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Assessing Swallowing & Cough Dysfunction in Patients with Parkinson's Disease

presented by Michelle Troche, PhD, CCC-SLP

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Financial: National Institutes of Health (Grant funds) Michael J Fox Foundation (Grant funds) CurePSP Foundation (Grant funds) Non-Financial: American Speech-Language Hearing Association (ASHA) - member International Society for the Advancement of Respiratory Psychophysiology (ISARP) – board member, President-elect Dysphagia Research Society - member Academy of Neurologic Communication Disorders and Sciences (ANCDS) - member

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

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Video Runtime: 111 Minutes; Learning Assessment Time: 39 Minutes

Dysphagia is an inevitable consequence of Parkinson's disease (PD). In fact, aspiration pneumonia is a leading cause of death in PD. The goal of this course is to provide information related to the assessment of airway protection, including swallowing and cough dysfunction in people with PD. The following topics will be addressed: 1) mechanisms underlying airway protective dysfunction in PD, and 2) methods for comprehensive assessment of swallowing and cough in PD. This information will help inform treatment planning and decision making for improved airway protection in PD (See Managing Swallowing and Cough Dysfunction in Parkinson's Disease).

Meet Your Instructor

Michelle Troche, PhD, CCC-SLP

Dr. Michelle S. Troche is currently an Assistant Professor in the Communication Sciences and Disorders Program, Department of Biobehavioral Sciences at Teachers College, Columbia University. Additionally, she holds adjunct positions in the departments of Neurology and Otolaryngology. She completed her doctoral studies at the University of Florida, where she also served as a faculty member…

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Chapters & Learning Objectives

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1. An Introduction to the Shared Substrates of Airway Protection

In this chapter, we will discuss the shared substrates of swallowing and cough for airway protection. We will introduce a framework for understanding the shared substrates of airway protection.

2. An Introduction to Parkinson’s Disease

In this chapter, we will discuss the underlying mechanisms of dysfunction resulting in PD. We will also discuss the variable dysfunction associated with PD which is relevant to the management of dysphagia in PD. We will briefly address the current medical management of PD (i.e. Levodopa, DBS, etc).

3. Airway Protective Dysfunction in PD

In this chapter, we will discuss how PD causes swallowing dysfunction. We will discuss what is known about swallowing biomechanics and airway protection in PD. We will discuss the role of PD severity on swallowing dysfunction.

4. Disease-Specific Factors and Their Influence on Airway Protection in PD

In this chapter, we will discuss the role of some PD-specific factors on airway protection in PD. We will focus on the influence of deep brain stimulation, PD medications, and dyskinesia on swallowing outcomes.

5. Assessment of Airway Protection in PD: Swallowing

In this chapter, we will discuss the role of a comprehensive and hypothesis-driven approach to the proper evaluation of airway protection in PD. We will focus on the use of instrumental swallowing assessment paired with adjunctive measures of swallowing physiology for the development of the management plan.

6. Assessment of Airway Protection in PD: Cough

In this chapter, we will continue to discuss the role of a comprehensive and hypothesis-driven approach to the proper evaluation of airway protection in PD. We will focus on the use of quantitative approaches to the assessment of cough-related outcomes, in both the laboratory and the clinic.

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