Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.

<h4>Objective</h4>To determine whether arytenoid cartilage position and dynamics change with advancing duration and severity (as graded by MDS-UPDRS part III scores) in Parkinson's disease, in a cross-sectional study design, we performed laryngeal four-dimensional computed tomograph...

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Autores principales:	Andrew Ma, Kenneth K Lau, Dominic Thyagarajan
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4020ed49f82a4917b2ab6816845b059f
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spelling	oai:doaj.org-article:4020ed49f82a4917b2ab6816845b059f2021-12-02T20:16:51ZRadiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.1932-620310.1371/journal.pone.0258786https://doaj.org/article/4020ed49f82a4917b2ab6816845b059f2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258786https://doaj.org/toc/1932-6203<h4>Objective</h4>To determine whether arytenoid cartilage position and dynamics change with advancing duration and severity (as graded by MDS-UPDRS part III scores) in Parkinson's disease, in a cross-sectional study design, we performed laryngeal four-dimensional computed tomography (4D-CT) in people with Parkinson's disease and controls.<h4>Methods</h4>31 people with Parkinson's disease covering a range of disease duration and severity and 19 controls underwent laryngeal 4D-CT whilst repeatedly vocalizing. We measured on each CT volume the glottic area (GA), inter-arytenoid distance (IAD), IAD-Area index (IAI) and arytenoid cartilage velocity ([Formula: see text]).<h4>Results</h4>People with Parkinson's disease had reductions in the mean/effective minimum IAD when compared to controls, while mean/effective minimum GA and mean/effective maximum IAI were increased. Arytenoid cartilage velocities showed no difference. On Spearman correlation analyses, advancing disease duration and severity of PD showed moderately strong and significant correlations with increasing mean/effective minimum GA, increasing mean/effective maximum IAI and decreasing effective minimum IAD. Linear mixed models which considered the effects of intra and inter-individual variation showed that both disease duration (b = -0.011, SEb = 0.053, 95% CI [-0.022, 0], t(27) = -2.10, p = 0.045) and severity (b = -0.069, SEb = 0.032, 95% CI [-0.14,-0.0039], t(27) = -2.17, p = 0.039) were significant predictors for IAD, and also for transformed values of the GA and IAI.<h4>Conclusions</h4>There are progressive alterations in phonatory posturing as Parkinson's disease advances. The increases in GA despite reductions in IAD are concordant with prior observations of vocal fold bowing. Our study provides a basis for using laryngeal 4D-CT to assess disease progression in Parkinson's disease.Andrew MaKenneth K LauDominic ThyagarajanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258786 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Andrew Ma Kenneth K Lau Dominic Thyagarajan Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.
description	<h4>Objective</h4>To determine whether arytenoid cartilage position and dynamics change with advancing duration and severity (as graded by MDS-UPDRS part III scores) in Parkinson's disease, in a cross-sectional study design, we performed laryngeal four-dimensional computed tomography (4D-CT) in people with Parkinson's disease and controls.<h4>Methods</h4>31 people with Parkinson's disease covering a range of disease duration and severity and 19 controls underwent laryngeal 4D-CT whilst repeatedly vocalizing. We measured on each CT volume the glottic area (GA), inter-arytenoid distance (IAD), IAD-Area index (IAI) and arytenoid cartilage velocity ([Formula: see text]).<h4>Results</h4>People with Parkinson's disease had reductions in the mean/effective minimum IAD when compared to controls, while mean/effective minimum GA and mean/effective maximum IAI were increased. Arytenoid cartilage velocities showed no difference. On Spearman correlation analyses, advancing disease duration and severity of PD showed moderately strong and significant correlations with increasing mean/effective minimum GA, increasing mean/effective maximum IAI and decreasing effective minimum IAD. Linear mixed models which considered the effects of intra and inter-individual variation showed that both disease duration (b = -0.011, SEb = 0.053, 95% CI [-0.022, 0], t(27) = -2.10, p = 0.045) and severity (b = -0.069, SEb = 0.032, 95% CI [-0.14,-0.0039], t(27) = -2.17, p = 0.039) were significant predictors for IAD, and also for transformed values of the GA and IAI.<h4>Conclusions</h4>There are progressive alterations in phonatory posturing as Parkinson's disease advances. The increases in GA despite reductions in IAD are concordant with prior observations of vocal fold bowing. Our study provides a basis for using laryngeal 4D-CT to assess disease progression in Parkinson's disease.
format	article
author	Andrew Ma Kenneth K Lau Dominic Thyagarajan
author_facet	Andrew Ma Kenneth K Lau Dominic Thyagarajan
author_sort	Andrew Ma
title	Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.
title_short	Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.
title_full	Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.
title_fullStr	Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.
title_full_unstemmed	Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.
title_sort	radiological correlates of vocal fold bowing as markers of parkinson's disease progression: a cross-sectional study utilizing dynamic laryngeal ct.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/4020ed49f82a4917b2ab6816845b059f
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Radiological correlates of vocal fold bowing as markers of Parkinson's disease progression: A cross-sectional study utilizing dynamic laryngeal CT.

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