Effect of Intestinal Levodopa-Carbidopa Infusion on Pharyngeal Dysphagia: Results from a Retrospective Pilot Study in Patients with Parkinson's Disease

Bendix Labeit; Inga Claus; Paul Muhle; Sonja Suntrup-Krueger; Rainer Dziewas; Tobias Warnecke

doi:10.1155/2020/4260501

Effect of Intestinal Levodopa-Carbidopa Infusion on Pharyngeal Dysphagia: Results from a Retrospective Pilot Study in Patients with Parkinson's Disease

Parkinsons Dis. 2020 Mar 11:2020:4260501. doi: 10.1155/2020/4260501. eCollection 2020.

Authors

Bendix Labeit^{1

2}, Inga Claus¹, Paul Muhle^{1

2}, Sonja Suntrup-Krueger^{1

2}, Rainer Dziewas¹, Tobias Warnecke¹

Affiliations

¹ University Hospital Muenster, Department of Neurology with Institute for Translational Neurology, Albert-Schweitzer-Campus 1; Gebäude A1, Münster 48149, Germany.
² Institute of Biomagnetism and Biosignalanalysis, University Hospital Muenster, University of Muenster, Malmedyweg 15, Münster 48149, Germany.

Abstract

Background: Pharyngeal dysphagia is a common symptom of Parkinson's disease (PD) leading to severe complications. PD-related pharyngeal dysphagia (PDrPD) may significantly improve in up to half of patients following acute oral levodopa challenge.

Objective: The aim of this study was to investigate the effects of levodopa-carbidopa intestinal gel (LCIG) on PDrPD.

Methods: Forty-five PD patients under LCIG treatment were available for retrospective analysis. In all patients with PDrPD who underwent flexible endoscopic evaluation of swallowing (FEES) in the clinical "on-state" both before and after implementation of LCIG treatment, FEES videos were systematically reassessed. PDrPD was characterized using a PD-specific FEES score evaluating premature bolus spillage, penetration/aspiration, and pharyngeal residue. Further, the duration of white-out was assessed, as a parameter for pharyngeal bradykinesia.

Results: Eleven patients with PDrPD (mean age 74.6 ± 4.4 years; mean Hoehn and Yahr stage 3.8 ± 0.6) received FEES both before and after the onset of LCIG treatment. The mean swallowing score improved from 14.9 ± 7.3 to 13.0 ± 6.9 after implementation of LCIG; however, this difference was not significant (p=0.312). Premature bolus spillage decreased significantly (p=0.312). Premature bolus spillage decreased significantly (p=0.312). Premature bolus spillage decreased significantly (.

Conclusions: LCIG may affect PDrPD and reduce premature bolus spillage and pharyngeal bradykinesia. Future studies with larger sample sizes are required to follow-up on these pilot results and identify which factors predict a good response of PDrPD to LCIG treatment.