Highlights
- •Swallowing functions were assessed in 50 patients with Parkinson's disease.
- •Therapeutic effects on swallowing were compared between levodopa and rotigotine.
- •Videofluoroscopic examinations were performed before and after treatment.
- •Rotigotine was more consistently effective on swallowing functions than levodopa.
- •Continuous dopaminergic stimulation may be important in swallowing.
Abstract
Objectives
Abnormal swallowing or dysphagia is a potentially fatal symptom in Parkinson's disease
(PD) and is characterized by frequent silent aspiration, which is an unrecognized
risk for aspiration pneumonia. While the effects of oral levodopa on swallowing functions
remain controversial, several small-scale studies have reported that rotigotine transdermal
patch seems effective. The different effects between levodopa and rotigotine may be
attributed to continuous dopaminergic stimulation (CDS), however, the absence of direct
comparative evidence precludes conclusion.
Methods
In the present retrospective open-label study of 50 patients with PD, swallowing functions
were assessed via videofluoroscopic (VF) examination before and after treatment. Treatment
included 2 mg/day rotigotine transdermal patch (N = 29) or 200 mg/day oral levodopa with carbidopa (N = 21) in drug-naïve and add-on groups of patients.
Results
Rotigotine more consistently improved all measures assessed via VF examination. Such
effects were similar to those in the drug-naïve and add-on groups. Improvement and
responder rates of certain measures were significantly higher in the rotigotine group
than in the levodopa group.
Conclusions
Our finding that rotigotine (levodopa equivalent dose = 60 mg) was more consistently
effective than 200 mg/day oral levodopa suggests that CDS is more important in improving
swallowing functions.
Keywords
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Article info
Publication history
Published online: July 09, 2019
Accepted:
July 8,
2019
Received in revised form:
June 12,
2019
Received:
April 30,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
