{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T04:13:40Z","timestamp":1785644020001,"version":"3.56.0"},"reference-count":56,"publisher":"IMR Press","issue":"11","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007129","name":"Natural Science Foundation of Shandong Province","doi-asserted-by":"crossref","award":["ZR2022MH124"],"award-info":[{"award-number":["ZR2022MH124"]}],"id":[{"id":"10.13039\/501100007129","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Shandong Medical and Health Technology Development Fund","award":["202103070325"],"award-info":[{"award-number":["202103070325"]}]},{"name":"Shandong Province Traditional Chinese Medical Science and Technology Project","award":["M-2022216"],"award-info":[{"award-number":["M-2022216"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Integr. Neurosci."],"abstract":"<jats:p>Background: Parkinson\u2019s disease (PD) is currently the second most common degenerative neurological disorder globally, with aspiration pneumonia caused by difficulty swallowing being the deadliest complication. The patient\u2019s subjective experience and the safety of swallowing have been the main focus of previous evaluations and treatment plans. The effectiveness of treatment may be attributed to the brain\u2019s ability to adapt and compensate. However, there is a need for more accurate assessment methods for dysphagia and further research on how treatment protocols work. Objective: This systematic review was designed to assess the effectiveness and long-term impact of published treatment options for swallowing disorders in patients with PD. Methods: In adherence to the Preferred Reporting Items for Reviews and Meta-analysis (PRISMA) guidelines, we conducted a systematic review where we thoroughly searched multiple databases (PubMed, Web of Science, Elsevier, and Wiley) for clinical studies published in various languages until December, 2023. Two reviewers evaluated the studies against strict inclusion\/exclusion criteria. Results: This systematic review included a total of 15 studies, including 523 participants, involving six treatment approaches, including breath training, deep brain stimulation, reduction of upper esophageal sphincter (UES) pressure, transcranial magnetic stimulation, postural compensation, and video-assisted swallowing therapy. Primary outcomes included video fluoroscopic swallowing study (VFSS), fiberoptic endoscopic evaluation of swallowing (FEES), high-resolution pharyngeal impedance manometry (HPRIM), and functional magnetic resonance imaging (fMRI). Conclusion: Treatments that reduce UES resistance may be an effective way to treat dysphagia in PD patients. HRPIM can quantify pressure changes during the pharyngeal period to identify patients with reduced swallowing function earlier. However, due to the limited number of randomized controlled trials (RCTs) included and the high risk of bias in some studies, large-scale RCTs are needed in the future, and objective indicators such as HRPIM should be used to determine the effectiveness and long-term impact of different therapies on dysphagia in PD patients.<\/jats:p>","DOI":"10.31083\/j.jin2311204","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T16:34:00Z","timestamp":1732725240000},"source":"Crossref","is-referenced-by-count":4,"title":["The Effects of Non-Pharmacological Therapies for Dysphagia in Parkinson\u2019s Disease: A Systematic Review"],"prefix":"10.31083","volume":"23","author":[{"given":"Fangli","family":"Ning","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi","family":"Lv","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenxin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinlei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guohua","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjing","family":"Ning","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyuan","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Qin","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhen","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, 271000 Taian, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Elbaz A, Carcaillon L, Kab S, Moisan F. Epidemiology of Parkinson\u2019s disease. Revue Neurologique. 