OBJECTIVE

To evaluate the main symptoms of the upper gastrointestinal dysfunction (salivation and swallowing disorders) and to determine their impact on the quality of life for patients with PD of stages I—III, as well as the possibility of their correction by dopamine receptor agonists.

MATERIAL AND METHODS

252 patients (128 women and 124 men, 42—80 years old) with PD of stages I—III were examined using: UPDRS items «salivation», «swallowing» and «anorexia», scale of daily activity (Schwab and England ADL scale), questionnaire quality of life (PDQ-39), measurement of saliva amount, BMI, MMSE scale; 53 patients were treated with piribedil during 6 months.

RESULTS

The upper gastrointestinal tract dysfunction of mild to moderate severity was detected in 51.2% of patients. The prevalence of sialorrhea was 38.9, 42.9 and 46.2%, and that of dysphagia was 22.2, 24.3 and 17.3% at stages I—III, respectively. According to the results of the correlation analysis dysphagia is associated with a long history of PD, low BMI, high doses of levodopa and low Sch & En score; and sialorrhea is also associated with low BMI and with old age. For the early stages of PD we can tell, that the quality of patients’ life deteriorates, and this to a large extent is due to impaired salivation and swallowing, which manifest themselves in daily activity and communication difficulties.

CONCLUSIONS

The inclusion of piribedil (150—250 mg/day) in the 6-months therapy reduces the dysfunction of the upper gastrointestinal tract (by 61 and 74% of the initial level of dysphagia and sialorrhea, respectively) regardless the drug use in monotherapy or in complex therapy with levodopa.