Respiratory Function and Dysregulation in Parkinson's Disease

Parkinson’s disease (PD) is primarily recognised for its motor disturbances, yet respiratory involvement is increasingly acknowledged as a substantial non-motor dimension. Patients may exhibit restrictive and obstructive ventilatory patterns, reduced lung volumes, impaired cough reflexes and weakened respiratory muscles. These changes stem from a combination of peripheral factors—such as rigidity of the chest wall, kyphotic posture and upper-airway obstruction—and central dysregulation of respiratory drive linked to degeneration in brainstem nuclei. Clinically, these alterations manifest as breathlessness, coughing difficulties, apnoeic episodes and silent aspiration, all of which can contribute to pneumonia, diminished exercise tolerance and reduced quality of life. Assessment modalities range from spirometry and mouth‐pressure measurements to advanced imaging and at‐home monitoring systems. Interventions under investigation include targeted inspiratory muscle training, rehabilitative exercise regimens and neuromodulatory strategies aimed at restoring central respiratory control. In parallel, novel biomarkers derived from breathing signals are emerging, offering the prospect of earlier detection and more precise monitoring of PD progression.

Research from Nature Portfolio

A randomised trial compared two forms of inspiratory muscle training in patients with mild to moderate PD. Over six weeks, both volume-based incentive spirometry and threshold inspiratory muscle training significantly increased maximal inspiratory pressure and six-minute walk distance; the threshold device yielded larger gains, highlighting its potential for routine respiratory rehabilitation programs.

An artificial intelligence model was developed to detect PD and estimate disease severity from nocturnal breathing patterns. Trained on thousands of individuals’ sleep‐derived respiratory signals, the model achieved high diagnostic accuracy and correlated closely with clinical disability scales. Importantly, it operates non-invasively in home environments, signalling a shift towards remote monitoring of respiratory and neurological health.

Respiratory Function and Dysregulation in Parkinson's Disease publication trend

The graph below shows the total number of articles in respiratory function and dysregulation in parkinson's disease across all publications each year (not limited to Nature Index journals).

Technical terms

Dyspnea: The subjective sensation of breathlessness or difficulty in breathing.

Dystussia: Impaired cough response, leading to ineffective airway clearance.

Maximal inspiratory pressure (MIP): A measure of the highest negative pressure generated during a maximal inhalation effort, reflecting inspiratory muscle strength.

Forced vital capacity (FVC): The total volume of air exhaled forcefully after a full inhalation, used to assess restrictive lung patterns.

Apnea: A temporary cessation of breathing, often observed during sleep in PD patients.

Laterodorsal tegmental nucleus (LDTg): A brainstem region involved in coordinating respiratory rhythm and sleep-wake states.

Inspiratory muscle training (IMT): A rehabilitative approach using resistive or volume-based devices to strengthen muscles involved in inhalation.

References

1. Dyspnea and dystussia in Parkinson’s disease: patient-reported prevalence and determinants. Journal of Neurology (2025).
2. Sleep-related respiratory disruptions and laterodorsal tegmental nucleus in a mouse model of Parkinson’s disease. iScience (2024).
3. Effects of an incentive spirometer versus a threshold inspiratory muscle trainer on lung functions in Parkinson’s disease patients: a randomized trial. Scientific Reports (2023).
4. Artificial intelligence-enabled detection and assessment of Parkinson’s disease using nocturnal breathing signals. Nature Medicine (2022).
5. Respiratory Abnormalities in Parkinson’s Disease: What Do We Know from Studies in Humans and Animal Models?. International Journal of Molecular Sciences (2022).