{
    "abstract": "Respiratory-swallow coordination (RSC) frequently changes in people with Parkinson's disease (PwPD). Little is known about how these changes relate to impairments in swallowing safety (penetration and aspiration) and efficiency (pharyngeal residue). Therefore, the aims of this study were to assess the relationships between RSC, pharyngeal residue, penetration, and aspiration in PwPD.\nTwenty-four PwPD were recruited to undergo simultaneous assessment of RSC, swallowing safety, and swallowing efficiency. RSC was assessed using respiratory inductive plethysmography and nasal airflow and included measurements of respiratory pause duration, respiratory phase patterning, and lung volume during swallowing. Swallowing safety and efficiency were assessed using flexible endoscopic evaluation of swallowing, analyzed using the Visual Analysis of Swallowing Efficiency and Safety, and included measurements of pharyngeal residue, penetration, and aspiration. All data were blindly analyzed, with 20% of the data repeated for interrater reliability assessment. Multilevel statistical models were used to examine the relationships between RSC and swallowing.\nA total of 812 swallows were analyzed from 24 participants. Only 33.4% of swallows exhibited the typical exhale-swallow-exhale pattern. Additionally, 95% of participants exhibited abnormal swallow function. More severe hypopharyngeal residue ratings were associated with inhaling before the swallow compared to exhaling before the swallow. Additionally, more severe events of penetration and aspiration were associated with (a) inhaling before the swallow compared to exhaling before the swallow, (b) inhaling after the swallow compared to exhaling after the swallow, and (c) longer swallow-related respiratory pause durations. Inhaling after the swallow exhibited the strongest relationship with impairments in swallowing safety when compared to all other RSC variables.\nRSC exhibited significant relationships with pharyngeal residue, penetration, and aspiration in these PwPD. Clinicians should attend to RSC when assessing swallowing in PwPD. Future research is needed to examine if training an exhale-swallow-exhale pattern can be used to improve disordered swallowing in PwPD.\nhttps://doi.org/10.23641/asha.27211770.",
    "authors": [
        {
            "affiliation": "Aerodigestive Innovations Research Lab, Department of Otolaryngology-Head & Neck Surgery, Weill Cornell Medicine, Cornell University, New York, NY.",
            "firstname": "James A",
            "initials": "JA",
            "lastname": "Curtis"
        },
        {
            "affiliation": "Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.",
            "firstname": "James C",
            "initials": "JC",
            "lastname": "Borders"
        },
        {
            "affiliation": "Department of Physical Medicine and Rehabilitation, University of California Davis Medical Center, Sacramento.",
            "firstname": "Brianna",
            "initials": "B",
            "lastname": "Kiefer"
        },
        {
            "affiliation": "The Neurological Institute, Division of Movement Disorders, Department of Neurology, Columbia University Irving Medical Center, New York, NY.\nNeurological Institute, Division of Movement Disorders, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.",
            "firstname": "Roy N",
            "initials": "RN",
            "lastname": "Alcalay"
        },
        {
            "affiliation": "Speech Physiology Laboratory, Department of Communicative Disorders and Sciences, University at Buffalo, NY.",
            "firstname": "Jessica E",
            "initials": "JE",
            "lastname": "Huber"
        },
        {
            "affiliation": "Laboratory for the Study of Upper Airway Dysfunction, Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY.",
            "firstname": "Michelle S",
            "initials": "MS",
            "lastname": "Troche"
        }
    ],
    "conclusions": null,
    "copyrights": null,
    "doi": "10.1044/2024_JSLHR-24-00056",
    "journal": "Journal of speech, language, and hearing research : JSLHR",
    "keywords": [],
    "methods": "Twenty-four PwPD were recruited to undergo simultaneous assessment of RSC, swallowing safety, and swallowing efficiency. RSC was assessed using respiratory inductive plethysmography and nasal airflow and included measurements of respiratory pause duration, respiratory phase patterning, and lung volume during swallowing. Swallowing safety and efficiency were assessed using flexible endoscopic evaluation of swallowing, analyzed using the Visual Analysis of Swallowing Efficiency and Safety, and included measurements of pharyngeal residue, penetration, and aspiration. All data were blindly analyzed, with 20% of the data repeated for interrater reliability assessment. Multilevel statistical models were used to examine the relationships between RSC and swallowing.",
    "publication_date": "2024-10-10",
    "pubmed_id": "39388722",
    "results": "A total of 812 swallows were analyzed from 24 participants. Only 33.4% of swallows exhibited the typical exhale-swallow-exhale pattern. Additionally, 95% of participants exhibited abnormal swallow function. More severe hypopharyngeal residue ratings were associated with inhaling before the swallow compared to exhaling before the swallow. Additionally, more severe events of penetration and aspiration were associated with (a) inhaling before the swallow compared to exhaling before the swallow, (b) inhaling after the swallow compared to exhaling after the swallow, and (c) longer swallow-related respiratory pause durations. Inhaling after the swallow exhibited the strongest relationship with impairments in swallowing safety when compared to all other RSC variables.",
    "title": "Respiratory-Swallow Coordination and Its Relationship With Pharyngeal Residue, Penetration, and Aspiration in People With Parkinson's Disease.",
    "xml": "<Element 'PubmedArticle' at 0x788502b4cd60>"
}