Respiratory-Muscle Involvement in Parkinson's Disease

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Abstract
To the Editor: The recent paper by Vincken et al. (Aug. 16 issue)1 claims that the abnormal flow oscillations frequently seen in patients with extrapyramidal disorders result from changes in airflow resistance due to involuntary contractions of upper-airway muscles. Although we accept the authors' observations of abnormal movements of glottic and supraglottic structures at endoscopy, we are uncomfortable with their conclusion that the flow oscillations are entirely related to the involvement of the upper-airway musculature.Indeed, we have recently had the opportunity to perform electromyographic studies of the respiratory-pump muscles in two patients with idiopathic Parkinson's disease and tremor as . . .

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