Obstructive and restrictive pulmonary dysfunctions in Parkinson's disease
Identifieur interne : 000525 ( Main/Curation ); précédent : 000524; suivant : 000526Obstructive and restrictive pulmonary dysfunctions in Parkinson's disease
Auteurs : Magdalena Sabaté [Espagne] ; Isidro González [Espagne] ; Felix Ruperez [Espagne] ; Manuel Rodríguez [Espagne]Source :
- Journal of the Neurological Sciences [ 0022-510X ] ; 1995.
Abstract
Pulmonary dysfunction was investigated in fifty-eight Parkinson's patients. Clinical disability was assessed by the Unified Parkinson's Disease Rating Scale. Pulmonary dysfunction was studied by spirometry with flow-volume loops, body plethysmography with lung volumes computation and maximal inspiratory and expiratory static mouth pressures. Forced vital capacity (FVC), forced expiratory volume in 1 min (FEV1), FEV1 FVC% and arterial PO2 and PCO2 were significantly below normal values. Residual volume (RV) and total rows were above normal values. Thirty-six had upper airway obstruction as judged by inspiratory flow peaks (PIF) <31/s and FEV1 PEF% (expiratory flow peak) > 8.51/min and MEF50 MIF50 > 1. Eighteen patients had a central (FEV1 < 80% and FEV1 FVC% < 80% of normal values) or peripheral (maximal expiratory flow between 75% and 25% of FVC and maximal expiratory flow after expiration of 50% below 70% of normal values) obstructive pattern. Sixteen patients had a restrictive dysfunction as judged by a total lung capacity < 85% or FVC < 80% with FEV1 FVC% > 80%. Sixteen patients had air trapping (RV > 120% and RV TLC > 40%) and seven patients had lung insufflation (TLC > 120%). Rigidity, Rx signs of cervical arthrosis and limitations for passive movement of neck were higher in patients with central or peripheral airway obstruction. Bradykinesia and Rx signs of dorsal arthrosis was higher in patients with upper airway obstruction. Restrictive dysfunction was not related to tremor, rigidity or bradykinesia. The present data support the hypothesis that Parkinson patients present a high risk for pneumologic disturbances. These pulmonary dysfunctions are induced by the simultaneous action of a group of factors including the degree of bradykinesia or rigidity and the musculoskeletal limitations of vertebral column probably induced by chronic anomalous posture.
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DOI: 10.1016/0022-510X(96)00003-2
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Manuel Rodríguez<affiliation><mods:affiliation>Corresponding autor. Fax: 34-22-603529; Phone; 34-22-603492.</mods:affiliation>
<wicri:noCountry code="no comma">Corresponding autor. Fax: 34-22-603529; Phone; 34-22-603492.</wicri:noCountry>
</affiliation>
<affiliation wicri:level="1"><mods:affiliation>Department of Physiology, Faculty of Medicine, University of La Laguna, 38320, Tenerife, Canary Islands, Spain</mods:affiliation>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Department of Physiology, Faculty of Medicine, University of La Laguna, 38320, Tenerife, Canary Islands</wicri:regionArea>
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<front><div type="abstract" xml:lang="en">Pulmonary dysfunction was investigated in fifty-eight Parkinson's patients. Clinical disability was assessed by the Unified Parkinson's Disease Rating Scale. Pulmonary dysfunction was studied by spirometry with flow-volume loops, body plethysmography with lung volumes computation and maximal inspiratory and expiratory static mouth pressures. Forced vital capacity (FVC), forced expiratory volume in 1 min (FEV1), FEV1 FVC% and arterial PO2 and PCO2 were significantly below normal values. Residual volume (RV) and total rows were above normal values. Thirty-six had upper airway obstruction as judged by inspiratory flow peaks (PIF) <31/s and FEV1 PEF% (expiratory flow peak) > 8.51/min and MEF50 MIF50 > 1. Eighteen patients had a central (FEV1 < 80% and FEV1 FVC% < 80% of normal values) or peripheral (maximal expiratory flow between 75% and 25% of FVC and maximal expiratory flow after expiration of 50% below 70% of normal values) obstructive pattern. Sixteen patients had a restrictive dysfunction as judged by a total lung capacity < 85% or FVC < 80% with FEV1 FVC% > 80%. Sixteen patients had air trapping (RV > 120% and RV TLC > 40%) and seven patients had lung insufflation (TLC > 120%). Rigidity, Rx signs of cervical arthrosis and limitations for passive movement of neck were higher in patients with central or peripheral airway obstruction. Bradykinesia and Rx signs of dorsal arthrosis was higher in patients with upper airway obstruction. Restrictive dysfunction was not related to tremor, rigidity or bradykinesia. The present data support the hypothesis that Parkinson patients present a high risk for pneumologic disturbances. These pulmonary dysfunctions are induced by the simultaneous action of a group of factors including the degree of bradykinesia or rigidity and the musculoskeletal limitations of vertebral column probably induced by chronic anomalous posture.</div>
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