Progression of Dysphagia in Parkinson's Disease

帕金森病吞咽困难的进展

• 批准号: 10598816
• 负责人: Corinne Ariel Jones
• 金额: $ 15.25万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10598816
• 关键词: Activities of Daily Living; Affect; Age; Algorithms; Aspiration Pneumonia; Behavior Therapy; Behavioral; Cause of Death; Clinical; Collection; Complex; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Deglutition; Deglutition Disorders; Development; Diagnosis; Disease; England; Exhibits; Functional disorder; Future; Goals; Health; Heterogeneity; Image; Image Analysis; Individual; Knowledge; Longitudinal Studies; Mastication; Measurement; Measures; Medical; Medical center; Morbidity - disease rate; Movement Disorder Society Unified Parkinson' s Disease Rating Scale; Nature; Nerve Degeneration; Operative Surgical Procedures; Oropharyngeal; Outcome; Outcome Measure; Parkinson Disease; Participant; Patient Outcomes Assessments; Patients; Persons; Physiological; Physiology; Population; Preparation; Prevalence; Protocols documentation; Quality of life; Rehabilitation therapy; Reporting; Research; Risk; Risk Factors; Staging; Symptoms; Techniques; Time; Tongue; United States National Institutes of Health; Work; X-Ray Medical Imaging; base; design; dysphagia rehabilitation; evidence base; illness length; imaging study; improved; indexing; innovation; insight; mortality; non-motor symptom; novel; patient oriented; patient population; personalized medicine; pressure; programs; respiratory; sensorimotor system; standard of care

PROJECT SUMMARY/ABSTRACT Parkinson’s disease (PD) is a progressive, neurodegenerative condition that impacts multiple sensorimotor systems. Swallowing disorders (dysphagia) occur frequently in PD and can devastatingly impact morbidity, mortality, and quality of life. As PD-centered medical and surgical approaches do not meaningfully impact dysphagia, behavioral rehabilitation is the standard of care for persons with PD-related dysphagia. However, it is unknown when and how swallowing function begins to decline in PD, prior to crossing the threshold into clinical dysphagia. This unclear understanding of dysphagia progression in PD leaves a critical gap in knowledge, forcing clinicians to wait to begin therapy until the patient complains of dysphagia, which may not occur until a point when significant neurodegeneration has occurred and lasting improvement in swallowing function may be unattainable. Several quantitative, objective, and sensitive techniques for measuring swallowing physiology have identified differences in function between healthy individuals and those with PD, but it is unknown how these measures of physiology change over time. In this study, we aim to identify measures that characterize progression of swallowing dysfunction in persons with Parkinson’s disease. This study proposes a cross-sequential, observational design to comprehensively assess swallowing physiology in a cross-sectional and longitudinal manner, paving the way for improved understanding of swallowing decline in PD and for a personalized medicine approach for dysphagia rehabilitation. Specifically, this study will allow for the collection of sufficient preliminary data and optimization of data collection and analysis protocols to support an NIH R01 application, with the overall objective to longitudinally follow patients, asses for dysphagia progression, and develop algorithms to predict risk for dysphagia development. Our central hypotheses are that 1) Pressure and mastication measures will exhibit greater amounts of change over time than imaging or respiratory measures; and 2) Rate of swallowing function change will be slower in early-stage PD compared to mid-stage PD. Optimization of comprehensive swallowing physiology assessment will lead to improvements in understanding of progression of swallowing deficits and potential for behavioral modification of swallowing in persons with PD. Improved characterization of swallowing decline will lead to more precise assessment and diagnosis of dysphagia, better targeting of windows of opportunity for swallowing rehabilitation, and more specific outcome measurements as the field explores novel treatment approaches.

项目总结/文摘