Progression of Dysphagia in Parkinson's Disease

帕金森病吞咽困难的进展

• 批准号: 10598816
• 负责人: Corinne Ariel Jones
• 金额: $ 15.25万
• 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/10598816
• 关键词: Activities of Daily Living; Affect; Age; Algorithms; Aspiration Pneumonia; Behavior Therapy; Behavioral; Cause of Death; Clinical; Collection; Complex; Cross-Sectional Studies; Data; Data Analyses; Data Collection; Deglutition; Deglutition Disorders; Development; Diagnosis; Disease; 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; 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; base; design; dysphagia rehabilitation; evidence base; illness length; imaging study; improved; indexing; innovation; insight; mortality; non-motor symptom; novel; patient oriented; patient population; personalized medicine; pressure; programs; respiratory; 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.

项目摘要/摘要 帕金森氏病（PD）是一种渐进的神经退行性疾病，会影响多个感觉运动 系统。吞咽障碍（吞咽困难）经常发生在PD中，可能会影响发病率， 死亡率和生活质量。由于以PD为中心的医学和手术方法不会有意义地影响 吞咽困难，行为康复是与PD相关吞咽困难患者的护理标准。但是，它 在将阈值越过阈值之前，未知何时以及如何开始吞咽功能开始下降 临床吞咽困难。对PD中吞咽困难进展的这种不清楚的理解留下了危险的差距 知识，迫使临床医生等待开始治疗，直到患者完成吞咽困难，这可能不会 发生直到发生显着神经变性并吞咽的持久改善 功能可能是无法实现的。用于测量的几种定量，客观和敏感技术 吞咽生理学已经确定了健康个体与患有PD的人之间的功能差异， 但是，这些生理学度量如何随着时间而变化是未知的。在这项研究中，我们旨在确定 表征帕金森氏病患者吞咽功能障碍进展的措施。这 研究提案提出了跨序列的，观察性的设计，以全面评估吞咽生理学 一种横截面和纵向方式，为了改善对吞咽下降的了解 PD和用于吞咽困难的个性化医学方法。具体来说，这项研究将允许 收集足够的初步数据以及数据收集和分析协议的优化 NIH R01的应用，其总体目标是纵向关注患者的肿瘤驴 进展和发展算法可以预测吞咽困难的风险。我们的中心假设是 1）压力和咀嚼措施将随着时间的推移与成像或 呼吸措施； 2）与 中期PD。优化全面的吞咽生理学评估将导致改善 了解吞咽不足的进展和吞咽行为改变的潜力 患有PD的人。改善吞咽下降的表征将导致更精确的评估，并且 诊断吞咽困难，更好地靶向吞咽康复的机会窗口以及更多 当该领域探索新的治疗方法时，具体的结果测量值。