Consensus on the treatment of dysphagia in Parkinson's disease

Schindler, Antonio; Pizzorni, Nicole; Cereda, Emanuele; Cosentino, Giuseppe; Avenali, Micol; Montomoli, Cristina; Abbruzzese, Giovanni; Antonini, Angelo; Barbiera, Filippo; Benazzo, Marco; Benarroch, Eduardo; Bertino, Giulia; Clave, Pere; Cortelli, Pietro; Eleopra, Roberto; Ferrari, Chiara; Hamdy, Shaheen; Huckabee, Maggie-Lee; Lopiano, Leonardo; Marchese-Ragona, Rosario; Masiero, Stefano; Michou, Emilia; Occhini, Antonio; Pacchetti, Claudio; Pfeiffer, Ronald F; Restivo, Domenico A; Rondanelli, Mariangela; Ruoppolo, Giovanni; Sandrini, Giorgio; Schapira, Anthony; Stocchi, Fabrizio; Tolosa, Eduardo; Valentino, Francesca; Zamboni, Mauro; Zangaglia, Roberta; Zappia, Mario; Tassorelli, Cristina; Alfonsi, Enrico

doi:10.1016/j.jns.2021.120008

Consensus on the treatment of dysphagia in Parkinson's disease

Author:

Schindler, Antonio

Pizzorni, Nicole ; Cereda, Emanuele ; Cosentino, Giuseppe ; Avenali, Micol ; Montomoli, Cristina ; Abbruzzese, Giovanni ; Antonini, Angelo ; Barbiera, Filippo ; Benazzo, Marco ; Benarroch, Eduardo ; Bertino, Giulia ; Clave, Pere ; Cortelli, Pietro ; Eleopra, Roberto ; Ferrari, Chiara ; Hamdy, Shaheen ; Huckabee, Maggie-Lee ; Lopiano, Leonardo ; Marchese-Ragona, Rosario ; Masiero, Stefano ; Michou, Emilia ; Occhini, Antonio ; Pacchetti, Claudio ; Pfeiffer, Ronald F ; Restivo, Domenico A ; Rondanelli, Mariangela ; Ruoppolo, Giovanni ; Sandrini, Giorgio ; Schapira, Anthony ; Stocchi, Fabrizio ; Tolosa, Eduardo ; Valentino, Francesca ; Zamboni, Mauro ; Zangaglia, Roberta ; Zappia, Mario ; Tassorelli, Cristina ; Alfonsi, Enrico

Keywords:

Clinical Neurology, Consensus development conference, DEEP-BRAIN-STIMULATION, Deglutition disorders, ESPEN GUIDELINES, INTENSIVE VOICE TREATMENT, Life Sciences & Biomedicine, NEUROMUSCULAR ELECTRICAL-STIMULATION, Neurosciences, Neurosciences & Neurology, Nutrition, OROPHARYNGEAL DYSPHAGIA, Parkinson's disease, PULMONARY-FUNCTION, QUALITY-OF-LIFE, Rehabilitation, Science & Technology, SUBTHALAMIC NUCLEUS, SWALLOWING DISORDERS, TREATMENT LSVT(R), Consensus, Deglutition Disorders, Humans, Italy, Parkinson Disease, 1103 Clinical Sciences, 1109 Neurosciences, 1701 Psychology, 3202 Clinical sciences, 3209 Neurosciences, 5202 Biological psychology

Abstract:

BACKGROUND: Dysphagia is common in Parkinson's disease (PD). The effects of antiparkinsonian drugs on dysphagia are controversial. Several treatments for dysphagia are available but there is no consensus on their efficacy in PD. OBJECTIVE: To conduct a systematic review of the literature and to define consensus statements on the treatment of dysphagia in PD and related nutritional management. METHODS: A multinational group of experts in the field of neurogenic dysphagia and/or Parkinson's disease conducted a systematic evaluation of the literature and reported the results according to PRISMA guidelines. The evidence from the retrieved studies was analyzed and discussed in a consensus conference organized in Pavia, Italy, and the consensus statements were drafted. The final version of statements was subsequently achieved by e-mail consensus. RESULTS: The literature review retrieved 64 papers on treatment and nutrition of patients with PD and dysphagia, mainly of Class IV quality. Based on the literature and expert opinion in cases where the evidence was limited or lacking, 26 statements were developed. CONCLUSIONS: The statements developed by the Consensus panel provide a guidance for a multi-disciplinary treatment of dysphagia in patients with PD, involving neurologists, otorhinolaryngologists, gastroenterologists, phoniatricians, speech-language pathologists, dieticians, and clinical nutritionists.