2016; 172: 14\u201326.","DOI":"10.1016\/j.neurol.2015.09.012"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Zhang W, Ye Y, Song J, Sang T, Xia T, Xie L, et al. Research Progress of Microbiota-Gut-Brain Axis in Parkinson\u2019s Disease. Journal of Integrative Neuroscience. 2023; 22: 157.","DOI":"10.31083\/j.jin2206157"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Eser P, Kocabicak E, Bekar A, Temel Y. The interplay between neuroinflammatory pathways and Parkinson\u2019s disease. Experimental Neurology. 2024; 372: 114644.","DOI":"10.1016\/j.expneurol.2023.114644"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Kalia LV, Lang AE. Parkinson\u2019s disease. Lancet (London, England). 2015; 386: 896\u2013912.","DOI":"10.1016\/S0140-6736(14)61393-3"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Pennington S, Snell K, Lee M, Walker R. The cause of death in idiopathic Parkinson\u2019s disease. Parkinsonism & Related Disorders. 2010; 16: 434\u2013437.","DOI":"10.1016\/j.parkreldis.2010.04.010"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Agirman G, Yu KB, Hsiao EY. Signaling inflammation across the gut-brain axis. Science (New York, N.Y.). 2021; 374: 1087\u20131092.","DOI":"10.1126\/science.abi6087"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Ma B, Zhang J, Cui Y, Gao H. The Anatomy and Clinical Significance of Sensory Disturbance in Parkinson\u2019s Disease. Journal of Integrative Neuroscience. 2023; 22: 56.","DOI":"10.31083\/j.jin2203056"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Braak H, Del Tredici K, R\u00fcb U, de Vos RAI, Jansen Steur ENH, Braak E. Staging of brain pathology related to sporadic Parkinson\u2019s disease. Neurobiology of Aging. 2003; 24: 197\u2013211.","DOI":"10.1016\/S0197-4580(02)00065-9"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Stopschinski BE, Diamond MI. The prion model for progression and diversity of neurodegenerative diseases. The Lancet. Neurology. 2017; 16: 323\u2013332.","DOI":"10.1016\/S1474-4422(17)30037-6"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Dogra N, Mani RJ, Katare DP. The Gut-Brain Axis: Two Ways Signaling in Parkinson\u2019s Disease. Cellular and Molecular Neurobiology. 2022; 42: 315\u2013332.","DOI":"10.1007\/s10571-021-01066-7"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Erny D, Hrab\u011b de Angelis AL, Jaitin D, Wieghofer P, Staszewski O, David E, et al. Host microbiota constantly control maturation and function of microglia in the CNS. Nature Neuroscience. 2015; 18: 965\u2013977.","DOI":"10.1038\/nn.4030"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Schafer DP, Stevens B. Phagocytic glial cells: sculpting synaptic circuits in the developing nervous system. Current Opinion in Neurobiology. 2013; 23: 1034\u20131040.","DOI":"10.1016\/j.conb.2013.09.012"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"\u00c7amc\u0131 G, O\u011fuz S. Association between Parkinson\u2019s Disease and Helicobacter Pylori. Journal of Clinical Neurology (Seoul, Korea). 2016; 12: 147\u2013150.","DOI":"10.3988\/jcn.2016.12.2.147"},{"key":"ref14","unstructured":"Inoue M. The neural mechanisms underlying swallowing. Brain and Nerve. 2015; 67: 157\u2013168. (In Japanese)"},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Braak H, Ghebremedhin E, R\u00fcb U, Bratzke H, Del Tredici K. Stages in the development of Parkinson\u2019s disease-related pathology. Cell and Tissue Research. 2004; 318: 121\u2013134.","DOI":"10.1007\/s00441-004-0956-9"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Mu L, Sanders I. Neuromuscular compartments and fiber-type regionalization in the human inferior pharyngeal constrictor muscle. The Anatomical Record. 2001; 264: 367\u2013377.","DOI":"10.1002\/ar.10020"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Lang IM, Medda BK, Jadcherla S, Shaker R. The role of the superior laryngeal nerve in esophageal reflexes. American Journal of Physiology. Gastrointestinal and Liver Physiology. 2012; 302: G1445\u2013G1457.","DOI":"10.1152\/ajpgi.00007.2012"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Sivarao DV, Goyal RK. Functional anatomy and physiology of the upper esophageal sphincter. The American Journal of Medicine. 2000; 108: 27S\u201337S.","DOI":"10.1016\/S0002-9343(99)00337-X"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Mu L, Sobotka S, Chen J, Su H, Sanders I, Adler CH, et al. Altered pharyngeal muscles in Parkinson disease. Journal of Neuropathology and Experimental Neurology. 2012; 71: 520\u2013530.","DOI":"10.1097\/NEN.0b013e318258381b"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing: a review. Dysphagia. 2010; 25: 323\u2013333.","DOI":"10.1007\/s00455-010-9301-5"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Suntrup S, Teismann I, Bejer J, Suttrup I, Winkels M, Mehler D, et al. Evidence for adaptive cortical changes in swallowing in Parkinson\u2019s disease. Brain: a Journal of Neurology. 2013; 136: 726\u2013738.","DOI":"10.1093\/brain\/awt004"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Alexander GE, Crutcher MD. Functional architecture of basal ganglia circuits: neural substrates of parallel processing. Trends in Neurosciences. 1990; 13: 266\u2013271.","DOI":"10.1016\/0166-2236(90)90107-L"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Omari T, Cock C, Wu P, Szczesniak MM, Schar M, Tack J, et al. Using high resolution manometry impedance to diagnose upper esophageal sphincter and pharyngeal motor disorders. Neurogastroenterology and Motility. 2023; 35: e14461.","DOI":"10.1111\/nmo.14461"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Omari TI, Ciucci M, Gozdzikowska K, Hern\u00e1ndez E, Hutcheson K, Jones C, et al. High-Resolution Pharyngeal Manometry and Impedance: Protocols and Metrics-Recommendations of a High-Resolution Pharyngeal Manometry International Working Group. Dysphagia. 2020; 35: 281\u2013295.","DOI":"10.1007\/s00455-019-10023-y"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"Sung HY, Kim JS, Lee KS, Kim YI, Song IU, Chung SW, et al. The prevalence and patterns of pharyngoesophageal dysmotility in patients with early stage Parkinson\u2019s disease. Movement Disorders: Official Journal of the Movement Disorder Society. 2010; 25: 2361\u20132368.","DOI":"10.1002\/mds.23290"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Hoffman MR, Jones CA, Geng Z, Abelhalim SM, Walczak CC, Mitchell AR, et al. Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition. Otolaryngology\u2013head and Neck Surgery: Official Journal of American Academy of Otolaryngology-Head and Neck Surgery. 2013; 149: 126\u2013133.","DOI":"10.1177\/0194599813489506"},{"key":"ref27","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Revista Espanola De Cardiologia (English Ed.). 2021; 74: 790\u2013799."},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Logemann JA, Gensler G, Robbins J, Lindblad AS, Brandt D, Hind JA, et al. A randomized study of three interventions for aspiration of thin liquids in patients with dementia or Parkinson\u2019s disease. Journal of Speech, Language, and Hearing Research: JSLHR. 2008; 51: 173\u2013183.","DOI":"10.1044\/1092-4388(2008\/013)"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Baijens LWJ, Speyer R, Passos VL, Pilz W, Roodenburg N, Clav\u00e9 P. The effect of surface electrical stimulation on swallowing in dysphagic Parkinson patients. Dysphagia. 2012; 27: 528\u2013537.","DOI":"10.1007\/s00455-011-9387-4"},{"key":"ref30","doi-asserted-by":"crossref","unstructured":"Heijnen BJ, Speyer R, Baijens LWJ, Bogaardt HCA. Neuromuscular electrical stimulation versus traditional therapy in patients with Parkinson\u2019s disease and oropharyngeal dysphagia: effects on quality of life. Dysphagia. 2012; 27: 336\u2013345.","DOI":"10.1007\/s00455-011-9371-z"},{"key":"ref31","doi-asserted-by":"crossref","unstructured":"Manor Y, Mootanah R, Freud D, Giladi N, Cohen JT. Video-assisted swallowing therapy for patients with Parkinson\u2019s disease. Parkinsonism & Related Disorders. 2013; 19: 207\u2013211.","DOI":"10.1016\/j.parkreldis.2012.10.004"},{"key":"ref32","doi-asserted-by":"crossref","unstructured":"Byeon H. Effect of simultaneous application of postural techniques and expiratory muscle strength training on the enhancement of the swallowing function of patients with dysphagia caused by parkinson\u2019s disease. Journal of Physical Therapy Science. 2016; 28: 1840\u20131843.","DOI":"10.1589\/jpts.28.1840"},{"key":"ref33","doi-asserted-by":"crossref","unstructured":"Ayres A, Jotz GP, Rieder CRM, Olchik MR. Benefit from the Chin-Down Maneuver in the Swallowing Performance and Self-Perception of Parkinson\u2019s Disease Patients. Parkinson\u2019s Disease. 