{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T12:01:27Z","timestamp":1784980887231,"version":"3.55.0"},"reference-count":58,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Respiratory Physiology & Neurobiology"],"published-print":{"date-parts":[[2026,8]]},"DOI":"10.1016\/j.resp.2026.104608","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T16:10:08Z","timestamp":1781107808000},"page":"104608","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Preserved diaphragm thickness and tidal contractility despite motor impairment in early-stage Parkinson\u2019s disease"],"prefix":"10.1016","volume":"344","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0107-627X","authenticated-orcid":false,"given":"Laura","family":"McMahon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Blake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olive","family":"Lennon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.resp.2026.104608_bib1","article-title":"Updated Parkinson's disease motor subtypes classification and correlation to cerebrospinal homovanillic acid and 5-hydroxyindoleacetic acid levels","volume":"8","author":"Adams","year":"2023","journal-title":"Clin. Park. Relat. Disord."},{"issue":"6","key":"10.1016\/j.resp.2026.104608_bib2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1136\/jnnp-2020-323939","article-title":"Prognostic predictors relevant to end-of-life palliative care in Parkinson's disease and related disorders: a systematic review","volume":"92","author":"Akbar","year":"2021","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"issue":"1","key":"10.1016\/j.resp.2026.104608_bib3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1152\/jn.00363.2021","article-title":"Respiratory disorders of Parkinson\u2019s disease","volume":"127","author":"Aquino","year":"2022","journal-title":"J. Neurophysiol."},{"issue":"4","key":"10.1016\/j.resp.2026.104608_bib4","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1164\/rccm.166.4.518","article-title":"Statement on respiratory muscle testing","volume":"166","author":"ATS\/ERS","year":"2002","journal-title":"Am. J. Respir. Crit. Care Med."},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib5","doi-asserted-by":"crossref","first-page":"595","DOI":"10.3390\/brainsci11050595","article-title":"Respiratory Dysfunctions in Parkinson's disease patients","volume":"11","author":"Axelerad","year":"2021","journal-title":"Brain Sci."},{"key":"10.1016\/j.resp.2026.104608_bib6","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.parkreldis.2018.09.001","article-title":"Dyspnea: an underestimated symptom in Parkinson's disease","volume":"60","author":"Baille","year":"2019","journal-title":"Park. Relat. Disord."},{"issue":"201","key":"10.1016\/j.resp.2026.104608_bib7","doi-asserted-by":"crossref","DOI":"10.3791\/65431","article-title":"Measuring diaphragm thickness and function using point of care ultrasound","author":"Bellissimo","year":"2023","journal-title":"J. Vis. Exp."},{"issue":"1","key":"10.1016\/j.resp.2026.104608_bib8","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1034\/j.1600-0404.2001.00191.x","article-title":"Causes of death in a community-based study of Parkinson's disease","volume":"103","author":"Beyer","year":"2001","journal-title":"Acta Neurol. Scand."},{"key":"10.1016\/j.resp.2026.104608_bib9","series-title":"Neurology of Breathing","author":"Bolton","year":"2004"},{"key":"10.1016\/j.resp.2026.104608_bib10","doi-asserted-by":"crossref","first-page":"II3","DOI":"10.1007\/PL00007758","article-title":"Pathoanatomy of Parkinson\u2019s disease","volume":"247","author":"Braak","year":"2000","journal-title":"J. Neurol."},{"key":"10.1016\/j.resp.2026.104608_bib11","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.resp.2018.02.012","article-title":"Analysis of respiratory movements in a mouse model of late Parkinson\u2019s disease submitted to stress","volume":"251","author":"de Campos","year":"2018","journal-title":"Respir. Physiol. Neurobiol."},{"key":"10.1016\/j.resp.2026.104608_bib12","series-title":"Statistical Power Analysis for the Behavioural Sciences","author":"Cohen","year":"1988"},{"issue":"1","key":"10.1016\/j.resp.2026.104608_bib13","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1002\/ana.410390112","article-title":"Strength in Parkinson's disease: Relationship to rate of force generation and clinical status","volume":"39","author":"Corcos","year":"1996","journal-title":"Ann. Neurol."},{"issue":"3","key":"10.1016\/j.resp.2026.104608_bib14","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1007\/s00455-019-10050-9","article-title":"Effects of verbal cueing on respiratory-swallow patterning, lung volume initiation, and swallow apnoea duration in Parkinson\u2019s disease","volume":"35","author":"Curtis","year":"2020","journal-title":"Dysphagia"},{"issue":"4","key":"10.1016\/j.resp.2026.104608_bib15","doi-asserted-by":"crossref","DOI":"10.1183\/23120541.00165-2020","article-title":"Respiratory dysfunction in Parkinson's disease: a narrative review","volume":"6","author":"D'Arrigo","year":"2020","journal-title":"ERJ Open. Res."