INVESTIGADORES
PEREZ LLORET Santiago
congresos y reuniones científicas
Título:
Dysphagia and hypersalivation in Parkinsons Disease: a cross-sectional survey.
Autor/es:
SANTIAGO PÉREZ LLORET; LAURENCE NEGRE-PAGES; OLIVIER RASCOL; MARCELO MERELLO
Lugar:
Paris, Francia
Reunión:
Congreso; Congreso Internacional de Movimientos Anormales; 2009
Resumen:
Introduction: Dysphagia and hypersialorrhea can affect patients with Parkinsons
Disease (PD). However such symptoms have been rarely evaluated in large samples
of patients recruited out of tertiary specialized units and its prevalence,
risk factors and impact on health-related quality of life is poorly known in
the general population of PD patients.
Objective: We explored the frequency of dysphagia and hypersalivation in 450 PD
patients of the Toulouse area in a cross-sectional survey and compared the
demographic, clinical and pharmacological features associated with the presence
or absence of such symptoms.
Methods: 450 patients underwent
structured standardized clinical examination (UPDRS parts I-IV, MMSE, PDQ39).
Dysphagia and hypersalivation were defined as UPDRS II items 6 or 7 ≥ 1, respectively. Drug
consumption was obtained from clinical records.
Results: The mean age of the 450 studied patients was 69±10 years, 57% of them
were males, with a mean PD duration of 6±5 years, a mean UPDRS II+III in ON
condition of 28±15. They were treated with levodopa for 5±4 years with a mean
daily dose of 580±360 mg/day.
77/450 patients (18.4%) reported
dysphagia and 154/450 (36.8%) hypersalivation.
Patients complaining of dysphagia had
longer PD duration (8±5 vs 5±4 years, p<0.0002), higher rates of hypotension
(21% vs 10 p<0.001), higher UPDRS II+III score (37±15 vs 26±14 p<0.0001),
more frequent depressive symptoms (60% vs 31% p<0.0001), longer duration of
treatment (7±4 vs 5±4 years p<0.001), greater levodopa dose (720±417 vs
550±335 mg/day p<0.004), more frequent amantadine therapy (15% vs 6% p<0.01)
and worse PDQ39 score (32.1±13.2 vs 25.5±13.3 p<0.0001)
Patients complaining of
hypersalivation had longer PD duration (7±5 vs 5±4 years, p<0.004), higher
UPDRS II+III score (36±15 vs 24±13 p<0.0001), longer duration of treatment (6±4
vs 5±4 years p<0.001), greater levodopa dose (641±368 vs 543±350 mg/day p<0.004),
less frequent benzodiazepine therapy (6% vs 14% p<0.02) and worse PDQ39
score (28.7±14.6 vs 25.7±12.8 p<0.02)
Conclusion:
Dysphagia and sialorrhea affected one-third of ambulatory
non-demented PD patients recruited in academic and non academic outpatient
clinics. Both symptoms were associated with more severe parkinsonism and impaired
health-related quality of life. Dysphagia was more prevalent in patients on
amantadine, while hypersalivation was less frequent among benzodiazepine users.