Bowing Index in Individuals With Parkinson's Disease, Progressive Supranuclear Palsy, and Ataxia

IF 2 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Laryngoscope Pub Date : 2025-02-02 DOI:10.1002/lary.31993

Courtney B. Tipton MD, J.C. Borders PhD, CCC-SLP, J.A. Curtis PhD, CCC-SLP, M.S. Troche PhD, CCC-SLP

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Abstract

Purpose

Variations in vocal fold bowing, as measured endoscopically with the bowing index (BI), across neurodegenerative diseases remain unexplored, which may inform interventions to minimize morbidity and mortality secondary to voice and airway protective dysfunction. The study's aim was to compare BI between people with Parkinson's disease, progressive supranuclear palsy, and cerebellar ataxia.

Methods

Thirty individuals with Parkinson's disease, 23 with progressive supranuclear palsy, and 24 with cerebellar ataxia were included and underwent flexible laryngoscopy. BI was measured using ImageJ software and a linear regression model was used to compare differences in total BI between groups, controlling for age.

Results

Average total BI was 14.60 (SD = 6.26, range 4.03–28.62) for people with progressive supranuclear palsy, 10.10 (SD = 6.64, range 0–34.13) for Parkinson's disease, and 8.35 (SD = 5.90, range 0–25.95) for cerebellar ataxia. Controlling for age, people with progressive supranuclear palsy demonstrated 4.74 greater BI compared to Parkinson's disease (95 CI: 1.19–8.28; p = 0.001), but there was no significant difference between people with Parkinson's disease and cerebellar ataxia (β = 0.37; 95% CI: −5.02, 5.77; p = 0.891) or people with progressive supranuclear palsy and cerebellar ataxia (β = 5.11; 95% CI: 0.01–10.21; p = 0.050).

Conclusions

The results suggest that BI is significantly greater in people with progressive supranuclear palsy compared to Parkinson's disease. It is important to recognize vocal fold atrophy and its potential impact on voice and airway protective measures in these patients.

Level of Evidence

3 Laryngoscope, 135:2081–2085, 2025

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帕金森病、进行性核上性麻痹和共济失调患者的弓形指数

目的：内窥镜下用弯曲指数（BI）测量的声带弯曲在神经退行性疾病中的变化仍未被探索，这可能为干预措施提供信息，以尽量减少继发于声音和气道保护功能障碍的发病率和死亡率。该研究的目的是比较帕金森病、进行性核上性麻痹和小脑性共济失调患者的脑损伤。方法：选取帕金森病患者30例，进行性核上性麻痹患者23例，小脑性共济失调患者24例，行软性喉镜检查。使用ImageJ软件测量BI，在控制年龄的情况下，使用线性回归模型比较组间总BI的差异。结果：进行性核上性麻痹患者的平均总BI为14.60 (SD = 6.26，范围4.03-28.62)，帕金森病患者的平均总BI为10.10 (SD = 6.64，范围0-34.13)，小脑共济失调患者的平均总BI为8.35 （SD = 5.90，范围0-25.95）。控制年龄，进行性核上性麻痹患者的BI比帕金森病患者高4.74 (95 CI: 1.19-8.28；p = 0.001)，但帕金森病和小脑性共济失调患者之间无显著差异(β = 0.37；95% ci: -5.02, 5.77；P = 0.891)或进行性核上性麻痹和小脑性共济失调患者(β = 5.11；95% ci: 0.01-10.21；p = 0.050)。结论：研究结果表明，与帕金森病相比，进行性核上性麻痹患者的BI明显更高。认识声带萎缩及其对这些患者的声音和气道保护措施的潜在影响是很重要的。证据等级：3喉镜，2025。

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来源期刊

Laryngoscope 医学-耳鼻喉科学

CiteScore

6.50

自引率

7.70%

发文量

500

审稿时长

2-4 weeks

期刊介绍： The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects