Objective: To determine whether differences exist in the perception of respiratory resistive loads between people with PD and age-matched control participants (HOAs).

Background: Patients with Parkinson’s disease (PD) under-report physiologic symptoms, including those related to airway protection. We have shown that patients with PD have a blunted perception of the urge-to-cough (UTC) compared to control participants. The UTC is a respiratory sensation; we hypothesize that blunted UTC is related to reduced perceptual respiratory sensitivity in PD.

Methods: Participants (14 PD; 13 HOA) were recruited to participate and provided written informed consent. All participants completed the Beck Depression Inventory (BDI) and Marin Apathy Index (MAI). Participants were fitted with a facemask connected to a non-rebreathing valve in-line with a differential pressure transducer and a resistive loading manifold. Five different resistive loads were delivered upon inspiration in a randomized block design. Participants rated the perceived magnitude (ME) of breathing difficulty following each load presentation on a modified Borg scale. Airflow and mouth pressure were also recorded. A multivariate ANOVA was used to compare the dependent variables between groups. Alpha was 0.05.

Results: There were not significant differences in terms of age, BDI, or MAI scores between PD and HOA participants. Participants with PD had a significantly lower ME slope compared with HOAs (F(5) = 7.697; p<.001). There were not differences for airflow (F(5) = 0.813; p=.543) or mouth pressure (F(5) = .947; p=.454).

Conclusions: Results show that the perceived magnitude of inspiratory resistive loads was blunted in people with PD compared with HOAs. These differences were not due to differences in depression or apathy between groups. There were not differences in pressure or airflow produced during inspiratory loading that would account for the difference in magnitude estimation. This supports our hypothesis that people with PD experience a blunting of perceived respiratory sensation, which could contribute to reduced ability to protect the airway with effective cough and swallowing. Further study is required to determine the mechanisms mediating these differences.

Portions of this abstract were presented at the 2015 International Society for the Advancement of Respiratory Psychophysiology conference in Sevilla, Spain, October 11, 2015.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/blunted-perception-of-respiratory-resistive-loads-in-parkinsons-disease/