ABSTRACT
Objective To explore the prevalence of sialorrhea and its clinical correlation with dysphagia in Chinese patients with Parkinson′s disease ( PD ).Methods One hundred and sixteen consecutive patients with a clinical diagnosis of PD were selected.Demographic data included sex , age, years of education, age at onset of PD, clinical genotype, disease duration, treatment, Hoehn and Yahr (H&Y) stage.Sialorrhea was assessed using the Unified Parkinson′s Disease Rating Scale (UPDRS) Ⅱitem number 6.All patients were studied with videofluoroscopic study of swallowing ( VFSS).Results The prevalence rate of sialorrhea in PD was 59.5% (69/116, 95% CI 50.6%-68.4%).Males were more likely to develop sialorrhea than females (47/70 vs 22/46,χ2 =4.298, P=0.038).PD patients′sialorrhea correlated with oral dysphagia:with food leaking from the mouth ( liquid r=0.229, P=0.014; juice r=0.197, P=0.034;pudding viscosities r=0.231, P=0.013;solid food r=0.255, P=0.006), with more than 1 ml of oral food residues (liquid r=0.319, P<0.01;solid food r=0.185, P=0.047), with delay in food transfer to the root of the tongue (liquid r=0.279, P=0.002; juice r=0.209, P=0.024), and delayed swallow transfer ( pudding viscosities r=0.257, P=0.005).Sialorrhea score was not related to H&Y stage, clinical course and levodopa equivalent doses (LED).The prevalence rate of dysphagia in PD was 87.1%(95% CI 81.0% -93.2%).Liquid was more likely to cause pharyngeal dysphagia ( P=0.03).With the increase in H&Y stage , so did the oral and pharyngeal stages of dysphagia.Late and mid-course was more likely to develop oral and pharyngeal dysphagia than those with early clinical course .Conclusions Sialorrhea and dysphagia are common non-motor symptoms in PD patients.Sialorrhea is more prevalent in males and correlates with oral phase of dysphagia.Liquid is more likely to cause pharyngeal dysphagia.With increase in H&Y stage , so did oral and pharyngeal dysphagia.Even though late clinical course is more likely to develop oral and pharyngeal dysphagia than early clinical course , the comparison between late and intermediate clinical courses does not reach statistical significance .
ABSTRACT
Objective To explore the value of the joint space in the prediction and evaluation of cervical vertigo(CV).Methods 45 CV patients were selected in our hospital from May 2011 to March 2015 as the observation group,and 45 healthy people in our hospital were selected as control group in the same period.The differences of atlas axis joint space including the atlantodental interval(ADI),LADI and VBLADI between the two groups were measured by three dimensional CT,evaluated the difference of indexes of joint space,CV symptom and function score of patients in observation group before treatment and 3 weeks after treatment were observed by CV symptom and function assess-ment scale,and analyzed theirs correlation.Results The differences of ADI and VBLADI between the two groups were statistically significant(t =3.430,87.753,all P <0.05 ).The vertigo,neck pain,headache,daily life and psychological of work and social adaptive capacity scores,ADI and VBLADI levels in the observation group were significantly decreased after treatment(t =67.236,31.795,25.198,18.494,19.180,98.194,10.972,75.895,all P <0.05).Correlation analysis showed that the ADI,VBLADI and the indexes scores of CV symptoms and function were positively correlated(r =0.456,0.829,0.578,0.456,0.378,all P <0.05;r =0.512,0.398,0.782,0.412, 0.477,0.891,all P <0.05).Conclusion Axial joint disease is an important factor in the pathogenesis of CV,and there is a significant correlation between the axial joint space and CV,which can be used as a predictive index for the assessment and treatment of patients with CV.