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Riva N, Domi T, Pozzi L, Lunetta C, Schito P, Spinelli EG, Cabras S, Matteoni E, Consonni M, Bella ED, Agosta F, Filippi M, Calvo A, Quattrini A. Update on recent advances in amyotrophic lateral sclerosis. J Neurol 2024:10.1007/s00415-024-12435-9. [PMID: 38802624 DOI: 10.1007/s00415-024-12435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
In the last few years, our understanding of disease molecular mechanisms underpinning ALS has advanced greatly, allowing the first steps in translating into clinical practice novel research findings, including gene therapy approaches. Similarly, the recent advent of assistive technologies has greatly improved the possibility of a more personalized approach to supportive and symptomatic care, in the context of an increasingly complex multidisciplinary line of actions, which remains the cornerstone of ALS management. Against this rapidly growing background, here we provide an comprehensive update on the most recent studies that have contributed towards our understanding of ALS pathogenesis, the latest results from clinical trials as well as the future directions for improving the clinical management of ALS patients.
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Affiliation(s)
- Nilo Riva
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy.
| | - Teuta Domi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Pozzi
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Christian Lunetta
- Istituti Clinici Scientifici Maugeri IRCCS, Neurorehabilitation Unit of Milan Institute, 20138, Milan, Italy
| | - Paride Schito
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Edoardo Gioele Spinelli
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Cabras
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Matteoni
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Monica Consonni
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy
| | - Eleonora Dalla Bella
- 3Rd Neurology Unit and Motor Neuron Disease Centre, Fondazione IRCCS "Carlo Besta" Neurological Insitute, Milan, Italy
| | - Federica Agosta
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute Huniversity, Milan, Italy
| | - Massimo Filippi
- Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Neuroimaging Research Unit, Department of Neurology, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute Huniversity, Milan, Italy
| | - Andrea Calvo
- ALS Centre, 'Rita Levi Montalcini' Department of Neuroscience, University of Turin; SC Neurologia 1U, AOU città della Salute e della Scienza di Torino, Turin, Italy
| | - Angelo Quattrini
- Experimental Neuropathology Unit, Division of Neuroscience, Institute of Experimental Neurology, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Cole MR, Cooper CS, Hanna EM, Zimmerman MB, Kinoshita J, Mathews KD. Gastrointestinal and genitourinary symptoms in facioscapulohumeral muscular dystrophy: Prevalence and impact. Muscle Nerve 2024; 69:325-333. [PMID: 38158588 DOI: 10.1002/mus.28028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION/AIMS Anecdotally, patients with facioscapulohumeral muscular dystrophy (FSHD) describe gastrointestinal (GI) and genitourinary (GU) symptoms. We explored the prevalence of GI and GU symptoms and their impact on quality of life (QOL) in people with FSHD compared to healthy household controls. METHODS In this descriptive, cross-sectional study, we emailed a survey exploring GI and GU symptoms to all FSHD Society patient contacts (n = 3507). We invited those with FSHD and unaffected household controls to respond. Non-parametric statistics were used to compare symptom frequency and impact of symptoms between respondents with FSHD and household controls. Within the FSHD group, symptom frequency was assessed relative to measures of disease progression (need for ambulatory or respiratory support). RESULTS Surveys from 701 respondents (652 with FSHD) ≥18 years old were included in analysis. Those with FSHD had symptoms affecting both GI and GU systems more frequently than controls using ordinal rating of symptom frequency. Within the FSHD group, more advanced disease was associated with increased symptom frequency. QOL was negatively impacted by the GI and GU symptoms. There was no difference between groups in use of medications to treat these symptoms. DISCUSSION Recognition and treatment of GI and GU symptoms in people with FSHD, particularly those with more advanced disease, could improve QOL. Additional investigation is required to confirm these findings and understand the physiology.
