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Sun J, Cheng L, Li Z, Jia J, Wu Q, Hou Y, Wang Q, Zhang G, Wang H, Li X, Li W, Zhang C. Deep brain stimulation of the subthalamic nucleus increases the risk of sialorrhea in patients with advanced Parkinson's disease. Parkinsonism Relat Disord 2024; 123:106075. [PMID: 38492517 DOI: 10.1016/j.parkreldis.2024.106075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION Sialorrhea is a common neurological manifestation of Parkinson's disease (PD). No specifically designed prospective study has tested the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) on sialorrhea in patients with advanced PD. We focused on the effect of STN-DBS on the incidence of sialorrhea in patients with PD. METHODS This multicenter, prospective, non-randomized concurrent clinical trial analyzed the incidence of sialorrhea during long-term follow-up in 170 patients with advanced PD (84 patients with STN-DBS and 86 patients with medication therapy). RESULTS After STN-DBS, 58.1% of patients presented with sialorrhea (Drooling Rating Scale (DRS) > 5) compared with 39.3% of patients with medication therapy (P < 0.001). STN-DBS stimulation demonstrated a significant increase in DRS and Drooling Severity and Frequency Scale (DSFS) compared with the patients with medication therapy (P < 0.001). At follow-up, the onabotulinumtoxin-A (BTX-A) injection ratio was significantly higher in the STN-DBS group (29.8% vs. 11.9%, P = 0.0057) compared with the patients with medication therapy. CONCLUSIONS STN-DBS increased the risk of sialorrhea in patients with advanced PD. TRIAL REGISTRATION clinicaltrials. gov (NCT06090929).
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Affiliation(s)
- Jinxing Sun
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Lian Cheng
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Zhenke Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Junheng Jia
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Qianqian Wu
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Ying Hou
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Qi Wang
- Department of Gerontology, Shandong Provincial Qianfoshan Hospital, Jinan, 250013, China
| | - Guangjian Zhang
- Department of Neurology, Weifang People's Hospital, Weifang, 261044, China
| | - Hong Wang
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Xingang Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Weiguo Li
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
| | - Chao Zhang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Jinan, 250012, China; Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China.
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Melleu FF, Canteras NS. Pathways from the Superior Colliculus to the Basal Ganglia. Curr Neuropharmacol 2024; 22:1431-1453. [PMID: 37702174 PMCID: PMC11097988 DOI: 10.2174/1570159x21666230911102118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 02/22/2023] [Accepted: 02/26/2023] [Indexed: 09/14/2023] Open
Abstract
The present work aims to review the structural organization of the mammalian superior colliculus (SC), the putative pathways connecting the SC and the basal ganglia, and their role in organizing complex behavioral output. First, we review how the complex intrinsic connections between the SC's laminae projections allow for the construction of spatially aligned, visual-multisensory maps of the surrounding environment. Moreover, we present a summary of the sensory-motor inputs of the SC, including a description of the integration of multi-sensory inputs relevant to behavioral control. We further examine the major descending outputs toward the brainstem and spinal cord. As the central piece of this review, we provide a thorough analysis covering the putative interactions between the SC and the basal ganglia. To this end, we explore the diverse thalamic routes by which information from the SC may reach the striatum, including the pathways through the lateral posterior, parafascicular, and rostral intralaminar thalamic nuclei. We also examine the interactions between the SC and subthalamic nucleus, representing an additional pathway for the tectal modulation of the basal ganglia. Moreover, we discuss how information from the SC might also be relayed to the basal ganglia through midbrain tectonigral and tectotegmental projections directed at the substantia nigra compacta and ventrotegmental area, respectively, influencing the dopaminergic outflow to the dorsal and ventral striatum. We highlight the vast interplay between the SC and the basal ganglia and raise several missing points that warrant being addressed in future studies.
