A multinational consensus on dysphagia in Parkinson's disease: screening, diagnosis and prognostic value

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

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: Parkinson's disease (PD) is a neurodegenerative disorder characterized by a combination of motor and non-motor dysfunction. Dysphagia is a common symptom in PD, though it is still too frequently underdiagnosed. Consensus is lacking on screening, diagnosis, and prognosis of dysphagia in PD.

OBJECTIVE: To systematically review the literature and to define consensus statements on the screening and the diagnosis of dysphagia in PD, as well as on the impact of dysphagia on the prognosis and quality of life (QoL) of PD patients.

METHODS: A multinational group of experts in the field of neurogenic dysphagia and/or PD conducted a systematic revision of the literature published since January 1990 to February 2021 and reported the results according to PRISMA guidelines. The output of the research was then analyzed and discussed in a consensus conference convened in Pavia, Italy, where the consensus statements were drafted. The final version of statements was subsequently achieved by e-mail consensus.

RESULTS: Eighty-five papers were used to inform the Panel's statements even though most of them were of Class IV quality. The statements tackled four main areas: (1) screening of dysphagia: timing and tools; (2) diagnosis of dysphagia: clinical and instrumental detection, severity assessment; (3) dysphagia and QoL: impact and assessment; (4) prognostic value of dysphagia; impact on the outcome and role of associated conditions.

CONCLUSIONS: The statements elaborated by the Consensus Panel provide a framework to guide the neurologist in the timely detection and accurate diagnosis of dysphagia in PD.

Original languageEnglish
JournalJ. Neurol.
DOIs
Publication statusE-pub ahead of print - Aug 21 2021

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