},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib16","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1136\/thx.52.5.472","article-title":"Diaphragm thickness and inspiratory strength in patients with Duchenne muscular dystrophy","volume":"52","author":"De Bruin","year":"1997","journal-title":"Thorax"},{"issue":"1","key":"10.1016\/j.resp.2026.104608_bib17","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1152\/jn.00330.2019","article-title":"Neural and muscular determinants of maximal rate of force development","volume":"123","author":"Dideriksen","year":"2019","journal-title":"J. Neurophysiol."},{"issue":"2","key":"10.1016\/j.resp.2026.104608_bib18","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.resp.2011.10.005","article-title":"Experimental approaches to the study of the mechanics of breathing during exercise","volume":"180","author":"Dominelli","year":"2012","journal-title":"Respir. Physiol. Neurobiol."},{"issue":"23","key":"10.1016\/j.resp.2026.104608_bib19","doi-asserted-by":"crossref","first-page":"1516","DOI":"10.1056\/NEJM198412063112314","article-title":"Respiratory-muscle involvement in Parkinson's disease: [Letter]","volume":"311","author":"Estenne","year":"1984","journal-title":"New. Engl. J. Med."},{"issue":"11","key":"10.1016\/j.resp.2026.104608_bib20","doi-asserted-by":"crossref","first-page":"1312","DOI":"10.1002\/mds.10537","article-title":"Survival time, mortality, and cause of death in elderly patients with Parkinson's disease: a 9-year follow-up","volume":"18","author":"Fall","year":"2003","journal-title":"Mov. Disord."},{"issue":"11","key":"10.1016\/j.resp.2026.104608_bib21","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/S1474-4422(17)30299-5","article-title":"Global, regional, and national burden of neurological disorders during 1990\u20132015: a systematic analysis for the Global Burden of Disease Study 2015","volume":"16","author":"Feigin","year":"2017","journal-title":"Lancet Neurol."},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib22","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0216641","article-title":"Chest wall volume and asynchrony in stroke and Parkinson's disease subjects: a case-control study","volume":"14","author":"Florencio","year":"2019","journal-title":"PLoS. One"},{"issue":"2","key":"10.1016\/j.resp.2026.104608_bib23","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1152\/physiol.00002.2018","article-title":"Breathing: motor control of diaphragm muscle","volume":"33","author":"Fogarty","year":"2018","journal-title":"Physiol."},{"issue":"15","key":"10.1016\/j.resp.2026.104608_bib24","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1002\/mds.22340","article-title":"Movement disorder society-sponsored revision of the unified parkinson's disease rating scale (MDS-UPDRS): scale presentation and clinimetric testing results","volume":"23","author":"Goetz","year":"2008","journal-title":"Mov. Disord."},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib25","doi-asserted-by":"crossref","first-page":"1570","DOI":"10.1164\/ajrccm.155.5.9154859","article-title":"Ultrasound evaluation of the paralyzed diaphragm","volume":"155","author":"Gottesman","year":"1997","journal-title":"Am. J. Respir. Crit. Care Med."},{"issue":"8","key":"10.1016\/j.resp.2026.104608_bib26","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1097\/01.PHM.0000133436.61009.02","article-title":"Effects of respiratory muscle weakness on daily living function, quality of life, activity levels, and exercise capacity in mild to moderate Parkinson's disease","volume":"83","author":"Haas","year":"2004","journal-title":"Am. J. Phys. Med. Rehabil."},{"issue":"12","key":"10.1016\/j.resp.2026.104608_bib27","doi-asserted-by":"crossref","first-page":"927","DOI":"10.2519\/jospt.2013.4931","article-title":"Variability in diaphragm motion during normal breathing, assessed with B-mode ultrasound","volume":"43","author":"Harper","year":"2013","journal-title":"J. Orthop. Sports Phys. Ther."