Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım

Merve Sapmaz Atalar; Gençer Genç

doi:10.47572/muskutd.974435

EN TR

Approach to Swallowing Disorders in Parkinson's Disease

Öz

Most of the patients with Parkinson's disease (PD) develop dysphagia during the course of their diseases. Dysphagia, which is usually overlooked by the patients, interferes with taking solid or liquid bolus, reduces their quality of life and leads to aspiration pneumonia, which is one of the leading causes of death in PD. Disease stage, weight loss, scores >26 on Unified Parkinson’s Disease Rating Scale (UPDRS) part III, sialorrhea, and dementia have been shown to be important clinical predictors. The underlying pathophysiology of dysphagia in PD is not clear, but it has been reported that disruptions in dopaminergic and non-dopaminergic mechanisms may play a role. The assessment of dysphagia in PD includes screening tools, clinical swallowing evaluation and instrumental methods that can be used to identify patients at risk for swallowing disorders. By the help of instrumental methods such as videofluoroscopic swallowing study (VFSS) and fiberoptic endoscopic evaluation of swallowing (FEES), which are considered as the gold standard, typical deterioration patterns in the swallowing phases of Parkinson's patients can be determined, dysphagia can be diagnosed earlier, aspiration events can be detected accurately, and early intervention can be provided. Management of PD-associated dysphagia includes compensatory, rehabilitative, and medical-pharmacological methods. Optimizing dopaminergic drugs may be helpfull in some cases. More research is needed on the beneficial effects of neuromuscular electrical stimulation (NMES), deep brain stimulation (DBS), and transcranial magnetic stimulation (TMS) in the treatment of PD-associated dysphagia.

The purpose of this review is to provide an overview of the epidemiology, pathophysiology, evaluation and management of PD-associated swallowing disorders and to guide future clinical research.

Anahtar Kelimeler

Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım

Öz

Parkinson hastalığı (PH) olan kişilerin büyük bir kısmında, hastalıklarının seyri sırasında yutma bozukluğu (disfaji) gelişir. Hastalar tarafından genellikle arka planda tutulan disfaji, katı veya sıvı bolus alımını zorlaştırır, yaşam kalitesini azaltır ve PH'de başta gelen ölüm nedenlerinden biri olan aspirasyon pnömonisine yol açar. Yutma bozukluğu gelişiminde hastalık evresi, kilo kaybı, Birleşik Parkinson Hastalığı Derecelendirme Ölçeği (BPHDÖ) bölüm III skorunun >26 olması, demans ve siyalore gibi klinik öngörücüler bulunmaktadır. PH’de disfajinin altta yatan patofizyolojisi tam olarak anlaşılamamasına rağmen dopaminerjik ve dopaminerjik olmayan mekanizmalardaki bozulmaların rol oynayabileceği bildirilmiştir. PH'de ortaya çıkan disfajinin değerlendirmesinde tarama araçları, klinik yutma değerlendirmesi ve enstrümantal yöntemler, yutma bozukluğu riski taşıyan hastaları belirlemek için kullanılabilir. Altın standart olarak düşünülen videofloroskopik yutma çalışması (VFYÇ) ve fiberoptik endoskopik yutma değerlendirmesi (FEYD) gibi enstrümantal yöntemler ile Parkinson hastalarının yutma fazlarındaki tipik bozulma paternleri belirlenebilir, disfaji daha erken tanılanabilir, aspirasyon olayları doğru bir şekilde tespit edilebilir ve erken müdahale sağlanabilir. PH ile ilişkili disfajinin yönetimi, kompansatuar, rehabilitatif ve tıbbi-farmakolojik yöntemleri içerir. Dopaminerjik ilaçların optimize edilmesi bazı durumlarda faydalı olabilir. Nöromusküler elektriksel stimülasyon (NMES), derin beyin stimülasyonu (DBS) ve transkraniyal manyetik stimülasyonun (TMS) PH ile ilişkili disfajinin tedavisinde faydalı etkilerine yönelik daha fazla araştırmaya ihtiyaç vardır. Bu derlemenin amacı, PH ile ilişkili yutma bozukluklarının epidemiyolojisi, patofizyolojisi, değerlendirilmesi ve yönetimi hakkında genel bir bakış açısı sunmak ve gelecekteki klinik araştırmalar için yol gösterici olmaktır.

Anahtar Kelimeler

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

İç Hastalıkları

Bölüm

Derleme

Yazarlar

Merve Sapmaz Atalar
0000-0003-2556-1026
Türkiye

Gençer Genç ^*
0000-0002-8094-3062
Türkiye

Yayımlanma Tarihi

24 Ağustos 2022

Gönderilme Tarihi

31 Temmuz 2021

Kabul Tarihi

8 Aralık 2021

Yayımlandığı Sayı

Yıl 2022 Cilt: 9 Sayı: 2

DOI

https://doi.org/10.47572/muskutd.974435

IZ

https://izlik.org/JA24BZ37GT

Kaynak Göster

RIS / Bibtex

APA

Sapmaz Atalar, M., & Genç, G. (2022). Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 9(2), 189-203. https://doi.org/10.47572/muskutd.974435

AMA

1.Sapmaz Atalar M, Genç G. Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım. MMJ. 2022;9(2):189-203. doi:10.47572/muskutd.974435

Chicago

Sapmaz Atalar, Merve, ve Gençer Genç. 2022. “Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 9 (2): 189-203. https://doi.org/10.47572/muskutd.974435.

EndNote

Sapmaz Atalar M, Genç G (01 Ağustos 2022) Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 9 2 189–203.

IEEE

[1]M. Sapmaz Atalar ve G. Genç, “Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım”, MMJ, c. 9, sy 2, ss. 189–203, Ağu. 2022, doi: 10.47572/muskutd.974435.

ISNAD

Sapmaz Atalar, Merve - Genç, Gençer. “Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 9/2 (01 Ağustos 2022): 189-203. https://doi.org/10.47572/muskutd.974435.

JAMA

1.Sapmaz Atalar M, Genç G. Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım. MMJ. 2022;9:189–203.

MLA

Sapmaz Atalar, Merve, ve Gençer Genç. “Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 9, sy 2, Ağustos 2022, ss. 189-03, doi:10.47572/muskutd.974435.

Vancouver

1.Merve Sapmaz Atalar, Gençer Genç. Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım. MMJ. 01 Ağustos 2022;9(2):189-203. doi:10.47572/muskutd.974435

Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım

Approach to Swallowing Disorders in Parkinson's Disease

Öz

Anahtar Kelimeler

Parkinson Hastalığında Yutma Bozukluklarına Yaklaşım

Öz

Anahtar Kelimeler

Kaynakça

Ayrıntılar

Birincil Dil

Konular

Bölüm

Yazarlar

Yayımlanma Tarihi

Gönderilme Tarihi

Kabul Tarihi

Yayımlandığı Sayı

DOI

IZ

Kaynak Göster

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Drooling may be Associated with Dysphagia Symptoms in Multiple Sclerosis

Deep Brain Stimulation in Swallowing Disorders in Individuals With Parkinson's Disease: A Narrative Review