Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease Purpose Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a) reduced, ... Research Article
Research Article  |   February 15, 2018
Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease
 
Author Affiliations & Notes
  • Laura L. Pitts
    Department of Communication Sciences & Disorders, University of Northern Iowa, Cedar Falls
    Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
    Speech-Language Pathology, Shirley Ryan AbilityLab, Chicago, IL
    School of Communication Science & Disorders, Florida State University, Tallahassee
  • Sarah Morales
    Department of Communication Sciences & Disorders, University of Northern Iowa, Cedar Falls
  • Julie A. G. Stierwalt
    School of Communication Science & Disorders, Florida State University, Tallahassee
    Division of Speech Pathology, Department of Neurology, Mayo Clinic, Rochester, MN
  • Disclosure: The authors have declared that no competing interests existed at the time of publication. Research was IRB approved and completed at Florida State University and the University of Northern Iowa. All participants gave consent for the study.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. Research was IRB approved and completed at Florida State University and the University of Northern Iowa. All participants gave consent for the study. ×
  • Correspondence to Laura L. Pitts: laura.pitts@uni.edu
  • Editor-in-Chief: Julie Liss
    Editor-in-Chief: Julie Liss×
  • Editor: Catriona Steele
    Editor: Catriona Steele×
Article Information
Swallowing, Dysphagia & Feeding Disorders / Special Populations / Older Adults & Aging / Speech / Research Articles
Research Article   |   February 15, 2018
Lingual Pressure as a Clinical Indicator of Swallowing Function in Parkinson's Disease
Journal of Speech, Language, and Hearing Research, February 2018, Vol. 61, 257-265. doi:10.1044/2017_JSLHR-S-17-0259
History: Received July 6, 2017 , Revised October 12, 2017 , Accepted November 17, 2017
 
Journal of Speech, Language, and Hearing Research, February 2018, Vol. 61, 257-265. doi:10.1044/2017_JSLHR-S-17-0259
History: Received July 6, 2017; Revised October 12, 2017; Accepted November 17, 2017

Purpose Swallowing impairment, or dysphagia, is a known contributor to reduced quality of life, pneumonia, and mortality in Parkinson's disease (PD). However, the contribution of tongue dysfunction, specifically inadequate pressure generation, to dysphagia in PD remains unclear. Our purpose was to determine whether lingual pressures in PD are (a) reduced, (b) reflect medication state, or are (c) consistent with self-reported diet and swallowing function.

Method Twenty-eight persons with idiopathic PD (PwPD) and 28 age- and sex-matched controls completed lingual pressure tasks with the Iowa Oral Performance Instrument. PwPD were tested during practically defined ON and OFF dopaminergic medication states. Participants were also stratified into three sex- and age-matched cohorts (7 men, 5 women): (a) controls, (b) PwPD without self-reported dysphagia symptoms or diet restrictions, and (c) PwPD with self-reported dysphagia symptoms with or without diet restrictions.

Results PwPD exhibited reduced tongue strength and used elevated proportions of tongue strength during swallowing compared with controls (p < .05) without an effect of medication state (p > .05). Reduced tongue strength distinguished PwPD with self-reported dysphagia symptoms from PwPD without reported symptoms or diet restrictions (p = .045) and controls (p = .002).

Conclusion Tongue strength was significantly reduced in PwPD and did not differ by medication state. Tongue strength differentiated between PwPD with and without self-reported swallowing symptoms. Therefore, measures of tongue strength and swallowing pressures may serve as clinical indicators for further dysphagia evaluation and may promote early diagnosis and management of dysphagia in PD.

Acknowledgments
The authors gratefully acknowledge the participants and their families, as well as the authors' colleagues, Lauren Leptrone, Sarah Foster Reising, and Ross Westemeyer, for their contributions to this research.
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