High prevalence (20% to 80%) of swallowing problems in neurodegenerative populations like Parkinson’s Disease (PD) is reported with aspiration pneumonia. Videofluoroscopy (VFS) is gold standard but has ionizing radiation and flexible endoscopic evaluation of swallowing (FEES) is invasive. Available techniques also have limitations- VFS of soft-tissue details and FEES of quantitative parameters. So, non-invasive reliable technique is required for appropriate optimal management.

Swallowing, a basic oromotor function for survival may have multifactorial involvement in PD (muscle rigidity, slow, hesitant and incoordinated movements) which are difficult to evaluate. Magnetic Resonance Imaging (MRI) is non-invasive, no-radioactive exposure and dynamic (dMRI) evaluate normal-saline (NS) bolus giving soft tissue details.

Sample- 12 subjects (6M and 6F) with idiopathic PD and 6 healthy controls (3M,3F). Clinical assessment-swallowing (SDQ), Neurodegeneration dysphagia (CADN); MRI acquisition of dynamic single slice 2-D sagittal images on 1.5T system (Aera, Siemens Healthcare, Germany) using 12H 4N and 4BFlex coils with T2 trueFISP (trufi-cine) sequence, parameters were- FOV 230, TR 162.54 msec, TE 1.27 msec, FA 44°, ST 10mm, 19.2 fps and AT 8.53 minutes. Swallowing bolus - normal saline (NS, 0.9%) delivered in mouth (rate 2ml/sec), parameters (i) jaw movement, (ii) tongue positioning, (iii) bolus transit (iv) velar closure, (v) hyoid bone elevation, (vi) epiglotic closure, (vii) pharyngeal wave, (viii) arytenoid movement, (ix) residual bolus, (x) spooling of saliva or bolus.

None of the subject was observed as positive on SDQ. On CADN all the patients with PD scored ‘no’ (zero score), or ‘subclinical’ (one score) signs of dysphagia similar to all the healthy control participants.  On dMRI the PD patients had significant difference in oral (tongue, velar posture), oropharyngeal (hyoid, transit time and residue) and oesophageal (arytenoid movement) phases.