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Affiliation(s)
| | - Newton Sabino Canteras
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
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Doruk C, Çaytemel B, Şahin E, Kara H, Samancı B, Abay SN, Bilgiç B, Hanağası H, Başaran B, Enver N, Rameau A. Evaluation of Post-Swallow Residue with Visual Analysis of Swallowing Efficiency and Safety in Patients with Idiopathic Parkinson's Disease. EAR, NOSE & THROAT JOURNAL 2023:1455613231210976. [PMID: 38050868 DOI: 10.1177/01455613231210976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
Objectives: Dysphagia is common in idiopathic Parkinson's disease (IPD) and is associated with impairments in both swallowing safety and swallowing efficiency. The goals of this study were to define post-swallow residue patterns in people with IPD and describe pathophysiological endoscopic findings affecting residue accumulation. Methods: This was a prospective single-blinded cross-sectional cohort study of patients with the diagnosis of IPD recruited from a Movement Disorder Clinic. Clinical variables included patient age, cognitive function, and measures of disease severity, and laryngoscopic examinations with a flexible endoscopic evaluation of swallowing (FEES) were completed for each patient. Visual Analysis of Swallowing Efficiency and Safety (VASES) was used to analyze FEES. Post-swallow residue outcomes and non-residue endoscopic outcomes including the Bowing index, Penetration Aspiration Scale (PAS) score, premature leakage, and build-up phenomenon were evaluated. Multiple regression models were used to evaluate factors affecting the residue at different anatomic levels. Results: Overall 53 patients completed the study. The multiple regression analyses showed a relation between (1) the presence of residue at the level of oropharynx and epiglottis with premature leakage, (2) the presence of residue at the level of the laryngeal vestibule and vocal folds with build-up phenomenon, and (3) the presence of residue at the level of the hypopharynx, laryngeal vestibule, and subglottis with airway invasion. Conclusion: Residue pattern during FEES is associated with specific swallow dysfunctions in IPD. Using residue localization and quantification may be a helpful tool in assessing the impact of targeted swallowing interventions in patients with IPD and dysphagia.
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Affiliation(s)
- Can Doruk
- Istanbul Faculty of Medical, Department of Otolaryngology Head and Neck Surgery, Istanbul University, Istanbul, Turkey
- Division of Laryngology, Department of Otolaryngology Head and Neck Surgery, Columbia University Irving Medical School, New York, NY, USA
| | - Berkay Çaytemel
- Istanbul Faculty of Medical, Department of Otolaryngology Head and Neck Surgery, Istanbul University, Istanbul, Turkey
| | - Erdi Şahin
- Department of Neurology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Hakan Kara
- Istanbul Faculty of Medical, Department of Otolaryngology Head and Neck Surgery, Istanbul University, Istanbul, Turkey
| | - Bedia Samancı
- Department of Neurology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Sevinç Nisa Abay
- Department of Neurology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
- Işık University, Istanbul, Turkey
| | - Başar Bilgiç
- Department of Neurology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Haşmet Hanağası
- Department of Neurology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Bora Başaran
- Istanbul Faculty of Medical, Department of Otolaryngology Head and Neck Surgery, Istanbul University, Istanbul, Turkey
| | - Necati Enver
- Department of Otolaryngology, Head and Neck Surgery, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Anais Rameau
- Department of Otolaryngology-Head & Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, NY, USA
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Cheng I, Sasegbon A, Hamdy S. Dysphagia treatments in Parkinson's disease: A systematic review and meta-analysis. Neurogastroenterol Motil 2023; 35:e14517. [PMID: 36546568 DOI: 10.1111/nmo.14517] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/02/2022] [Accepted: 11/27/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND The majority of patients with Parkinson's disease (PD) develop oropharyngeal dysphagia during the course of their disease. However, the efficacy of dysphagia treatments for these patients remains controversial. Therefore, we conducted this systematic review and meta-analysis to evaluate treatment efficacy based on the evidence from randomized controlled trials (RCTs). METHODS Five electronic databases were systematically searched from inception date to April 2022. Two reviewers independently extracted and analyzed the data. The outcome measures were changes in swallowing-related characteristics based on instrumental swallowing assessments. KEY RESULTS An initial search identified 187 RCT studies of relevance. After screening, nine studies with a total sample size of 286 were included in the meta-analysis. The pooled effect size for all dysphagia treatments compared with control comparators was significant and medium (SMD [95% CI] = 0.58 [0.22, 0.94], p = 0.001; I2 = 50%). Subgroup analysis revealed a significant and medium pooled effect size for stimulation treatments (brain stimulation, peripheral neurostimulation and acupuncture) (SMD [95% CI] = 0.54 [0.15, 0.92]; p = 0.006; I2 = 22%). Specifically, the effect sizes for the single RCTs on neuromuscular stimulation (SMD [95% CI] = 1.58 [0.49, 2.86]; p = 0.005) and acupuncture (SMD [95% CI] = 0.82 [0.27, 1.37]; p = 0.003) were significant and large. CONCLUSIONS AND INFERENCES Our results showed that overall, dysphagia treatments, particularly stimulation treatments, can potentially benefit PD patients. However, given the limited number of small RCTs for each type of treatment, the evidence remains weak and uncertain. Further large-scale, multicenter RCTs are warranted to fully explore their clinical efficacy in the PD population.