},{"issue":"3","key":"10.1016\/j.resp.2026.104608_bib28","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1136\/jnnp.67.3.300","article-title":"The Sydney multicentre study of Parkinson's disease: progression and mortality at 10 years","volume":"67","author":"Hely","year":"1999","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib29","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.17.5.427","article-title":"Parkinsonism: onset, progression, and mortality","volume":"17","author":"Hoehn","year":"1967","journal-title":"Neurology"},{"issue":"10","key":"10.1016\/j.resp.2026.104608_bib30","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.1212\/WNL.40.10.1529","article-title":"Variable expression of Parkinson's disease: a base-line analysis of the DATATOP cohort. The Parkinson Study Group","volume":"40","author":"Jankovic","year":"1990","journal-title":"Neurology"},{"issue":"12","key":"10.1016\/j.resp.2026.104608_bib31","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1589\/jpts.29.2176","article-title":"The correlation between diaphragm thickness, diaphragmatic excursion, and pulmonary function in patients with chronic stroke","volume":"29","author":"Jung","year":"2017","journal-title":"J. Phys. Ther. Sci."},{"issue":"7","key":"10.1016\/j.resp.2026.104608_bib32","doi-asserted-by":"crossref","DOI":"10.3390\/ijms23073499","article-title":"Respiratory abnormalities in Parkinson's disease: what do we know from studies in humans and animal models?","volume":"23","author":"Kaczynska","year":"2022","journal-title":"Int. J. Mol. Sci."},{"key":"10.1016\/j.resp.2026.104608_bib33","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.expneurol.2018.01.003","article-title":"The involvement of the pathway connecting the substantia nigra, the periaqueductal gray matter and the retrotrapezoid nucleus in breathing control in a rat model of Parkinson's disease","volume":"302","author":"Lima","year":"2018","journal-title":"Exp. Neurol."},{"issue":"7","key":"10.1016\/j.resp.2026.104608_bib34","doi-asserted-by":"crossref","first-page":"882","DOI":"10.3390\/brainsci12070882","article-title":"Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function","volume":"12","author":"Liu","year":"2022","journal-title":"Brain Sci."},{"issue":"3","key":"10.1016\/j.resp.2026.104608_bib35","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1378\/chest.93.3.580","article-title":"Evaluation of clinical methods for rating dyspnea","volume":"93","author":"Mahler","year":"1988","journal-title":"Chest"},{"issue":"4","key":"10.1016\/j.resp.2026.104608_bib36","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1136\/jnnp-2012-303455","article-title":"Parkinson's disease subtypes: lost in translation?","volume":"84","author":"Marras","year":"2013","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib37","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1111\/ene.15743","article-title":"A systematic review and meta-analysis of respiratory dysfunction in Parkinson's disease","volume":"30","author":"McMahon","year":"2023","journal-title":"Eur. J. Neurol."},{"key":"10.1016\/j.resp.2026.104608_bib38","doi-asserted-by":"crossref","DOI":"10.1016\/j.resp.2025.104472","article-title":"Disordered tidal breathing pattern and dyspnoea related disability in Parkinson's disease: a case-controlled study","volume":"337","author":"McMahon","year":"2025","journal-title":"Respir. Physiol. Neurobiol."},{"issue":"6","key":"10.1016\/j.resp.2026.104608_bib39","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1093\/ptj\/80.6.578","article-title":"Movement disorders in people with Parkinson disease: a model for physical therapy","volume":"80","author":"Morris","year":"2000","journal-title":"Phys. Ther."},{"issue":"4","key":"10.1016\/j.resp.2026.104608_bib40","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1002\/mus.24902","article-title":"Ultrasonographic diaphragm thickness correlates with compound muscle action potential amplitude and forced vital capacity","volume":"53","author":"Noda","year":"2016","journal-title":"Muscle Nerve"},{"key":"10.1016\/j.resp.2026.104608_bib41","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.parkreldis.2020.02.018","article-title":"Factors associated with hospitalisation among people with Parkinson's disease - a systematic review and meta-analysis","volume":"71","author":"Okunoye","year":"2020","journal-title":"Park. Relat. Disord."},{"issue":"5","key":"10.1016\/j.resp.2026.104608_bib42","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1113\/EP087507","article-title":"Respiratory disturbances in a mouse model of Parkinson's disease","volume":"104","author":"Oliveira","year":"2019","journal-title":"Exp. Physiol."},{"issue":"6","key":"10.1016\/j.resp.2026.104608_bib43","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1093\/ageing\/afz079","article-title":"Assessment of core and lower limb muscles for static\/dynamic balance in the older people: an ultrasonographic study","volume":"48","author":"\u00d6zkal","year":"2019","journal-title":"Age Ageing"},{"issue":"2","key":"10.1016\/j.resp.2026.104608_bib44","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2340\/1650197719976774","article-title":"Gait analysis, isokinetic muscle strength measurement in patients with Parkinson's disease","volume":"29","author":"Pedersen","year":"1997","journal-title":"Scand. J. Rehabil. Med."},{"issue":"7","key":"10.1016\/j.resp.2026.104608_bib45","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/j.parkreldis.2010.04.010","article-title":"The cause of death in idiopathic Parkinson's disease","volume":"16","author":"Pennington","year":"2010","journal-title":"Park. Relat. Disord."},{"key":"10.1016\/j.resp.2026.104608_bib46","first-page":"413","article-title":"Electrical activity of the diaphragm in Parkinson's disease","volume":"69","author":"Petit","year":"1961","journal-title":"Arch. Int. Physiol. Biochim."},{"issue":"1","key":"10.1016\/j.resp.2026.104608_bib47","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1016\/j.clinph.2015.03.024","article-title":"Ultrasound for assessment of diaphragm in ALS","volume":"127","author":"Pinto","year":"2016","journal-title":"Clin. Neurophysiol."},{"key":"10.1016\/j.resp.2026.104608_bib48","doi-asserted-by":"crossref","DOI":"10.1016\/j.msard.2019.08.011","article-title":"Ultrasonographic evaluation of the diaphragm thickness in patients with multiple sclerosis","volume":"36","author":"\u015eahin","year":"2019","journal-title":"Mult. Scler. Relat. Disord."},{"issue":"12","key":"10.1016\/j.resp.2026.104608_bib49","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.4187\/respcare.03063","article-title":"Neurodegenerative disorders increase decline in respiratory muscle strength in older adults","volume":"59","author":"Sanches","year":"2014","journal-title":"Respir. Care"},{"issue":"6","key":"10.1016\/j.resp.2026.104608_bib50","article-title":"Diaphragmatic ultrasound: a review of its methodological aspects and clinical uses","volume":"46","author":"Santana","year":"2020","journal-title":"J. Bras. Pneumol."},{"issue":"6","key":"10.1016\/j.resp.2026.104608_bib51","doi-asserted-by":"crossref","DOI":"10.1590\/1806-3713\/e20180148","article-title":"Respiratory muscle strength and lung function in the stages of Parkinson's disease","volume":"45","author":"Santos","year":"2019","journal-title":"J. Bras. Pneumol."},{"issue":"3","key":"10.1016\/j.resp.2026.104608_bib52","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1002\/mus.23671","article-title":"Neuromuscular ultrasound for evaluation of the diaphragm","volume":"47","author":"Sarwal","year":"2013","journal-title":"Muscle Nerve"},{"issue":"4","key":"10.1016\/j.resp.2026.104608_bib53","first-page":"251","article-title":"Pulmonary Functions in Parkinson\u2019s Disease","volume":"47","author":"Sathyaprabha","year":"2005","journal-title":"Indian. J. Chest Dis. Allied Sci."},{"key":"10.1016\/j.resp.2026.104608_bib54","first-page":"1","article-title":"Chapter 1 - Respiratory rhythm and pattern generation: Brainstem cellular and circuit mechanisms","volume":"188","author":"Smith","year":"2022"},{"key":"10.1016\/j.resp.2026.104608_bib55","series-title":"Pulmonary Physiology. The Essentials","first-page":"111","author":"West","year":"2000"},{"key":"10.1016\/j.resp.2026.104608_bib56","doi-asserted-by":"crossref","first-page":"381","DOI":"10.3233\/NRE-192983","article-title":"Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: a randomized control trial","volume":"46","author":"Yoon","year":"2020","journal-title":"NeuroRehabilitation"},{"key":"10.1016\/j.resp.2026.104608_bib57","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2021.785020","article-title":"The role of the diaphragm in postural stability and visceral function in Parkinson's disease","volume":"13","author":"Yu","year":"2021","journal-title":"Front. Aging Neurosci."},{"key":"10.1016\/j.resp.2026.104608_bib58","doi-asserted-by":"crossref","DOI":"10.3389\/fnagi.2021.785020","article-title":"The role of the diaphragm in postural stability and visceral function in Parkinson\u2019s disease","volume":"13","author":"Yu","year":"2021","journal-title":"Front. Aging Neurosci."}],"container-title":["Respiratory Physiology & Neurobiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1569904826000674?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1569904826000674?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T11:33:22Z","timestamp":1784979202000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1569904826000674"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":58,"alternative-id":["S1569904826000674"],"URL":"https:\/\/doi.org\/10.1016\/j.resp.2026.104608","relation":{},"ISSN":["1569-9048"],"issn-type":[{"value":"1569-9048","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Preserved diaphragm thickness and tidal contractility despite motor impairment in early-stage Parkinson\u2019s disease","name":"articletitle","label":"Article Title"},{"value":"Respiratory Physiology & Neurobiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.resp.2026.104608","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V.","name":"copyright","label":"Copyright"}],"article-number":"104608"}}