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Affiliation(s)
- Michael R Cole
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Christopher S Cooper
- Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Eyad M Hanna
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - M Bridget Zimmerman
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA
| | | | - Katherine D Mathews
- Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Zang J, Witt S, Johannsen J, Weiss D, Denecke J, Dumitrascu C, Nießen A, Quitmann JH, Pflug C, Flügel T. DySMA - an Instrument to Monitor Swallowing Function in Children with Spinal Muscular Atrophy ages 0 to 24 Months: Development, Consensus, and Pilot Testing. J Neuromuscul Dis 2024; 11:473-483. [PMID: 38457144 PMCID: PMC10977442 DOI: 10.3233/jnd-230177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2023] [Indexed: 03/09/2024]
Abstract
Background The manifestation of bulbar symptoms, especially swallowing, is important for evaluating disease-modifying therapies for spinal muscular atrophy (SMA). Due to the lack of instruments, the topic is still underrepresented in research. Objective This study aimed to develop a tool to monitor swallowing development in children aged 0 to 24 months with SMA. Methods The method was guided by the COSMIN guidelines and followed a multi-stage Delphi process. The first step was a rapid review of swallowing outcomes in children with SMA younger than 24 months. In the second step, online group interviews with experts (n = 7) on dysphagia in infants were conducted, followed by an anonymous online survey among experts in infants with SMA (n = 19). A predefined consensus threshold for nominal scaled voting was set at≥75 % and for 5-point Likert scale voting at 1.25 of the interquartile range. The third step was the pilot test of the instrument, performed with three groups (healthy controls n = 8; pre-symptomatic n = 6, symptomatic n = 6). Results Based on the multi-level interprofessional consensus, the DySMA comprises two parts (history and examination), ten categories, with 36 items. Implementation and scoring are clearly articulated and easy to implement. The pilot test showed that swallowing development could be recorded in all groups. Conclusion The DySMA is well suited for monitoring swallowing development in pre-symptomatic and symptomatic treated infants with SMA. It can be performed in a time-efficient and interprofessional manner. The resulting score is comparable to results from other instruments measuring other domains, e.g., motor function.
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Affiliation(s)
- Jana Zang
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefanie Witt
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jessika Johannsen
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Deike Weiss
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jonas Denecke
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Charlotte Dumitrascu
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Almut Nießen
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Hannah Quitmann
- Department of Medical Psychology, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Pflug
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till Flügel
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Bedside evaluation of swallowing function to predict aspiration pneumonia in Duchenne muscular dystrophy. Auris Nasus Larynx 2023; 50:247-253. [PMID: 35973890 DOI: 10.1016/j.anl.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/01/2022] [Accepted: 07/22/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Aspiration pneumonia is one of the leading causes of death in patients with muscular dystrophy; therefore, it is important to predict its occurrence in the clincal setting. We aimed to examine the usefulness of repeated saliva swallowing test (RSST), modified water swallowing test (MWST), and flexible endoscopic evaluation of swallowing (FEES) for evaluating the Hyodo score at the bedside, to predict the risk of aspiration pneumonia in patients with Duchenne muscular dystrophy (DMD). METHODS In this retrospective cohort study involving 43 patients, we evaluated the swallowing function using the RSST, MWST, and FEES, and predicted the likelihood of aspiration pneumonia within 2 years after the assessment. The Hyodo score, a scoring system for evaluating the swallowing function determined by the FEES, was used. RESULTS Pneumonia was observed in 14 patients (32.6%). The RSST was not significantly useful for predicting the onset of pneumonia. The MWST was reported to have a cutoff value of < 4 points. Significantly more patients in the pneumonia group had an MWST score of < 4 points. The results revealed that the occurrence of pneumonia could be predicted based on a Hyodo cutoff score of ≥ 6. Significantly more patients in the pneumonia group had an MWST score of < 4 or a Hyodo score of ≥ 6. CONCLUSIONS Combining MWST and FEES is useful for evaluating the bedside swallowing function and predicting the onset of pneumonia.
