A comprehensive review of the diagnosis and treatment of Parkinson's disease dysphagia and aspiration.
A comprehensive review of the diagnosis and treatment of Parkinson's disease dysphagia and aspiration.
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DOI：
10.1080/17474124.2020.1769475
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发表时间：
2020-06
影响因子：
3.9
通讯作者：
Herndon, Nicole E.
中科院分区：
文献类型：
--
作者：
Patel, Bhavana;Legacy, Joseph;Hegland, Karen W.;Okun, Michael S.;Herndon, Nicole E.
延髓功能障碍在帕金森病 (PD) 中很常见，超过 80% 的患者在病程中出现吞咽困难。症状可能在临床前阶段就开始出现，并且个体可能在病程多年后仍保持临床无症状。此外，患者并不总是意识到吞咽变化，这可能导致自我报告的吞咽困难患病率与仪器评估结果之间的差异。吞咽困难未被充分认识，它会导致吸入性肺炎的发生，而吸入性肺炎是帕金森病死亡的主要原因。 PD 吞咽困难很复杂，尚未完全了解，因为多巴胺能和非多巴胺能途径似乎都是这种症状的基础。这篇全面的综述将涵盖帕金森病患者吞咽困难和误吸的流行病学、病理生理学、临床评估以及专家管理。多学科团队的方法对于正确识别和治疗 PD 吞咽困难非常重要。使用吞咽特异性问卷和临床床边吞咽评估 (CSE) 进行定期筛查，以及使用视频荧光吞咽研究 (VFSS) 或光纤内窥镜评估 (FEES) 进行客观仪器评估对于检测吞咽困难是必要的。未来的研究需要更好地了解 PD 吞咽困难的机制，建立早期检测和进展的标志物，并开发基于证据的治疗方案。
Bulbar dysfunction is common in Parkinson’s disease (PD) with more than 80% of affected individuals developing dysphagia during the course of the disease. Symptoms can begin in the preclinical stage and individuals may remain clinically asymptomatic for years into the disease course. Furthermore, patients are not always aware of swallowing changes, which may contribute to the difference between the prevalence of self-reported dysphagia and the findings during instrumental evaluations. Dysphagia is underrecognized and contributes to the development of aspiration pneumonia which is the leading cause of death in PD. Dysphagia in PD is complex and not completely understood as both dopaminergic and non-dopaminergic pathways seem to underpin this symptom. This comprehensive review will cover the epidemiology, pathophysiology, clinical evaluation, and the expert management of dysphagia and aspiration in patients with PD. A multidisciplinary team approach is important to properly identify and to manage PD dysphagia. Regular screenings using swallowing-specific questionnaires and a clinical bedside swallow evaluation (CSE) along with objective instrumental assessments using videofluoroscopic swallow study (VFSS) or fiberoptic endoscopic evaluation (FEES) are necessary for the detection of dysphagia. Future studies are needed to better understand the mechanism(s) involved in PD dysphagia, establish markers for early detection and progression, and develop evidence-based treatment options.
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DOI：
10.1044/jshr.3705.1041
发表时间：
1994-10-01
期刊：
JOURNAL OF SPEECH AND HEARING RESEARCH
影响因子：
--
作者：
BISCH, EM;LOGEMANN, JA;LAZARUS, CL
通讯作者：
LAZARUS, CL
影响因子：
2.4
作者：
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通讯作者：
Okuda, K
影响因子：
2
作者：
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通讯作者：
Noack, Michael Johannes
影响因子：
2.6
作者：
Bonilha, Heather Shaw;Blair, Julie;Martin-Harris, Bonnie
通讯作者：
Martin-Harris, Bonnie
影响因子：
9.6
作者：
Brodsky, Martin B.;Suiter, Debra M.;Schooling, Tracy
通讯作者：
Schooling, Tracy