The purpose of the study is to examine the effectiveness of different methods for the treatment of dysphagia in Parkinson's disease (PD). More than 80% of patients suffering from PD develop dysphagia during the course of their disease leading to malnutrition, loss of life quality, weight loss and pneumonia, which is the leading cause of death in these patients. So far, only a few specific treatment approaches have been investigated in PD patients with swallowing disorders. The investigator want to compare a 4-week expiratory muscle strength training (EMST), transcranial magnetic stimulation (TMS), and combination of both with a sham therapy. Dysphagia severity before and after intervention is measured by flexible endoscopic evaluation of swallowing (FEES). For the evaluation of changes in cortical swallowing processing the investigators apply magnetoencephalography (MEG).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
53
The EMST is performed 4 weeks, 5 days per week, for 20 minutes per day, using a calibrated or sham, handheld device (EMST 150, Aspire Products, Gainesville, FL).
A sham or active transcranial magnetic stimulation is performed at the last 5 days of EMST training.
Department of neurology, University Hospital of Muenster
Münster, North Rhine-Westphalia, Germany
Dysphagia severity as measured by FEES
Time frame: Four weeks
Cortical reorganization of swallowing process as detected by MEG
Time frame: Four weeks and three month
Changes in quality of life as measured by the swallowing quality of life questionnaire (Swal-Qol)
Time frame: Four weeks and three months
Dysphagia severity as measured by FEES
Time frame: Three month
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