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Hypoglycemia in Patients With LAMA2-CMD. Pediatr Neurol 2023; 143:1-5. [PMID: 36934516 DOI: 10.1016/j.pediatrneurol.2023.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/26/2022] [Accepted: 01/29/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND Hypoglycemia has been reported in patients with LAMA2-CMD, but the frequency, risk factors, and correlation to genotype/phenotype have not been systematically assessed to date. METHODS A retrospective cohort study was performed on 48 patients with LAMA2-CMD. Patients were divided into two groups: a hypoglycemic group, with at least one episode of hypoglycemia, and a nonhypoglycemic group. The groups were compared according to gait function, epilepsy, intellectual disability, constipation, gastroesophageal reflux, gastrostomy, weight percentile, scoliosis, the use of a ventilator device, the use of a feeding device, neuromuscular disease swallowing status scale, and type of mutation. RESULTS Fifteen patients (31.2%) presented with at least one episode of symptomatic hypoglycemia and eight (16.6% of the cohort) had two or more episodes. All patients who had hypoglycemia were in the nonambulant group. We observed a correlation between gait, the use of ventilator and feeding devices, and swallow function with hypoglycemia. Patients with extremely low weight were five times more likely to have recurrent episodes of hypoglycemia. The presence of at least one missense variant appears to be associated with a lower risk of hypoglycemia. CONCLUSION Patients with LAMA2-CMD are at risk of hypoglycemia. The risk is more relevant in patients with severe phenotype and patients with loss-of-function variants. For patients with extremely low weight, the risk is higher. Blood glucose should be actively measured in patients who are fasting or have infections, and health care providers should be prepared to identify and treat these patients.
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Yokoi S, Nishio N, Maruo T, Hiramatsu M, Mukoyama N, Tsuzuki H, Wada A, Atsuta N, Ito D, Tsuboi T, Sobue G, Katsuno M, Fujimoto Y, Sone M. Safety and Clinical Benefits of Laryngeal Closure in Patients with Amyotrophic Lateral Sclerosis. Dysphagia 2023; 38:211-219. [PMID: 35507038 PMCID: PMC9873708 DOI: 10.1007/s00455-022-10454-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 04/11/2022] [Indexed: 01/28/2023]
Abstract
This study evaluated the safety of laryngeal closure and post-surgical changes in swallowing function of patients with amyotrophic lateral sclerosis (ALS) and proposed an appropriate surgical strategy for patients with ALS. Clinical and surgical data of 26 consecutive patients with ALS who underwent laryngeal closure at Nagoya University Hospital in Japan between 2003 and 2020 were retrospectively analyzed. Changes in swallowing functions were evaluated before and approximately 1 month post-surgery using Neuromuscular Disease Swallowing Status Scale (NdSSS), and Functional Oral Intake Scale (FOIS). The median operation time was 126 min (range, 51-163 min), and the median intraoperative blood loss was 20 mL (range, 0-88 mL). Among the 26 ALS patients who underwent laryngeal closure, grade 1 (mild) complications occurred in three patients (12%); however, no severe complications were observed. After surgery, 25 patients (96%) maintained the swallowing function and only one patient (4%) had deteriorating NdSSS and FOIS scores. No patients were referred to our hospital due to severe aspiration pneumonia after the surgery. Two patients did not require a feeding tube after the surgery and returned to oral intake. Laryngeal closure may be a safe surgical procedure for preventing chronic aspiration and may also maintain swallowing function of patients with ALS. Further multicenter prospective studies using the gold standard videofluoroscopic swallowing examination are required to support our findings.
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Affiliation(s)
- Sayaka Yokoi
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Naoki Nishio
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan.
