Sialorrhea and Salivary Composition in Patients With Parkinson's Disease

Objective: To evaluate the salivary composition and production in mild and severe Parkinson's Disease (PD) patients. Materials and Methods: A total of 37 patients with PD and age matched 30 control subjects were participated in this study. The Hoehn and Yahr (HY) disability scale was used to determine the severity of the disease. Salivary collection was performed according to a methodology described in the literature and salivary composition was determined. Between group comparisons were performed using the independent t test and chi-square. Results: Salivary production in patients of the Parkinson group was significantly lower than in controls (0.68 +/- 0.26 mg vs. 1.27 +/- 0.65 mg, respectively; p=0.009). But there was no significant difference in salivary production between mild and severe Parkinson patients (0.71 +/- 0.33 mg vs. 0.66 +/- 0.17 mg, respectively; p=0.62). Decrease in the production of saliva was not significantly correlated with levodopa/benserazide dose, HY scale and UPDRS score (r=0.283, p=0.09; r=-0.166, p=0.325; r=-0.208, p=0.217; respectively). In PD patients, salivary concentrations of sodium, potassium, chloride were higher but amylase was lower than in controls (p=0.02, p<0.001, p=0.003, p=0.04, respectively). When mild and severe PD patients were compared there were no significant difference between amylase, potassium, and chloride concentrations of the groups (p=0.07, p=0.32, p=0.16, respectively). Conclusions: PD is associated with decreased salivary production, abnormally high electrolyte and low amylase concentrations. Drooling of saliva is caused by concomitant swallowing difficulties. Thus, using botulinum toxin or anticolinergic drugs in treatment of drooling may cause xerostomia.