Dystussia and Dysphagia in Parkinson’s Disease
Aspiration pneumonia is the leading cause of death in Parkinson’s disease (PD) and much of this pulmonary sequelae can likely be attributed to the concomitant presence of swallowing (dysphagia) and cough (dystussia) disturbances, which are often present in PD.1 – 4 This case highlights the need to evaluate and manage behaviors across the continuum of airway protection (from cough to swallowing) for improved long-term health outcomes.
GB was a 69-year-old man who presented with Hoehn and Yahr stage III PD with symptom onset 8 years prior. His medical history was also significant for right unilateral subthalamic nucleus (STN) deep brain stimulation (DBS) surgery followed by left globus pallidus interna (GPi) DBS surgery 3 years later. Of note, DBS has evolved as the management option of choice for persons with PD. The two subcortical structures most commonly targeted during surgery for the treatment of PD are the STN and GPi. Although STN and GPi DBS are generally considered safe and effective for the treatment of people with PD, less is known about the impact of DBS on airway protection. Recent work suggests that STN DBS may result in adverse effects to swallowing function, which are not observed with GPi DBS.