ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2014
Characterization of corticobulbar pharyngeal neurophysiology in dysphagic patients with Parkinson's disease.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 35 citations in OpenAlex.
- Effectiveness of Interventions for Dysphagia in Parkinson Disease: A Systematic Review.American journal of speech-language pathology · 2022Pooled it
- Dysphagia Is Associated with Incident Non-Motor Symptoms in Parkinson's Disease.Movement disorders clinical practice · 2025Article
- Neurogenic Dysphagia: Peripheral and Central Neuromodulation.Clinics and practice · 2025Review
- Postoperative Dysphagia Management in Hemifacial Spasm: A Case Report of Combined Catheter Balloon and Neuromuscular Stimulation.The American journal of case reports · 2025Article
- Management of Gastrointestinal Symptoms in Parkinson's Disease.Journal of central nervous system disease · 2025Review
- A multinational consensus on dysphagia in Parkinson's disease: screening, diagnosis and prognostic value.Journal of neurology · 2022Review
- Pathophysiology of Swallowing Dysfunction in Parkinson Disease and Lack of Dopaminergic Impact on the Swallow Function and on the Effect of Thickening Agents.Brain sciences · 2020Article
- Oro-Pharyngeal Dysphagia in Parkinson's Disease and Related Movement Disorders.Journal of movement disorders · 2019Article
- Evidence of Oropharyngeal Dysfunction in Feeding in the Rat Rotenone Model of Parkinson's Disease.Parkinson's disease · 2018Article
- Article
- Videofluoroscopic Predictors of Penetration-Aspiration in Parkinson's Disease Patients.Dysphagia · 2015Article
- Dysphagia: current reality and scope of the problem.Nature reviews. Gastroenterology & hepatology · 2015Review
- Emergence of deglutology: a transdisciplinary field.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2014Article
- Lung Function TestingMovement disorders clinical practiceArticle
- The Role of Repetitive Transcranial Magnetic Stimulation for Enhancing the Quality of Life in Parkinson's Disease: A Systematic Review.Annals of Indian Academy of NeurologyReview
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7 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsDysphagia in patients with Parkinson's disease, persisting despite dopaminergic treatment, affects intake of nutrients and medication, and reduces quality of life (QOL). We investigated the neurophysiologic mechanisms that contribute to dysphagia in these patients, on and off L-3,4-dihydroxyphenylalanine (levodopa), using transcranial magnetic stimulation.
methodsWe studied 26 patients with Parkinson's disease (age, 65 ± 9 y; 10 men). Dysphagia and QOL were first assessed with qualitative questionnaires. Twelve hours after patients were taken off levodopa, they underwent cortical transcranial magnetic stimulation mapping of the pharyngeal musculature and trigeminal (bulbar) transcranial magnetic stimulation, as well as videofluoroscopy to examine swallowing. The analyses were repeated after administration of levodopa.
resultsEleven patients initially reported dysphagia and reduced QOL scores. Videofluoroscopy identified 10 patients with swallowing impairments on and off levodopa, and 6 patients with swallowing impairments only on levodopa; the remaining 10 subjects showed no swallowing impairments, on or off the drug. While patients were on levodopa, those with swallowing impairments had bilateral increases in pharyngeal cortical excitability compared with those with no swallowing impairment (P < .05). By contrast, with medication, amplitudes of brainstem reflexes were altered only in patients with swallowing impairments on levodopa; these were decreased compared with when the patients were off levodopa.
conclusionsIn patients with Parkinson's disease, dopaminergic medications such as levodopa can negatively affect swallowing. The increased cortical excitability observed in dysphagic patients after they begin taking levodopa likely results from compensatory mechanisms, perhaps secondary to subcortical disease, because we observed associated inhibition of brainstem reflexes in patients with affected swallowing on medication. UK clinical trials registration no., 9882.
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