Biomedical Research Center Promotion Fund.

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    Authors and Affiliations

    1. Department of Rehabilitation Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Bangdong-ri, Sacheon-myeon, Gangneung, 210-711, Gangwon-do, Republic of Korea

      Kyung Duck Lee, Jung Hoi Koo & Sun Hong Song

    2. Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Bangdong-ri, Sacheon-myeon, Gangneung, 210-711, Gangwon-do, Republic of Korea

      Kwang Deog Jo, Moon Kyu Lee & Wooyoung Jang

    3. Biomedical Research Center, Gangneung Asan Hospital, Bangdong-ri, Sacheon-myeon, Gangneung, 210-711, Gangwon-do, Republic of Korea

      Wooyoung Jang

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    1. Kyung Duck Lee
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    Correspondence to Wooyoung Jang.

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    The authors have reported no potential conflicts of interest concerning this article and have equally contributed to this study in a meaningful manner. None of the authors have anything to disclose.

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    K. D. Lee and J. H. Koo contributed equally to this work.

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    Lee, K.D., Koo, J.H., Song, S.H. et al. Central cholinergic dysfunction could be associated with oropharyngeal dysphagia in early Parkinson’s disease. J Neural Transm 122, 1553–1561 (2015). https://doi.org/10.1007/s00702-015-1427-z

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    • DOI: https://doi.org/10.1007/s00702-015-1427-z

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