Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 May 11;59(5):921.
doi: 10.3390/medicina59050921.

Cut-Off Value of Voluntary Peak Cough Flow in Patients with Parkinson's Disease and Its Association with Severe Dysphagia: A Retrospective Pilot Study

Affiliations

Cut-Off Value of Voluntary Peak Cough Flow in Patients with Parkinson's Disease and Its Association with Severe Dysphagia: A Retrospective Pilot Study

Kyeong-Woo Lee et al. Medicina (Kaunas). .

Abstract

Background and Objectives. Swallowing and coughing reflexes are both closely associated with airway protection. Peak cough flow (PCF) is associated with dysphagia in several neurogenic diseases. In this study, we aimed to analyze the relationship between PCF and aspiration in Parkinson's disease (PD) and determine the cut-off value of PCF. Materials and Methods. We retrospectively analyzed the records of patients with PD who underwent a videofluoroscopic swallowing study and checked for PCF. A total of 219 patients were divided into an aspiration group (n = 125) and a non-aspiration group (n = 94). Results. Significantly lower PCF values were observed in the aspiration group compared to the non-aspiration group (132.63 ± 83.62 vs. 181.38 ± 103.92 L/min, p < 0.001). Receiver operating characteristic curve analysis revealed that a PCF cut-off value of 153 L/min (area under the receiver operating characteristic curve, 0.648; sensitivity, 73.06%; specificity, 51.06%) was associated with aspiration in PD. Additionally, a univariate analysis showed that the male sex, lower body mass indexes, higher Hoehn and Yahr scales, and PCF values of ≤153 L/min indicated an increased risk of aspiration. Conclusions. Through a multivariate analysis, we demonstrated that a PCF value ≤153 L/min was associated with an increased risk of aspiration (odds ratio 3.648; 1.797-7.407), highlighting that a low PCF is a risk factor for aspiration in patients with PD.

Keywords: Parkinson’s disease; aspiration; dysphagia; peak cough flow.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PCF values of the non-aspiration group and the aspiration group.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve analysis for the cut-off values of PCF (L/min).

Similar articles

Cited by

References

    1. Pal P.K., Sathyaprabha T.N., Tuhina P., Thennarasu K. Pattern of subclinical pulmonary dysfunctions in Parkinson’s disease and the effect of levodopa. Mov. Disord. 2007;22:420–424. doi: 10.1002/mds.21330. - DOI - PubMed
    1. Hegland K.W., Okun M.S., Troche M.S. Sequential voluntary cough and aspiration or aspiration risk in Parkinson’s disease. Lung. 2014;192:601–608. doi: 10.1007/s00408-014-9584-7. - DOI - PMC - PubMed
    1. Ebihara S., Saito H., Kanda A., Nakajoh M., Takahashi H., Arai H., Sasaki H. Impaired efficacy of cough in patients with Parkinson disease. Chest. 2003;124:1009–1015. doi: 10.1378/chest.124.3.1009. - DOI - PubMed
    1. Bolser D.C., Gestreau C., Morris K.F., Davenport P.W., Pitts T.E. Central neural circuits for coordination of swallowing, breathing, and coughing: Predictions from computational modeling and simulation. Otolaryngol. Clin. N. Am. 2013;46:957–964. doi: 10.1016/j.otc.2013.09.013. - DOI - PMC - PubMed
    1. Troche M.S., Brandimore A.E., Godoy J., Hegland K.W. A framework for understanding shared substrates of airway protection. J. Appl. Oral Sci. 2014;22:251–260. doi: 10.1590/1678-775720140132. - DOI - PMC - PubMed

Grants and funding

This work was supported by the Dong-A University research fund.