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Affiliation(s)
- Ivy Cheng
- Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Ayodele Sasegbon
- Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Shaheen Hamdy
- Centre for Gastrointestinal Sciences, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Villadóniga M, Cabañes-Martínez L, López-Viñas L, Fanjul S, del Álamo M, Regidor I. Combined Stimulation of the Substantia Nigra and the Subthalamic Nucleus for the Treatment of Refractory Gait Disturbances in Parkinson's Disease: A Preliminary Study. J Clin Med 2022; 11:jcm11082269. [PMID: 35456362 PMCID: PMC9027187 DOI: 10.3390/jcm11082269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 12/10/2022] Open
Abstract
Deep brain stimulation of the subthalamic nucleus is efficient for the treatment of motor symptoms (i.e., tremors) in patients with Parkinson's disease. Gait disorders usually appear during advanced stages of idiopathic Parkinson's disease in up to 80% of patients and have an important impact on their quality of life. The effects of deep brain stimulation of the subthalamic nucleus on gait and balance are still controversial. For this reason, alternative targets have been considered, such as stimulation of the pedunculopontine nucleus and the pars reticulata of substantia nigra, involved in the integration of the functional connections for gait. Due to the proximity of the subthalamic nucleus to the substantia nigra, their combined stimulation is feasible and may lead to better outcomes, improving axial symptoms. Our objective was to prospectively compare simultaneous stimulation of both structures versus conventional subthalamic stimulation in improving gait disorders. In ten patients with advanced Parkinson's disease, deep brain stimulation leads (eight linear contacts) were implanted, and gait analysis was performed 6 months after surgery in off-stimulation and after 4 weeks of dual or single subthalamic stimulation. An improvement in gait parameters was confirmed with both stimulation conditions, with better results with combined substantia nigra and subthalamic stimulation compared with conventional subthalamic stimulation. Further studies are needed to determine if this effect remains after long-term dual-target stimulation.
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Affiliation(s)
- Marta Villadóniga
- Department of Clinical Neurophysiology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (M.V.); (L.L.-V.); (I.R.)
| | - Lidia Cabañes-Martínez
- Department of Clinical Neurophysiology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (M.V.); (L.L.-V.); (I.R.)
- Correspondence:
| | - Laura López-Viñas
- Department of Clinical Neurophysiology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (M.V.); (L.L.-V.); (I.R.)
| | - Samira Fanjul
- Department of Neurology, Hospital Ramón y Cajal, 28034 Madrid, Spain;
| | - Marta del Álamo
- Department of Neurosurgery, Hospital Ramón y Cajal, 28034 Madrid, Spain;
| | - Ignacio Regidor
- Department of Clinical Neurophysiology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (M.V.); (L.L.-V.); (I.R.)
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Warnecke T, Schäfer KH, Claus I, Del Tredici K, Jost WH. Gastrointestinal involvement in Parkinson's disease: pathophysiology, diagnosis, and management. NPJ Parkinsons Dis 2022; 8:31. [PMID: 35332158 PMCID: PMC8948218 DOI: 10.1038/s41531-022-00295-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 02/23/2022] [Indexed: 12/12/2022] Open
Abstract
Growing evidence suggests an increasing significance for the extent of gastrointestinal tract (GIT) dysfunction in Parkinson's disease (PD). Most patients suffer from GIT symptoms, including dysphagia, sialorrhea, bloating, nausea, vomiting, gastroparesis, and constipation during the disease course. The underlying pathomechanisms of this α-synucleinopathy play an important role in disease development and progression, i.e., early accumulation of Lewy pathology in the enteric and central nervous systems is implicated in pharyngeal discoordination, esophageal and gastric motility/peristalsis impairment, chronic pain, altered intestinal permeability and autonomic dysfunction of the colon, with subsequent constipation. Severe complications, including malnutrition, dehydration, insufficient drug effects, aspiration pneumonia, intestinal obstruction, and megacolon, frequently result in hospitalization. Sophisticated diagnostic tools are now available that permit more detailed examination of specific GIT impairment patterns. Furthermore, novel treatment approaches have been evaluated, although high-level evidence trials are often missing. Finally, the burgeoning literature devoted to the GIT microbiome reveals its importance for neurologists. We review current knowledge about GIT pathoanatomy, pathophysiology, diagnosis, and treatment in PD and provide recommendations for management in daily practice.
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Affiliation(s)
- T Warnecke
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, 48149, Münster, Germany
| | - K-H Schäfer
- Research and Transfer Working Group Enteric Nervous System (AGENS), University of Applied Sciences Kaiserslautern, Campus Zweibrücken, 66482, Zweibrücken, Germany
| | - I Claus
- Department of Neurology with Institute of Translational Neurology, University Hospital of Münster, 48149, Münster, Germany
| | - K Del Tredici
- Clinical Neuroanatomy, Department of Neurology, Center for Biomedical Research, University of Ulm, 89081, Ulm, Germany
| | - W H Jost
- Parkinson-Klinik Ortenau, 77709, Wolfach, Germany.
