Although medication advancements and surgical interventions such as deep brain stimulation (DBS) have provided significant improvement in managing the motor symptoms of Parkinson’s disease, the non-motor symptoms, which can include drooling, dysphagia, sleep disorders and anxiety, remain problematic for many individuals and have less available treatment options.
Recently, at our monthly journal club, hosted by a local neurologist, I was asked to review a paper: Drooling in Parkinson’s Disease: Prevalence and Progression from the Non‑motor International Longitudinal Study.(Dysphagia (2020) 35:955–961 https://doi.org/10.1007/s00455-020-10102-5)
The paper reported on a retrospective analysis of 728 consecutive Idiopathic Parkinson’s Disease patients who had a baseline and follow-up assessment as part of the Non-motor International longitudinal study. A report of drooling was derived from a question on the Non-Motor Symptoms Scale (NMSS).
In addition to drooling, investigators looked at prevalence of dysphagia (swallowing impairment) through self-reported outcomes and also administed a Quality of Life Scale and Cognitive assessment.
The aim of the study was to assess if the prevalence of drooling would increase with age and negatively impact quality of life. A summary of findings indicated that drooling occurs in all stages of PD and all ages with highest prevalence >80yrs, and >15yrs disease duration. At final follow-up (3 yrs) close to half of patients had drooling, reduced quality of life scores, and drooling had an association with cognitive impairment.
At the final follow-up nearly ½ patients had dysphagia, though based on other research, this may have been an underestimate. In this particular study, a diagnosis of dysphagia was made by patient report only, but it has been noted by other researchers that individuals with PD often under-report dysphagia, and as high as 86% of people with drooling have been reported to have oral-pharyngeal dysphagia with day time drooling associated with silent aspiration.(Nóbrega A C, Rodrigues B & Melo A 2008)
Because of dysphagia’s occurrance in patients with drooling, Parkinson’s patients with drooling should undergo a clinical and instrumental swallowing assessment. Drooling also had a high correlation with poorer quality of life scores and management strategies should be offered to patients.
Chewing gum is a simple strategy without side effects to control drooling by increasing the flow of saliva and rate of swallowing.(South A R, Somers SM & Jog M S (2010). I also like to recommend use of a terrycloth sports wrist band which may serve as a cue to swallow before wiping one’s mouth, and also is more hygienic then tissues and handkerchiefs which get set on surfaces.
LOUD Crowd Members in the News
The Punta Gorda/Port Charlotte, Florida LOUD Crowd® recently received a Grant from the Parkinson’s Voice Project.
Calling all Parkinson’s Individuals with DBS
Jennifer Revell, a second year grad student pursuing a speech-language pathology degree is developing a research project about the patient-perceived outcomes of receiving DBS in individuals with Parkinson’s disease. If you are 45-70 years, have a diagnosis of Parkinson’s, and have received DBS in the last 5 years, please take a few moments to complete her survey which consists of 13 questions. For more information: https://semoir.qualtrics.com/jfe/form/SV_bOOwn4oyCdiwt6d
Internation Aphasia Choir is recruiting new members. (Aphasia is a communication impairment affecting the ability to speak or understand language, and is usually the result of a stroke, head injury, or other damage to the brain).
In May 2020, Trent Barrick, board-certified music therapist, had an idea to connect people with aphasia through music and reached out to Dr. Gillian Velmer, a speech-language pathologist, about recruiting people with aphasia to sing in a “virtual aphasia choir” during Aphasia Awareness Month in June 2020. The event was a success with over 100 participants, and so now, they are recruiting again for 2021.
If you or someone you know has aphasia, please share the contact and registration link: https://singaphasia.com/international-aphasia-choir/
My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower. Mary Spremulli, MA, CCC-SLP * FiTOUR® Group Exercise Instructor * Voice Aerobics® A Whole Body Approach to Voice Practice
Voice Aerobics the heART and Science of Voice Practice