Abstract
Background: Dysphagia in patients with Parkinson's disease (PD) significantly reduces quality of life and predicted lifetime. Current screening procedures are insufficiently evaluated. We aimed to develop and validate a patient-reported outcome questionnaire for early diagnosis of dysphagia in patients with PD. Methods: The two-phased project comprised the questionnaire, diagnostic scales construction (N=105), and a validation study (N=82). Data for the project were gathered from PD patients at a German Movement Disorder Center. For validation purposes, a clinical evaluation focusing on swallowing tests, tests of sensory reflexes, and fiberoptic endoscopic evaluation of swallowing (FEES) was performed that yielded a criteria sum score against which the results of the questionnaire were compared. Specificity and sensitivity were evaluated for the detection of noticeable dysphagia and for the risk of aspiration. Results: The Munich Dysphagia Test - Parkinson's disease (MDT-PD) consists of 26 items that show high internal consistency (α=0.91). For the validation study, 82 patients, aged 70.9±8.7 (mean±SD), with a median Hoehn & Yahr stage of 3, were assessed. 73% of patients had dysphagia with noticeable oropharyngeal symptoms (44%) or with penetration/aspiration (29%). The criteria sum score correlated positively with the screening result (r=0.70, p<0.001). The MDT-PD sum score classified not noticeable dysphagia vs. risk of aspiration (noticeable dysphagia) with a sensitivity of 90% (82%) and a specificity of 86% (71%), and yielded similar results in cross-validation, respectively. Conclusions: MDT-PD is a valid screening tool for early diagnosis of swallowing problems and aspiration risk, as well as initial graduation of dysphagia severity in PD patients.
| Original language | English |
|---|---|
| Journal | Parkinsonism and Related Disorders |
| Volume | 20 |
| Issue number | 9 |
| Pages (from-to) | 992-998 |
| Number of pages | 7 |
| ISSN | 1353-8020 |
| DOIs | |
| Publication status | Published - 09.2014 |
Funding
Dr. Schuster's current affiliation is supported by the Canadian Network for Observational Drug Effect Studies (CNODES). CNODES is funded by a grant from Health Canada, the Drug Safety and Effectiveness Network (DSEN), and the Canadian Institutes for Health Research (CIHR). Prof. Dr. Ceballos-Baumann has received an unrestricted grant from the German Parkinson Association (Deutsche Parkinson Vereinigung e.V.) and the German Foundation for Neurology (Deutsche Stiftung Neurologie). He has received honoraria for advisory work or speeches from Archimedes, Allergan, Desitin, GlaxoSmithKline, Ipsen, Licher-MT, Meda, Merz, Medtronic, Novartis, Orion, Teva, UCB.
