Progression of Dysphagia in Parkinson's Disease

帕金森病吞咽困难的进展

• 批准号: 10710205
• 负责人: Corinne Ariel Jones
• 金额: $ 15.23万
• 依托单位: UNIVERSITY OF TEXAS AT AUSTIN
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-26 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10710205
• 关键词: Activities of Daily Living; Affect; Age; Algorithms; Aspiration Pneumonia; Behavior Therapy; Behavioral; Cause of Death; Clinical; Collection; Compensation; Complex; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Deglutition; Deglutition Disorders; Development; Diagnosis; Disease; Disease Progression; England; Exhibits; Functional disorder; Future; Goals; Health; Heterogeneity; Image; Image Analysis; Individual; Knowledge; Longitudinal Studies; Mastication; Measurement; Measures; Medical; Medical center; Morbidity - disease rate; Movement Disorder Society Unified Parkinson' s Disease Rating Scale; Nature; Nerve Degeneration; Operative Surgical Procedures; Oropharyngeal; Outcome; Outcome Measure; Parkinson Disease; Participant; Patient Outcomes Assessments; Patients; Persons; Pharyngeal structure; Physiological; Physiology; Population; Preparation; Prevalence; Protocols documentation; Quality of life; Rehabilitation therapy; Reporting; Research; Risk; Risk Factors; Staging; Symptoms; Techniques; Time; Tongue; United States National Institutes of Health; Work; X-Ray Medical Imaging; design; dysphagia rehabilitation; evidence base; illness length; imaging study; improved; indexing; innovation; insight; mortality; neuropathology; non-motor symptom; novel; patient oriented; patient population; personalized medicine; pressure; programs; respiratory; risk prediction; sensorimotor system; standard of care

PROJECT SUMMARY/ABSTRACT Parkinson’s disease (PD) is a progressive, neurodegenerative condition that impacts multiple sensorimotor systems. Swallowing disorders (dysphagia) occur frequently in PD and can devastatingly impact morbidity, mortality, and quality of life. As PD-centered medical and surgical approaches do not meaningfully impact dysphagia, behavioral rehabilitation is the standard of care for persons with PD-related dysphagia. However, it is unknown when and how swallowing function begins to decline in PD, prior to crossing the threshold into clinical dysphagia. This unclear understanding of dysphagia progression in PD leaves a critical gap in knowledge, forcing clinicians to wait to begin therapy until the patient complains of dysphagia, which may not occur until a point when significant neurodegeneration has occurred and lasting improvement in swallowing function may be unattainable. Several quantitative, objective, and sensitive techniques for measuring swallowing physiology have identified differences in function between healthy individuals and those with PD, but it is unknown how these measures of physiology change over time. In this study, we aim to identify measures that characterize progression of swallowing dysfunction in persons with Parkinson’s disease. This study proposes a cross-sequential, observational design to comprehensively assess swallowing physiology in a cross-sectional and longitudinal manner, paving the way for improved understanding of swallowing decline in PD and for a personalized medicine approach for dysphagia rehabilitation. Specifically, this study will allow for the collection of sufficient preliminary data and optimization of data collection and analysis protocols to support an NIH R01 application, with the overall objective to longitudinally follow patients, asses for dysphagia progression, and develop algorithms to predict risk for dysphagia development. Our central hypotheses are that 1) Pressure and mastication measures will exhibit greater amounts of change over time than imaging or respiratory measures; and 2) Rate of swallowing function change will be slower in early-stage PD compared to mid-stage PD. Optimization of comprehensive swallowing physiology assessment will lead to improvements in understanding of progression of swallowing deficits and potential for behavioral modification of swallowing in persons with PD. Improved characterization of swallowing decline will lead to more precise assessment and diagnosis of dysphagia, better targeting of windows of opportunity for swallowing rehabilitation, and more specific outcome measurements as the field explores novel treatment approaches.

项目概要/摘要 帕金森病 (PD) 是一种影响多种感觉运动的进行性神经退行性疾病 吞咽障碍（吞咽困难）经常发生在帕金森病中，并且会对发病率产生毁灭性的影响。 由于以 PD 为中心的医疗和手术方法不会对死亡率和生活质量产生有意义的影响。 吞咽困难，行为康复是 PD 相关吞咽困难患者的标准治疗方法。 在跨越帕金森病阈值之前，尚不清楚吞咽功能何时以及如何开始下降。 临床吞咽困难对 PD 吞咽困难进展的认识尚不清楚，这在 知识，迫使人群等待患者抱怨吞咽困难才开始治疗，而这可能不会 发生直到发生显着的神经退行性变并且吞咽能力持续改善为止 一些定量的、客观的、灵敏的测量技术可能无法实现。 吞咽生理学已经确定健康个体和帕金森病患者之间的功能差异， 但尚不清楚这些生理学指标如何随时间变化。在这项研究中，我们的目的是确定。 表征帕金森病患者吞咽功能障碍进展的指标。 研究提出了一种跨序贯的观察设计来全面评估吞咽生理学 横断面和纵向的方式，为更好地理解吞咽能力下降铺平了道路 具体来说，这项研究将允许针对吞咽困难康复的个性化医疗方法。 收集足够的初步数据并优化数据收集和分析协议以支持 NIH R01 应用程序，总体目标是纵向跟踪患者，评估吞咽困难 我们的中心假设是 1) 压力和咀嚼测量随着时间的推移会表现出比成像或咀嚼测量更大的变化量 呼吸措施；2) 与早期 PD 相比，吞咽功能改变的速度会更慢 中期 PD 的综合吞咽生理学评估的优化将导致吞咽功能的改善。 了解吞咽缺陷的进展以及吞咽行为改变的潜力 帕金森病患者吞咽能力下降的特征的改善将导致更精确的评估和评估。 吞咽困难的诊断、更好地瞄准吞咽康复的机会窗口等等 随着该领域探索新的治疗方法，具体的结果测量。