Author: Corinne Ariel JonesPublisher:
ISBN:
Category :
Languages : en
Pages : 0
Book Description
Motor control abilities change with age and as a result of Parkinson disease (PD). Although not a cardinal motor symptom of PD, swallowing disorders (dysphagia) occur in up to 90% of persons with the disease, and can lead to a decreased quality of life and aspiration pneumonia, the leading cause of death among patients with PD. Dysphagia is believed to manifest in the later stages of PD; however, sub-clinical swallowing disorders have not been investigated in this neurodegenerative disease. A domain for identification of subtle but objective motor deficits is the evaluation of intra-individual motor variability, which increases in limb movements both with age and with PD. It is unknown how motor variability manifests in oropharyngeal swallowing, how it changes with age and with PD, and how it relates to limb motor variability. The goal of this thesis is to characterize swallowing pressures and swallowing pressure variability in individuals with PD and healthy older adults. Specifically, the aims of this work were to: 1) Determine quantitative differences in swallowing function in early and mid-stage PD; 2) Determine the effects of age, sex, pharyngeal region, and volume of liquid swallowed on swallowing pressure variability; and 3) Compare oromotor and limb motor variability in patients with early-stage PD and healthy older adults. Results from these studies provide evidence that swallowing function quantitatively changes in the early and mid-stages of Parkinson disease, before gross swallowing disorders set in. Specifically, swallow-to-swallow pressure variability is increased in individuals with early and mid-stage PD, although this effect is less apparent in the very early stages of PD. This swallowing pressure variability increases slightly with healthy aging, interacts with sex and pharyngeal region, and increases with large volumes and when individuals select their own sip size. Oromotor variability is not related to limb motor variability in neither healthy individuals nor persons with PD, demonstrating that motor control for stereotyped, repetitive tasks are likely governed by separate sensorimotor control mechanisms. Further investigation of how PD impacts swallowing motor control and specific measurements of early changes in swallowing function can assist in developing preventative swallowing rehabilitation programs, with the goal of prolonging functional swallowing for as long as possible.
