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Erschienen in: Dysphagia 6/2016

26.07.2016 | Original Article

Reflex Cough and Disease Duration as Predictors of Swallowing Dysfunction in Parkinson’s Disease

verfasst von: Michelle S. Troche, Beate Schumann, Alexandra E. Brandimore, Michael S. Okun, Karen W. Hegland

Erschienen in: Dysphagia | Ausgabe 6/2016

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Abstract

Patients with Parkinson’s disease (PD) have progressive and pervasive disorders of airway protection. Recent work has highlighted the relationship between reflex and voluntary cough and swallowing safety. The goal of this study was to test the sensitivity and specificity of several airway protective and disease-specific factors for predicting swallowing safety outcomes in PD. Sixty-four participants (44 males) completed measures of voluntary and reflex cough, and swallowing safety. Clinical predictors included disease severity and duration, and cough airflow and sensitivity measures. ROC and Chi-square analyses identified predictors of swallowing safety (penetration–aspiration score) in PD. Disease duration significantly discriminated between patients with normal and abnormal swallowing safety (p = 0.027, sensitivity: 71 %, specificity: 55.4 %). Cough reflex sensitivity significantly discriminated between patients who penetrated above the level of the vocal folds and those with more severe penetration/aspiration (p = 0.021, sensitivity: 71.0 %, specificity 57.6 %). Urge-to-cough sensitivity (log–log linear slope) was the only variable which significantly discriminated between patients with penetration versus aspiration (p = 0.017, sensitivity: 85.7 %, specificity 73.2 %). It is important to identify the factors which influence airway protective outcomes in PD especially given that aspiration pneumonia is a leading cause of death. Results from this study highlight the ecological validity of reflex cough in the study of airway protection and this study further identifies important factors to consider in the screening of airway protective deficits in PD.
Literatur
1.
Zurück zum Zitat Fernandez HH, Lapane KL. Predictors of mortality among nursing home residents with a diagnosis of Parkinson’s disease. Med Sci Monit. 2002;8(4):CR241–6.PubMed Fernandez HH, Lapane KL. Predictors of mortality among nursing home residents with a diagnosis of Parkinson’s disease. Med Sci Monit. 2002;8(4):CR241–6.PubMed
2.
Zurück zum Zitat Fall PA, Saleh A, Fredrickson M, Olsson JE, Granerus AK. Survival time, mortality, and cause of death in elderly patients with Parkinson’s disease: a 9-year follow-up. Mov Disord. 2003;18(11):1312–6.CrossRefPubMed Fall PA, Saleh A, Fredrickson M, Olsson JE, Granerus AK. Survival time, mortality, and cause of death in elderly patients with Parkinson’s disease: a 9-year follow-up. Mov Disord. 2003;18(11):1312–6.CrossRefPubMed
3.
Zurück zum Zitat D’Amelio M, Ragonese P, Morgante L, Reggio A, Callari G, Salemi G, Savettieri G. Long-term survival of Parkinson’s disease: a population-based study. J Neurol. 2006;253(1):33–7.CrossRefPubMed D’Amelio M, Ragonese P, Morgante L, Reggio A, Callari G, Salemi G, Savettieri G. Long-term survival of Parkinson’s disease: a population-based study. J Neurol. 2006;253(1):33–7.CrossRefPubMed
4.
Zurück zum Zitat Gorell JM, Johnson CC, Rybicki BA. Parkinson’s disease and its comorbid disorders: an analysis of Michigan mortality data, 1970 to 1990. Neurology. 1994;4(10):1865–8.CrossRef Gorell JM, Johnson CC, Rybicki BA. Parkinson’s disease and its comorbid disorders: an analysis of Michigan mortality data, 1970 to 1990. Neurology. 1994;4(10):1865–8.CrossRef
5.
Zurück zum Zitat Miller N, Noble E, Jones D, Burn D. Hard to swallow: dysphagia in Parkinson’s disease. Age Ageing. 2006;35(6):614–8.CrossRefPubMed Miller N, Noble E, Jones D, Burn D. Hard to swallow: dysphagia in Parkinson’s disease. Age Ageing. 2006;35(6):614–8.CrossRefPubMed
6.
