Lingual pressure dysfunction contributes to reduced swallowing-related quality of life in Parkinson’s disease

Purpose: Dysphagia in Parkinson’s disease (PD) is a major cause of depression and reduced quality of life (QOL). PD-related dysphagia often involves lingual dysfunction and weak pressure generation. The relation of disordered lingual pressure generation to swallowing-related QOL in persons with PD remains unknown. Method: Twenty-four persons with idiopathic PD completed the Swallowing Quality of Life (SWAL-QOL) questionnaire and an evaluation of anterior and posterior tongue strength. Peak pressures were compared to age- and sex-matched controls. The magnitude of and latency to peak pressure were explored in relation to SWAL-QOL scores. Results: Persons with PD exhibited significant anterior (p = .019) but not posterior (p = .081) lingual weakness compared to controls. Persons with PD and reduced anterior tongue strength (< 42 kPa) reported lower SWAL-QOL total (p = .043), extended eating durations (p = .025), and a reduced desire to eat (p = .020). Prolonged latency to peak anterior pressure in PD inversely correlated with SWAL-QOL total (r = -.750, p < .001) and served as a significant, independent predictor of 67% of the variance in SWAL-QOL total when controlling for age, sex, and disease stage. Conclusion: Overall, SWAL-QOL scores declined in the presence of lingual pressure dysfunction. Lingual weakness and prolonged pressure building patterns secondary to PD, especially of the anterior tongue, may represent clinically relevant disruptions to mealtime behaviors that undermine swallowing-related QOL. These preliminary findings support further investigation of lingual pressure patterns in PD to help identify debilitating dysphagia and develop treatment strategies.