Biological determinants and neural compensatory mechanisms of oropharyngeal dysphagia in Parkinson’s disease

• Applicant: Dr. Bendix Labeit
• Subject Area: Clinical Neurology; Neurosurgery and Neuroradiology ; Biogerontology and Geriatric Medicine ; Human Cognitive and Systems Neuroscience
• Term: since 2024
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 529859742

Dysphagia in Parkinson’s disease is a common and clinically relevant symptom associated with high mortality due to serious complications such as aspiration pneumonia and malnutrition. The pathophysiology of dysphagia in Parkinson's disease is rudimentarily understood to date: Both central mechanisms, such as dopamine deficiency, and peripheral mechanisms, such as pharyngeal sensory dysfunction, are discussed. In addition, an extensive cortical and subcortical network is involved in the central control of swallowing, which is presumably affected by neurodegeneration. Single pilot studies have described neuroplasticity and cortical activation during swallowing as a compensatory mechanism of impaired swallowing function. In contrast, the relationship between clinical and biological determinants and preserved capacity for adaptive neuroplasticity as a compensatory mechanism of dysphagia has not been investigated to date. In this research project, the swallowing function of patients with Parkinson's disease will be systematically investigated using Flexible Endoscopic Evaluation of Swallowing (FEES). Influencing factors such as cognitive function, frailty, sarcopenia, impairment of sensitivity including sense of smell and taste, alterations of biochemical signal cascades and central nervous control of swallowing will be comprehensively characterized using validated clinical and technical procedures. In addition, the consequences of dysphagia on quality of life, nutritional status, fluid balance and morbidity will be assessed. The aims of this research project are 1) the mechanistic phenotyping of dysphagia in Parkinson’s disease, 2) the identification of the main clinical and biological determinants, and 3) the characterization of neuroplastic adaptive mechanisms of the central nervous system to maintain swallowing function despite neurodegeneration. Such findings represent the prerequisite for the targeted development of evidence-based therapeutic approaches in dysphagia rehabilitation.

• DFG Programme: WBP Position