2017; 2017: 7460343.","DOI":"10.1155\/2017\/7460343"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Triadafilopoulos G, Gandhy R, Barlow C. Pilot cohort study of endoscopic botulinum neurotoxin injection in Parkinson\u2019s disease. Parkinsonism & Related Disorders. 2017; 44: 33\u201337.","DOI":"10.1016\/j.parkreldis.2017.08.020"},{"key":"ref35","doi-asserted-by":"crossref","unstructured":"Park JS, Oh DH, Hwang NK, Lee JH. Effects of neuromuscular electrical stimulation in patients with Parkinson\u2019s disease and dysphagia: A randomized, single-blind, placebo-controlled trial. NeuroRehabilitation. 2018; 42: 457\u2013463.","DOI":"10.3233\/NRE-172306"},{"key":"ref36","doi-asserted-by":"crossref","unstructured":"Khedr EM, Mohamed KO, Soliman RK, Hassan AMM, Rothwell JC. The Effect of High-Frequency Repetitive Transcranial Magnetic Stimulation on Advancing Parkinson\u2019s Disease With Dysphagia: Double Blind Randomized Clinical Trial. Neurorehabilitation and Neural Repair. 2019; 33: 442\u2013452.","DOI":"10.1177\/1545968319847968"},{"key":"ref37","doi-asserted-by":"crossref","unstructured":"Pflug C, Nienstedt JC, Gulberti A, M\u00fcller F, Vettorazzi E, Koseki JC, et al. Impact of simultaneous subthalamic and nigral stimulation on dysphagia in Parkinson\u2019s disease. Annals of Clinical and Translational Neurology. 2020; 7: 628\u2013638.","DOI":"10.1002\/acn3.51027"},{"key":"ref38","doi-asserted-by":"crossref","unstructured":"Claus I, Muhle P, Czechowski J, Ahring S, Labeit B, Suntrup-Krueger S, et al. Expiratory Muscle Strength Training for Therapy of Pharyngeal Dysphagia in Parkinson\u2019s Disease. Movement Disorders: Official Journal of the Movement Disorder Society. 2021; 36: 1815\u20131824.","DOI":"10.1002\/mds.28552"},{"key":"ref39","doi-asserted-by":"crossref","unstructured":"Wu PI, Szczesniak MM, Omari T, Lam TY, Wong M, Maclean J, et al. Cricopharyngeal peroral endoscopic myotomy improves oropharyngeal dysphagia in patients with Parkinson\u2019s disease. Endoscopy International Open. 2021; 9: E1811\u2013E1819.","DOI":"10.1055\/a-1562-7107"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Born LJ, Harned RH, Rikkers LF, Pfeiffer RF, Quigley EM. Cricopharyngeal dysfunction in Parkinson\u2019s disease: role in dysphagia and response to myotomy. Movement Disorders: Official Journal of the Movement Disorder Society. 1996; 11: 53\u201358.","DOI":"10.1002\/mds.870110110"},{"key":"ref41","doi-asserted-by":"crossref","unstructured":"Restivo DA, Palmeri A, Marchese-Ragona R. Botulinum toxin for cricopharyngeal dysfunction in Parkinson\u2019s disease. The New England Journal of Medicine. 2002; 346: 1174\u20131175.","DOI":"10.1056\/NEJM200204113461517"},{"key":"ref42","doi-asserted-by":"crossref","unstructured":"Huang PL, Wang SJ, Sun RF, Zhu ZM, Li XL, Li WS, et al. Increased activation of the caudate nucleus and parahippocampal gyrus in Parkinson\u2019s disease patients with dysphagia after repetitive transcranial magnetic stimulation: a case-control study. Neural Regeneration Research. 2022; 17: 1051\u20131058.","DOI":"10.4103\/1673-5374.324863"},{"key":"ref43","doi-asserted-by":"crossref","unstructured":"Warnecke T, Suttrup I, Schr\u00f6der JB, Osada N, Oelenberg S, Hamacher C, et al. Levodopa responsiveness of dysphagia in advanced Parkinson\u2019s disease and reliability testing of the FEES-Levodopa-test. Parkinsonism & Related Disorders. 2016; 28: 100\u2013106.","DOI":"10.1016\/j.parkreldis.2016.04.034"},{"key":"ref44","doi-asserted-by":"crossref","unstructured":"Melo A, Monteiro L. Swallowing improvement after levodopa treatment in idiopathic Parkinson\u2019s disease: lack of evidence. Parkinsonism & Related Disorders. 2013; 19: 279\u2013281.","DOI":"10.1016\/j.parkreldis.2012.11.017"},{"key":"ref45","doi-asserted-by":"crossref","unstructured":"O\u2019Dell SJ, Gross NB, Fricks AN, Casiano BD, Nguyen TB, Marshall JF. Running wheel exercise enhances recovery from nigrostriatal dopamine injury without inducing neuroprotection. Neuroscience. 2007; 144: 1141\u20131151.","DOI":"10.1016\/j.neuroscience.2006.10.042"},{"key":"ref46","doi-asserted-by":"crossref","unstructured":"Tillerson JL, Cohen AD, Philhower J, Miller GW, Zigmond MJ, Schallert T. Forced limb-use effects on the behavioral and neurochemical effects of 6-hydroxydopamine. The Journal of Neuroscience: the Official Journal of the Society for Neuroscience. 