Zurück zum Zitat Pitts T, Bosler DC, Rosenbeck JC, Troche MS, Sapienza C. Voluntary cough production and swallow dysfunction in Parkinson’s disease. Dysphagia. 2008;23(3):297–301.CrossRefPubMedPubMedCentral Pitts T, Bosler DC, Rosenbeck JC, Troche MS, Sapienza C. Voluntary cough production and swallow dysfunction in Parkinson’s disease. Dysphagia. 2008;23(3):297–301.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Pitts T, Troche MS, Mann G, Rosenbeck JC, Okun MS, Sapienza C. Using voluntary cough to detect penetration and aspiration during oropharyngeal swallowing in patients with Parkinson disease. Chest. 2010;138(6):1426–31.CrossRefPubMed Pitts T, Troche MS, Mann G, Rosenbeck JC, Okun MS, Sapienza C. Using voluntary cough to detect penetration and aspiration during oropharyngeal swallowing in patients with Parkinson disease. Chest. 2010;138(6):1426–31.CrossRefPubMed
8.
Zurück zum Zitat Troche MS, Brandimore AE, Okun MS, Davenport PW, Hegland KW. Decreased cough sensitivity and aspiration in Parkinson’s disease. Chest. 2014;146(5):1294–9.CrossRefPubMedPubMedCentral Troche MS, Brandimore AE, Okun MS, Davenport PW, Hegland KW. Decreased cough sensitivity and aspiration in Parkinson’s disease. Chest. 2014;146(5):1294–9.CrossRefPubMedPubMedCentral
9.
Zurück zum Zitat Smith Hammond CA, Goldstein LB, Zajac DJ, Gray L, Davenport PW, Bolser DC. Assessment of aspiration risk in stroke patients with quantification of voluntary cough. Neurology. 2001;56(4):502–6.CrossRefPubMed Smith Hammond CA, Goldstein LB, Zajac DJ, Gray L, Davenport PW, Bolser DC. Assessment of aspiration risk in stroke patients with quantification of voluntary cough. Neurology. 2001;56(4):502–6.CrossRefPubMed
10.
Zurück zum Zitat Smith Hammond CA, Goldstein LB, Horner RD, Ying J, Gray L, Gonzalez-Rothi DC, Bolser DC. Predicting aspiration in patients with ischemic stroke: comparison of clinical signs and aerodynamic measures of voluntary cough. Chest. 2009;135(3):769–77.CrossRefPubMed Smith Hammond CA, Goldstein LB, Horner RD, Ying J, Gray L, Gonzalez-Rothi DC, Bolser DC. Predicting aspiration in patients with ischemic stroke: comparison of clinical signs and aerodynamic measures of voluntary cough. Chest. 2009;135(3):769–77.CrossRefPubMed
11.
Zurück zum Zitat Hegland KW, Okun MS, Troche MS. Sequential voluntary cough and aspiration or aspiration risk in Parkinson’s disease. Lung. 2014;192(4):601–8.CrossRefPubMedPubMedCentral Hegland KW, Okun MS, Troche MS. Sequential voluntary cough and aspiration or aspiration risk in Parkinson’s disease. Lung. 2014;192(4):601–8.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Wheeler Hegland K, Troche MS, Brandimore AE, Davenport PW, Okun MS. Comparison of voluntary and reflex cough effectiveness in Parkinson’s disease. Parkinsonism Relat Disord. 2014;20(11):1226–30.CrossRefPubMed Wheeler Hegland K, Troche MS, Brandimore AE, Davenport PW, Okun MS. Comparison of voluntary and reflex cough effectiveness in Parkinson’s disease. Parkinsonism Relat Disord. 2014;20(11):1226–30.CrossRefPubMed
13.
Zurück zum Zitat Vovk A, Bolser DC, Hey JA, Danzig M, Vickroy T, Berry R, Martin AD, Davenport PW. Capsaicin exposure elicits complex airway defensive motor patterns in normal humans in a concentration-dependent manner. Pulm Pharmacol Ther. 2007;20(4):423–32.CrossRefPubMed Vovk A, Bolser DC, Hey JA, Danzig M, Vickroy T, Berry R, Martin AD, Davenport PW. Capsaicin exposure elicits complex airway defensive motor patterns in normal humans in a concentration-dependent manner. Pulm Pharmacol Ther. 2007;20(4):423–32.CrossRefPubMed
14.
15.
Zurück zum Zitat Rosenbeck JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8.CrossRef Rosenbeck JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8.CrossRef
16.
Zurück zum Zitat Troche MS, Brandimore AE, Godoy J, Hegland KW. A framework for understanding shared substrates of airway protection. J Appl Oral Sci. 2014;22(4):251–60.CrossRefPubMedPubMedCentral Troche MS, Brandimore AE, Godoy J, Hegland KW. A framework for understanding shared substrates of airway protection. J Appl Oral Sci. 2014;22(4):251–60.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Bolser DC, Poliacek J, Jakus J, Fuller DD, Davenport PW. Neurogenesis of cough, other airway defensive behaviors and breathing: a holarchical system. Respir Physiol Neurobiol. 2006;152(3):255–65.CrossRefPubMedPubMedCentral Bolser DC, Poliacek J, Jakus J, Fuller DD, Davenport PW. Neurogenesis of cough, other airway defensive behaviors and breathing: a holarchical system. Respir Physiol Neurobiol. 2006;152(3):255–65.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Davenport PW, Bolser DC, Morris KF. Swallow remodeling of respiratory neural networks. Head Neck. 2013;33(Suppl 1):S8–13. Davenport PW, Bolser DC, Morris KF. Swallow remodeling of respiratory neural networks. Head Neck. 2013;33(Suppl 1):S8–13.
