Publication: Parkinson hastalığında yutma bozukluklarının elektrofizyolojik incelemesi
Abstract
Parkinson hastalığı (PH) olan 59 hasta ve yaş uyumlu 44 normal kontrol olgusu elektrofizyolojik olarak incelenmiştir. Larinks hareketleri larinks sensörü; submental kasların ve ve m.Cricopharyngeusun (CP) aktivitesi elektromyografi ile incelenmiştir. Bu yöntemlerle elde edilen submental EMG (SM-EMG) disfaji limiti (DL) parametrelerinin değerleri normal kontrol (NK) grubu ile karşılaştırılmıştır. PH grubunda SM-EMG parametrelerinin değerlerinin NK grubuna göre anlamlı derecede uzadığı görülmüştür. Yine hasta grubunda disfaji limitinde istatistiksel olarak anlamlı bir azalma bulunmuştur. CP-kas aktivitesindeki değişiklikler istatistiksel olarak anlamlı değildir. SM-EMG parametrelerindeki değişikliğin disfajiyi doğrudan açıklamadığı, fakat disfajiye yatkınlığı gösterme açısından anlamlı olduğu sonucuna varılmıştır. Çalışma sırasında PH olgularından sadece birinde aspirasyon görülmesi disfaji limiti tekniği ile gösterilen bölerek yutmanın bir kompanzsayon mekanizması olabileceğini düşündürmüştür. Elektrofizyolojik yöntemlerle yapılacak daha ayrıntılı çalışmaların PH'da disfajinin fizyopatolojisini aydınlatmaya katkıda bulunacağı sonucuna varılmıştır.
In this study 59 patients with Parkinson's disease (PD) and 44 age matched controls were investigated electrophysiologically. A piezo-electric laryngeal sensor is used to record vertical movements of larynx. The activities of submental muscles and cricopharynx (CP) muscle are recorded by electromyogarphy (EMG). Submental muscle EMG (SM-EMG) and dysphagia limit (DL) parameters were obtained by described methods compared between PH and normal control (NC) groups. Measured SMEMG parameters were increased significantly in comparison to NC group. DL was found to be significantly different from NC group. The changes of CP-muscle activity in PH group were not significant. Although changes of SM-EMG parameters in PD group reflects the clinical changes due to disease process were not correlated with dysphagia spesifically DL was thought to be very valuable to disclose the subclinical dysphagia. In this study aspiration occured only in one patient. This suggests that piece-meal deglutition shown by DL mehod may be a compensatory mechanism against dysphagia. It is concluded that further studies about dysphagia with elctropysiological means will help to disclose the physiopathology of dysphagia.
In this study 59 patients with Parkinson's disease (PD) and 44 age matched controls were investigated electrophysiologically. A piezo-electric laryngeal sensor is used to record vertical movements of larynx. The activities of submental muscles and cricopharynx (CP) muscle are recorded by electromyogarphy (EMG). Submental muscle EMG (SM-EMG) and dysphagia limit (DL) parameters were obtained by described methods compared between PH and normal control (NC) groups. Measured SMEMG parameters were increased significantly in comparison to NC group. DL was found to be significantly different from NC group. The changes of CP-muscle activity in PH group were not significant. Although changes of SM-EMG parameters in PD group reflects the clinical changes due to disease process were not correlated with dysphagia spesifically DL was thought to be very valuable to disclose the subclinical dysphagia. In this study aspiration occured only in one patient. This suggests that piece-meal deglutition shown by DL mehod may be a compensatory mechanism against dysphagia. It is concluded that further studies about dysphagia with elctropysiological means will help to disclose the physiopathology of dysphagia.