2001; 21: 4427\u20134435.","DOI":"10.1523\/JNEUROSCI.21-12-04427.2001"},{"key":"ref47","doi-asserted-by":"crossref","unstructured":"Tillerson JL, Caudle WM, Rever\u00f3n ME, Miller GW. Exercise induces behavioral recovery and attenuates neurochemical deficits in rodent models of Parkinson\u2019s disease. Neuroscience. 2003; 119: 899\u2013911.","DOI":"10.1016\/S0306-4522(03)00096-4"},{"key":"ref48","doi-asserted-by":"crossref","unstructured":"Fisher BE, Wu AD, Salem GJ, Song J, Lin CHJ, Yip J, et al. The effect of exercise training in improving motor performance and corticomotor excitability in people with early Parkinson\u2019s disease. Archives of Physical Medicine and Rehabilitation. 2008; 89: 1221\u20131229.","DOI":"10.1016\/j.apmr.2008.01.013"},{"key":"ref49","doi-asserted-by":"crossref","unstructured":"Rose MH, L\u00f8kkegaard A, Sonne-Holm S, Jensen BR. Improved clinical status, quality of life, and walking capacity in Parkinson\u2019s disease after body weight-supported high-intensity locomotor training. Archives of Physical Medicine and Rehabilitation. 2013; 94: 687\u2013692.","DOI":"10.1016\/j.apmr.2012.11.025"},{"key":"ref50","doi-asserted-by":"crossref","unstructured":"Steib S, Klamroth S, Ga\u00dfner H, Pasluosta C, Eskofier B, Winkler J, et al. Perturbation During Treadmill Training Improves Dynamic Balance and Gait in Parkinson\u2019s Disease: A Single-Blind Randomized Controlled Pilot Trial. Neurorehabilitation and Neural Repair. 2017; 31: 758\u2013768.","DOI":"10.1177\/1545968317721976"},{"key":"ref51","doi-asserted-by":"crossref","unstructured":"Troche MS, Okun MS, Rosenbek JC, Musson N, Fernandez HH, Rodriguez R, et al. Aspiration and swallowing in Parkinson disease and rehabilitation with EMST: a randomized trial. Neurology. 2010; 75: 1912\u20131919.","DOI":"10.1212\/WNL.0b013e3181fef115"},{"key":"ref52","doi-asserted-by":"crossref","unstructured":"Grinberg LT, Rueb U, Alho ATDL, Heinsen H. Brainstem pathology and non-motor symptoms in PD. Journal of the Neurological Sciences. 2010; 289: 81\u201388.","DOI":"10.1016\/j.jns.2009.08.021"},{"key":"ref53","doi-asserted-by":"crossref","unstructured":"Troche MS, Brandimore AE, Foote KD, Okun MS. Swallowing and deep brain stimulation in Parkinson\u2019s disease: a systematic review. Parkinsonism & Related Disorders. 2013; 19: 783\u2013788.","DOI":"10.1016\/j.parkreldis.2013.05.001"},{"key":"ref54","doi-asserted-by":"crossref","unstructured":"Taira K, Fujiwara K, Fukuhara T, Koyama S, Morisaki T, Takeuchi H. Evaluation of the pharynx and upper esophageal sphincter motility using high-resolution pharyngeal manometry for Parkinson\u2019s disease. Clinical Neurology and Neurosurgery. 2021; 201: 106447.","DOI":"10.1016\/j.clineuro.2020.106447"},{"key":"ref55","doi-asserted-by":"crossref","unstructured":"Huckabee ML, Lamvik K, Jones R. Pharyngeal mis-sequencing in dysphagia: characteristics, rehabilitative response, and etiological speculation. Journal of the Neurological Sciences. 2014; 343: 153\u2013158.","DOI":"10.1016\/j.jns.2014.05.064"},{"key":"ref56","doi-asserted-by":"crossref","unstructured":"Mitchell SD, Sidiropoulos C. Therapeutic Applications of Botulinum Neurotoxin for Autonomic Symptoms in Parkinson\u2019s Disease: An Updated Review. Toxins. 2021; 13: 226.","DOI":"10.3390\/toxins13030226"}],"container-title":["Journal of Integrative Neuroscience"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.imrpress.com\/journal\/JIN\/23\/11\/10.31083\/j.jin2311204","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T16:48:12Z","timestamp":1732726092000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/JIN\/23\/11\/10.31083\/j.jin2311204"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,15]]},"references-count":56,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024]]}},"alternative-id":["S0219-6352(24)00841-6"],"URL":"https:\/\/doi.org\/10.31083\/j.jin2311204","relation":{},"ISSN":["0219-6352","1757-448X"],"issn-type":[{"value":"0219-6352","type":"print"},{"value":"1757-448X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,15]]},"article-number":"204"}}