Abstract
Pulmonary function was investigated in 31 consecutive patients with relatively severe Parkinson's disease. Clinical disability was assessed by Hoehn and Yahr scale, Northwestern University Disability Scale and Websterscore. All patients were on levodopa substitution therapy and used anticholinergics. Pulmonary function was investigated by spirography, determination of a maximal inspiratory and expiratory flow-volume curve and, when possible, maximal static mouth pressures were determined. Peak inspiratory and expiratory flow, maximal expiratory flow at 50% and maximal static mouth pressures were significantly below normal values. Vital capacity, forced inspiratory volume in 1 s and the ratio of forced expiratory volume in 1 s and vital capacity were relatively normal. Nine patients had upper airway obstruction (UAO) as judged by abnormal values for peak inspiratory flow, the ratio of forced expiratory volume in 1 s and peak expiratory flow and the ratio of maximal expiratory and inspiratory flow at 50%. Flow-volume curves were normal in eight patients; four patients demonstrated flow decelerations and accelerations (type A) and 16 had a rounded off flow-volume curve (type B). Type A can be explained by UAO and type B by a combination of decreased effective muscle strength and possible UAO. Overall results of pulmonary function tests in patients without any clinical signs or symptoms of pulmonary disease point to subclinical upper airway obstruction and decreased effective muscle strength in a significant proportion of patients.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Black L. F., Hyatt R. E. Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis. 1969 May;99(5):696–702. doi: 10.1164/arrd.1969.99.5.696. [DOI] [PubMed] [Google Scholar]
- Bogaard J. M., Pauw K. H., Versprille A. Flow limitation in upper-airway obstruction. Theoretical analysis. ORL J Otorhinolaryngol Relat Spec. 1987;49(1):42–47. doi: 10.1159/000275905. [DOI] [PubMed] [Google Scholar]
- CANTER G. J., DE LA TORRE R., MIER M. A method for evaluating disability in patients with Parkinson's disease. J Nerv Ment Dis. 1961 Aug;133:143–147. doi: 10.1097/00005053-196108000-00010. [DOI] [PubMed] [Google Scholar]
- Estenne M., Hubert M., De Troyer A. Respiratory-muscle involvement in Parkinson's disease. N Engl J Med. 1984 Dec 6;311(23):1516–1517. doi: 10.1056/NEJM198412063112314. [DOI] [PubMed] [Google Scholar]
- Hoehn M. M., Yahr M. D. Parkinsonism: onset, progression and mortality. Neurology. 1967 May;17(5):427–442. doi: 10.1212/wnl.17.5.427. [DOI] [PubMed] [Google Scholar]
- Hyatt R. E., Black L. F. The flow-volume curve. A current perspective. Am Rev Respir Dis. 1973 Feb;107(2):191–199. doi: 10.1164/arrd.1973.107.2.191. [DOI] [PubMed] [Google Scholar]
- Lilker E. S., Woolf C. R. Pulmonary function in Parkinson's syndrome: the effect of thalamotomy. Can Med Assoc J. 1968 Oct 19;99(15):752–757. [PMC free article] [PubMed] [Google Scholar]
- Neu H. C., Connolly J. J., Jr, Schwertley F. W., Ladwig H. A., Brody A. W. Obstructive respiratory dysfunction in parkinsonian patients. Am Rev Respir Dis. 1967 Jan;95(1):33–47. doi: 10.1164/arrd.1967.95.1.33. [DOI] [PubMed] [Google Scholar]
- Obenour W. H., Stevens P. M., Cohen A. A., McCutchen J. J. The causes of abnormal pulmonary function in Parkinson's disease. Am Rev Respir Dis. 1972 Mar;105(3):382–387. doi: 10.1164/arrd.1972.105.3.382. [DOI] [PubMed] [Google Scholar]
- Schiffman P. L. A "saw-tooth" pattern in Parkinson's disease. Chest. 1985 Jan;87(1):124–126. doi: 10.1378/chest.87.1.124. [DOI] [PubMed] [Google Scholar]
- Vincken W. G., Gauthier S. G., Dollfuss R. E., Hanson R. E., Darauay C. M., Cosio M. G. Involvement of upper-airway muscles in extrapyramidal disorders. A cause of airflow limitation. N Engl J Med. 1984 Aug 16;311(7):438–442. doi: 10.1056/NEJM198408163110704. [DOI] [PubMed] [Google Scholar]
- Vincken W., Ghezzo H., Cosio M. G. Maximal static respiratory pressures in adults: normal values and their relationship to determinants of respiratory function. Bull Eur Physiopathol Respir. 1987 Sep-Oct;23(5):435–439. [PubMed] [Google Scholar]
- Webster D. D. Critical analysis of the disability in Parkinson's disease. Mod Treat. 1968 Mar;5(2):257–282. [PubMed] [Google Scholar]