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Both behaviors are impaired in Parkinson's disease, but it is unknown whether a similar relationship of dysfunction exists in forms of atypical Parkinsonism (APD). Elucidating this association in APD may lead to early, comprehensive airway protection treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We tested the hypotheses that swallow deficits in APD are associated with impaired cough and that airway protective dysfunction is associated with longer disease duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Swallowing difficulty was described by 11 participants with APD. Penetration\u2010Aspiration Scale (PAS) and DIGEST scores for thin liquid trials were extracted from medical records of videofluoroscopic swallow study reports. Voluntary and capsaicin induced\u2010reflex cough measures of flow, volume, and timing were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>While most participants did not have post\u2010swallow residue, ~80% received abnormal PAS scores and reported swallowing difficulty. Those with abnormal PAS scores had lower voluntary cough expired volume (<jats:italic>P<\/jats:italic>\u2009=\u20090.037; mean rank difference\u2009=\u20095.0); lower reflex inspiratory flow rate (<jats:italic>P<\/jats:italic>\u2009=\u20090.034; mean rank difference\u2009=\u20095.5); and longer reflex expiratory flow rise time (<jats:italic>P<\/jats:italic>\u2009=\u20090.034; mean rank difference\u2009=\u20095.5). Higher PAS scores and reduced reflex cough volume acceleration were significantly correlated (r\u2009=\u2009\u22120.63; <jats:italic>P<\/jats:italic>\u2009=\u20090.04) and longer disease duration predicted larger voluntary cough expired volume (R<jats:sup>2<\/jats:sup>\u2009=\u20090.72) and longer flow rise times (R<jats:sup>2<\/jats:sup>\u2009=\u20090.47).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As swallow safety worsens, so might the ability to clear the airways with effective cough in in APD; particularly with longer disease duration. Assessing cough in conjunction with swallowing is important for informing airway protection treatment plans in APD.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mdc3.13965","type":"journal-article","created":{"date-parts":[[2023,12,26]],"date-time":"2023-12-26T01:39:56Z","timestamp":1703554796000},"page":"265-275","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cough Correlates of Functional Swallow Outcomes in Atypical Parkinsonism"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7594-5453","authenticated-orcid":false,"given":"Michela J.","family":"Mir","sequence":"first","affiliation":[{"name":"Breathing Research and Therapeutics Center, Department of Physical Therapy University of Florida  Gainesville Florida USA"},{"name":"Brooks Clinical Research Center, Brooks Rehabilitation  Jacksonville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin T.","family":"Childers","sequence":"additional","affiliation":[{"name":"College of Medicine Florida Atlantic University  Boca Raton Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Wheeler\u2010Hegland","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases UF Health  Gainesville Florida USA"},{"name":"Upper Airway Dysfunction Lab, Department of Speech, Language, and Hearing Sciences University of Florida  Gainesville Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-016-9734-6"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00408-014-9584-7"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-0066"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1122"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-020-10171-6"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-015-9687-1"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1590\/1678-775720140132"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1006\/pupt.2002.0361"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.20743"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200612-1856OC"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00039.2015"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2019.tb00080.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/PL00009559"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000348"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1602422"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-015-9671-9"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135823"},{"issue":"5","key":"e_1_2_10_19_1","article-title":"Dysphagia in Parkinson's disease: prevalence, impact and management challenges. 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