The coordination of breathing and swallowing in Parkinson's disease
The coordination of breathing and swallowing in Parkinson's disease
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DOI：
10.1007/s00455-007-9113-4
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发表时间：
2008-06-01
期刊：
影响因子：
2.6
通讯作者：
Doyle, Patrick J.
中科院分区：
文献类型：
--
作者：
Gross, Roxann Diez;Atwood, Charles W., Jr.;Doyle, Patrick J.
多项调查已经确定，健康的成年人最常在呼气时吞咽，而呼气通常伴随着吞咽，即使在吸入时发生吞咽。我们假设患有特发性帕金森病的人在自主进食时会表现出呼吸和吞咽协调受损。25名健康志愿者和25名帕金森病患者自发地吞下校准过的布丁和饼干，同时使用鼻腔气流和呼吸感应容积描记仪来跟踪自发呼吸。表面肌电信号用于记录呼吸周期内每次吞咽的时间。与健康对照组相比，帕金森氏症患者在吸气和低潮时吞咽的频率明显更高。帕金森氏症的参与者在两种一致性下都表现出明显更多的吞咽后吸入。只有健康受试者在吸入过程中出现的吞咽呼吸暂停比在呼气过程中出现的吞咽呼吸暂停明显更长。帕金森病患者口咽吞咽困难的高发生率和吸入性肺炎的风险可能部分归因于呼吸和吞咽协调受损。
Multiple investigations have determined that healthy adults swallow most often during exhalation and that exhalation regularly follows the swallow, even when a swallow occurs during inhalation. We hypothesized that persons with idiopathic Parkinson's disease would demonstrate impaired breathing and swallowing coordination during spontaneous eating. Twenty-five healthy volunteers and 25 Parkinson's disease patients spontaneously swallowed calibrated pudding and cookie portions while simultaneous nasal airflow and respiratory inductance plethysmography were used to track spontaneous breathing. Surface EMG was used to record the timing of each swallow within the respiratory cycle. When compared to the healthy control group, those with Parkinson's disease swallowed significantly more often during inhalation and at low tidal volumes. The Parkinson's participants also exhibited significantly more postswallow inhalation for both consistencies. Only the healthy subjects exhibited significantly longer deglutitive apnea when swallows that occurred during inhalation were compared with those that occurred during exhalation. The high incidence of oropharyngeal dysphagia and risk of aspiration pneumonia found in Parkinson's disease patients may be partially attributable to impaired coordination of breathing and swallowing.