19.
Zurück zum Zitat Mazzone SB, McGovern AE, Yang SK, Woo A, Phipps S, Ando A, Leech J, Farrel MJ. Sensorimotor circuitry involved in the higher brain control of coughing. Cough. 2013;9(1):7.CrossRefPubMedPubMedCentral Mazzone SB, McGovern AE, Yang SK, Woo A, Phipps S, Ando A, Leech J, Farrel MJ. Sensorimotor circuitry involved in the higher brain control of coughing. Cough. 2013;9(1):7.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Mazzone SB, Cole LJ, Ando A, Egan GF, Farrel MJ. Investigation of the neural control of cough and cough suppression in humans using functional brain imaging. J Neurosci. 2011;31(8):2948–58.CrossRefPubMed Mazzone SB, Cole LJ, Ando A, Egan GF, Farrel MJ. Investigation of the neural control of cough and cough suppression in humans using functional brain imaging. J Neurosci. 2011;31(8):2948–58.CrossRefPubMed
21.
Zurück zum Zitat Simonyan K, Saad ZS, Loucks TM, Poletto CJ, Ludlow CL. Functional neuroanatomy of human voluntary cough and sniff production. Neuroimage. 2007;37(2):401–9.CrossRefPubMedPubMedCentral Simonyan K, Saad ZS, Loucks TM, Poletto CJ, Ludlow CL. Functional neuroanatomy of human voluntary cough and sniff production. Neuroimage. 2007;37(2):401–9.CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Davenport PW. Clinical cough I: the urge-to-cough: a respiratory sensation. Handb Exp Pharmacol. 2009;187:263–76.CrossRef Davenport PW. Clinical cough I: the urge-to-cough: a respiratory sensation. Handb Exp Pharmacol. 2009;187:263–76.CrossRef
23.
Zurück zum Zitat Theurer JA, Bihari F, Barr AM, Martin RE. Oropharyngeal stimulation with air-pulse trains increases swallowing frequency in healthy adults. Dysphagia. 2005;20(4):254–60.CrossRefPubMed Theurer JA, Bihari F, Barr AM, Martin RE. Oropharyngeal stimulation with air-pulse trains increases swallowing frequency in healthy adults. Dysphagia. 2005;20(4):254–60.CrossRefPubMed
24.
Zurück zum Zitat Davenport PW, Sapienza CS, Bolser D. Psychophysical assessment of the urge-to-cough. Eur Respir J. 2002;12(85):249–53. Davenport PW, Sapienza CS, Bolser D. Psychophysical assessment of the urge-to-cough. Eur Respir J. 2002;12(85):249–53.
25.
Zurück zum Zitat Davenport PW, Bolser DC, Vickroy T, Berry RB, Martin AD, Hey JA, Danzig M. The effect of codeine on the urge-to-cough response to inhaled capsaicin. Pulm Pharmacol Ther. 2007;20(4):338–46.CrossRefPubMed Davenport PW, Bolser DC, Vickroy T, Berry RB, Martin AD, Hey JA, Danzig M. The effect of codeine on the urge-to-cough response to inhaled capsaicin. Pulm Pharmacol Ther. 2007;20(4):338–46.CrossRefPubMed
26.
Zurück zum Zitat Ebihara S, Saito H, Kanda A, Nakajoh M, Takahashi H, Arai H, Sasaki H. Impaired efficacy of cough in patients with Parkinson disease. Chest. 2003;124(3):1009–15.CrossRefPubMed Ebihara S, Saito H, Kanda A, Nakajoh M, Takahashi H, Arai H, Sasaki H. Impaired efficacy of cough in patients with Parkinson disease. Chest. 2003;124(3):1009–15.CrossRefPubMed
27.
Zurück zum Zitat Fontana GA, Pantaleo T, Lavorini F, Benvenuti F, Gangemi S. Defective motor control of coughing in Parkinson’s disease. Am J Respir Crit Care Med. 1998;158(2):458–64.CrossRefPubMed Fontana GA, Pantaleo T, Lavorini F, Benvenuti F, Gangemi S. Defective motor control of coughing in Parkinson’s disease. Am J Respir Crit Care Med. 1998;158(2):458–64.CrossRefPubMed
28.
Zurück zum Zitat Hegland KW, Troche MS, Brandimore AE, Okun MS, Davenport PW. Comparison of two methods for inducing reflex cough in patients with Parkinson’s disease, with and without dysphagia. Dysphagia. 2016;31(1):66–73.CrossRefPubMed Hegland KW, Troche MS, Brandimore AE, Okun MS, Davenport PW. Comparison of two methods for inducing reflex cough in patients with Parkinson’s disease, with and without dysphagia. Dysphagia. 2016;31(1):66–73.CrossRefPubMed
Metadaten
Titel
Reflex Cough and Disease Duration as Predictors of Swallowing Dysfunction in Parkinson’s Disease
verfasst von
Michelle S. Troche
Beate Schumann
Alexandra E. Brandimore
Michael S. Okun
Karen W. Hegland
Publikationsdatum
26.07.2016
Verlag
Springer US
Erschienen in
Dysphagia / Ausgabe 6/2016
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-016-9734-6

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