Objective:
To investigate whether frequency of saliva swallows reduced, and drooling severity and frequency increased, when people with PD engaged in a distracting cognitively demanding task.

Background: While drooling in Parkinson’s Disease is thought to predominantly occur due to reduced efficiency and variable frequency of saliva swallows, compounded by poor posture and mouth opening, rather than hyper-salivation (1), it is reported to occur most frequently during cognitively distracting concurrent tasks (2). This suggests divided attention in a dual task situation maybe impacting on the effectiveness of saliva management. However, this supposition has not been systematically examined.

Methods: 18 patients with idiopathic PD reporting daytime drooling on the Unified Parkinson’s Disease Rating Scale (UPDRS) were recruited. Participants completed the Radboud Oral Motor Inventory for PD saliva questionnaire and the Montreal Cognitive Assessment. UPDRS drooling score, disease stage, duration, gender and age were recorded. Their swallow frequency and drooling severity and frequency were measured at rest and during a distracting computer based language task.

Results: There was no significant difference between drooling severity at rest and during distraction (Wilcoxon signed rank test z=-1.724, p=.085). There was a significant difference between at rest and distraction conditions for both drooling frequency (Wilcoxon signed rank test z=-2.041, p=.041) and swallow frequency (Wilcoxon signed rank test z=-3.054, p=.002). Participants swallowed less frequently and drooled more frequently during the distraction task.

Conclusions: This study suggests that the frequency of saliva swallows and drooling are affected by divided attention in a dual task paradigm. Further studies are needed to explore the exact role of attention in saliva management and the clinical applications in assessment and treatment.

Please note that at time of this submission to the International Congress, an abstract of research related to this paper has also been submitted to the British Geriatric Society 2017 Spring Meeting for consideration. Acceptance or rejection had not be received at point of submission.

References: (1) Srivanitchapoom, P., Pandey, S. and Hallett, M., 2014. Drooling in Parkinson’s disease: a review. Parkinsonism & related disorders, 20(11), pp.1109-1118

(2) Kalf J, Smit, A, Bloem B, Zwarts, M, Munneke M 2007. Impact of drooling in Parkinson’s disease. Journal of Neurology (2007) 254:1227–1232

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-impact-of-divided-attention-in-dual-task-conditions-on-drooling-in-parkinsons-disease-pd-a-pilot-study/