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Consensus on the treatment of dysphagia in Parkinson's disease. J Neurol Sci 2021; 430:120008. [PMID: 34624796 DOI: 10.1016/j.jns.2021.120008] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 02/07/2023]
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.
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Chang MC, Park JS, Lee BJ, Park D. The Effect of Deep Brain Stimulation on Swallowing Function in Parkinson's Disease: A Narrative Review. Dysphagia 2021; 36:786-799. [PMID: 33389176 DOI: 10.1007/s00455-020-10214-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/10/2020] [Indexed: 01/04/2023]
Abstract
Unlike appendicular motor symptoms, such as bradykinesia and rigidity, in Parkinson's disease (PD), which have already been reported to respond well to deep brain stimulation (DBS), there is limited literature on the effects of DBS on swallowing function in patients with PD. The field lacks consensus as there are conflicting reports among existing studies regarding whether swallowing function improves or declines following DBS implantation. This narrative review aims to summarize and analyze the studies published on the effect of DBS on swallowing function in patients with PD. We collated studies published up to February 2020 using a comprehensive electronic database search of PubMed, SCOPUS, EMBASE, and the Cochrane Library. Two reviewers independently assessed the studies using strict inclusion and exclusion criteria. The primary literature search yielded 529 relevant papers. After reading their titles and abstracts and assessing their eligibility based on the full-text, we finally included and reviewed 14 publications. Nine of these studies reported positive effects of DBS on swallowing function and four studies showed no significant positive results. The remaining study showed decreased swallowing function after unilateral subthalamic nucleus-DBS surgery. In conclusion, we found that DBS has the potential to improve swallowing function in patients with PD. However, high-quality evidence is lacking. To clearly elucidate the effect of DBS on swallowing function in patients with PD, high-quality randomized controlled trials should be conducted in the future.
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Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Jin-Sung Park
- Department of Neurology, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, Republic of Korea
| | - Byung Joo Lee
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu, Republic of Korea
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunghwndo-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
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Yu H, Takahashi K, Bloom L, Quaynor SD, Xie T. Effect of Deep Brain Stimulation on Swallowing Function: A Systematic Review. Front Neurol 2020; 11:547. [PMID: 32765388 PMCID: PMC7380112 DOI: 10.3389/fneur.2020.00547] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 05/14/2020] [Indexed: 12/18/2022] Open
Abstract
The effect of deep brain stimulation (DBS) on swallowing function in movement disorders is unclear. Here, we systematically reviewed this topic by searching keywords following PICOS strategy of problem (swallowing or swallow or dysphagia or aspiration) and intervention (deep brain stimulation, or DBS) in the PubMed and Web of Science in English in April 2020, with comparators [subthalamic nucleus (STN), globus pallidus interna (GPi), ventralis intermedius, (ViM), post-subthalamic area, or caudal zona incerta (PSA/cZi); ON/OFF DBS state/settings, ON/OFF medication state, Parkinson's disease (PD), dystonia, tremor], outcomes (swallowing function measures, subjective/objective) and study types (good quality original studies) in mind. We found that STN DBS at usual high-frequency stimulation could have beneficial effect (more so on subjective measures and/or OFF medication), no effect, or detrimental effect (more so on objective measures and/or ON medication) on swallowing function in patients with PD, while low-frequency stimulation (LFS) could have beneficial effect on swallowing function in patients with freezing of gait. GPi DBS could have a beneficial effect (regardless of medication state and outcome measures) or no effect, but no detrimental effect, on swallowing function in PD. GPi DBS also has beneficial effects on swallowing function in majority of the studies on Meige syndrome but not in other diseases with dystonia. PSA/cZi DBS rarely has detrimental effect on swallowing functions in patients with PD or tremor. There is limited information on ViM to assess. Information on swallowing function by DBS remains limited. Well-designed studies and direct comparison of targets are further needed.
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Affiliation(s)
- Huiyan Yu
- Department of Neurology, Beijing Hospital, National Center of Gerontology, Beijing, China.,Department of Neurology, The University of Chicago Medicine, Chicago, IL, United States
| | - Kazutaka Takahashi
- Department of Organismal Biology and Anatomy, The University of Chicago, Chicago, IL, United States
| | - Lisa Bloom
- Department of Neurology, The University of Chicago Medicine, Chicago, IL, United States.,Speech and Swallowing Service, The University of Chicago Medicine, Chicago, IL, United States
| | - Samuel D Quaynor
- Department of Neurology, The University of Chicago Medicine, Chicago, IL, United States
| | - Tao Xie
- Department of Neurology, The University of Chicago Medicine, Chicago, IL, United States
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