Djup hjärnstimulering vid dysfagi hos parkinsonpatienter. Den självskattade sväljningsfunktionen förbättrades i pilotstudie
Sammanfattning
Swallowing disorders are common in patients with Parkinson's disease (PD). In addition to pharmacological treatment, DBS is used as a surgical treatment option.
Swallowing function was self evaluated during a test meal using a VA scale recorded as a reduction from 100 % function by 12 PD patients who had undergone DBS (11 subthalamic nucleus, one ventrolateral thalamic nucleus). Comparisons were made pre-operatively (without medication and then with an L-dopa test dose) and 6 and 12 months post-operatively (stimulation on and off, with optimised medication).
Preoperative test dose medication as well as 6 and 12 months postoperative “stimulator on” conditions revealed significantly improved self-estimated swallowing function as compared to the “off” conditions. Post-operative response to stimulation did not exceed pre-operative L-dopa improvement.
Objective measures of swallowing function as a complement to self estimation should now be evaluated, as should the effect of stimulation of other targets in the brain.