Electromyographic measures of asymmetric muscle control of swallowing in Parkinson's disease

• Published in: PloS one 2022-02, Vol.17 (2), p.e0262424-e0262424
• Main Authors: Diaz, Kasandra, Stegemöller, Elizabeth E L
• Format: Article
• Language: English
• Subjects: Aged; Asymmetry; Biology and Life Sciences; Coefficient of variation; Deglutition; Deglutition Disorders - complications; Deglutition Disorders - diagnosis; Dopamine; Dysphagia; Electromyography; Electromyography - methods; Engineering and Technology; Esophagus; Evaluation; Female; Humans; Impairment; Kinesiology; Laryngeal Muscles - physiopathology; Male; Medicine and Health Sciences; Middle Aged; Movement disorders; Muscle function; Muscles; Neurodegenerative diseases; Parkinson Disease - complications; Parkinson Disease - physiopathology; Parkinson's disease; Parkinsons disease; Pharynx; Physiological aspects; Quality of Life; Questionnaires; Research and Analysis Methods; Rigidity; Severity of Illness Index; Statistical analysis; Surveys and Questionnaires; Swallowing; Tremor
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0262424

During the early stages, Parkinson's disease (PD) is well recognized as an asymmetric disease with unilateral onset of resting tremor with varying degrees of rigidity, and bradykinesia. However, it remains unknown if other impairments, such as swallowing impairment (i.e., dysphagia), also present asymmetrically. The primary aim of this study was to examine muscle activity associated with swallow on the most affected side (MAS) and least affected side (LAS) in persons with PD. A secondary aim was to explore the relationship between differences in muscle activity associated with swallow and subjective reports of swallowing impairment and disease severity. Function of muscles associated with swallowing was assessed using surface electromyography placed over the right and left submental and laryngeal regions during three swallows for a THIN and THICK condition. The Swallowing Quality of Life (SWAL-QOL) questionnaire and the Unified Parkinson's Disease Rating Scale (UPDRS) were collected as measures of subjective swallow impairment and disease severity, respectively. Thirty-five participants diagnosed with idiopathic PD and on a stable antiparkinsonian medication regimen completed this study. Results revealed no significant mean difference in muscle activity during swallow between the more and less affected side. For the laryngeal muscle region, a significant difference in coefficient of variation between the MAS and LAS was revealed for peak amplitude for the THIN swallow condition. For the laryngeal muscle region, a significant association was revealed between muscle activity and disease severity but not subjective reports of swallowing impairment. Superficially it appears that swallowing impairment present symmetrical during the early stages of PD, however, our variability data indicates otherwise. These results will be used to inform future studies in specific types of swallowing impairment (i.e., oral dysphagia, pharyngeal dysphagia, and esophageal dysphagia), disease progression, and overall asymmetry.