| | - Takashi Maruo
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mariko Hiramatsu
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Nobuaki Mukoyama
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Hidenori Tsuzuki
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Akihisa Wada
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Naoki Atsuta
- Department of Neurology, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Daisuke Ito
- Department of Neurology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Takashi Tsuboi
- Department of Neurology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Gen Sobue
- Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Masahisa Katsuno
- Department of Neurology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yasushi Fujimoto
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
- Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| | - Michihiko Sone
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
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Moreno CAM, Artilheiro MC, Fonseca ATQSM, Camelo CG, de Medeiros GC, Sassi FC, de Andrade CRF, Donkervoort S, Silva AMS, Dalfior-Junior L, Abath-Neto OL, Reed UC, Bönnemann C, Zanoteli E. Clinical Manifestation of Nebulin-Associated Nemaline Myopathy. Neurol Genet 2023; 9:e200056. [PMID: 36714460 PMCID: PMC9879277 DOI: 10.1212/nxg.0000000000200056] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/28/2022] [Indexed: 01/26/2023]
Abstract
Background and Objectives Nemaline myopathy (NM) is a genetically heterogeneous inherited myopathy related with at least 12 genes, whereas pathogenic variants in NEB gene are the most common genetic cause. The clinical spectrum of NM caused by NEB pathogenic variants (NM-NEB) is very broad, ranging from mild to severe presentations manifesting with generalized weakness, as well as respiratory and bulbar involvement. There is currently not enough data regarding the progression of the disease. In this study, we present a genotypic and phenotypic spectrum of 33 patients with NM caused by NEB variants (NM-NEB) classified according to age groups and the use of ventilatory support. We focused on interventional support, genotype-phenotype correlation, and association between respiratory, bulbar, and motor systems in groups of patients stratified by age and by the use of ventilatory support (VS). Methods Clinical and genetic data from patients with NM-NEB followed up in one specialized center were collected through regular consultations. Patients were evaluated regarding motor, bulbar, and respiratory functions. Results Thirty-three patients with NM-NEB were evaluated consisting of 15 females and 18 males with an average age of 18 (±12) years and a median of 17 (±11) years. 32% of patients with NM-NEB used a G tube, 35% were not able to walk without support, and 55% needed VS. Scoliosis and dysphagia were more common among patients who used VS. Described for the first time, half of the patients presented tongue atrophy in a triple furrow pattern, and the presence of the atrophy was associated with dysphagia. Comparing the patients grouped by age, we found that, proportionally, older patients had more scoliosis and respiratory dysfunction than younger groups, suggesting the progression of the disease in these domains. In addition to that, we showed that VS use was associated with scoliosis and dysphagia. Discussion NM-NEB is a very debilitating disease. There is an association between scoliosis and respiratory dysfunction while patients using VS have more often scoliosis than the no-VS group. Triple furrow tongue atrophy is a novel and frequent finding, which is directly associated with dysphagia. Grouping patients by age suggested disease stability in motor and swallow function, but a progression in respiratory dysfunction and skeletal deformities. All observations are relevant in the management care of patients with NM.
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Affiliation(s)
- Cristiane Araujo Martins Moreno
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mariana Cunha Artilheiro
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Alulin Tacio Quadros Santos Monteiro Fonseca
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Clara Gontijo Camelo
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Gisele Chagas de Medeiros
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Fernanda Chiarion Sassi
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Claudia Regina Furquim de Andrade
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Sandra Donkervoort
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Andre Macedo Serafim Silva
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Luiz Dalfior-Junior
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Osorio Lopes Abath-Neto
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Umbertina Conti Reed
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Carsten Bönnemann
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Edmar Zanoteli
- Department of Neurology (C.A.M.M., M.C.A., A.T.Q.S.M.F., C.G.C., A.M.S.S., U.C.R., E.Z.), School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Department of Physical Therapy (G.C.M., F.C.S., C.R.F.A.), Speech Language and Hearing Science Adn Occupational Therapy, School of Medicine, Universidade de São Paulo (FMUSP), Brazil; Neuromuscular and Neurogenetic Disorders of Childhood Section (S.D., C.B.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Department of Neurology, Hospital Santa Marcelina (L.D.J.), São Paulo, Brazil; and Department of Pathology (O.L.A.-N.), Division of Neuropathology, University of Pittsburgh Medical Center, Pittsburgh, PA
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8
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Zang J, Johannsen J, Denecke J, Weiss D, Koseki JC, Nießen A, Müller F, Nienstedt JC, Flügel T, Pflug C. Flexible endoscopic evaluation of swallowing in children with type 1 spinal muscular atrophy. Eur Arch Otorhinolaryngol 2023; 280:1329-1338. [PMID: 36209319 PMCID: PMC9547642 DOI: 10.1007/s00405-022-07685-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/28/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE This study aimed to report on implementing flexible endoscopic evaluation of swallowing (FEES) in infants and toddlers with type 1 spinal muscular atrophy (SMA). In addition, a comparison of FEES results and clinical scores was carried out. METHODS A prospective pilot study was conducted including ten symptomatic children with SMA type 1 (two SMN2 copies). They started treatment with one of the three currently approved therapies for SMA at a median age of 3.8 months (range 0.7-8.9). FEES was performed according to a standard protocol using Penetration-Aspiration Scale (PAS) and Murray Secretion Scale as a primary outcome. The Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) for motor function, Neuromuscular Disease Swallowing Status Scale (NdSSS), Oral and Swallowing Abilities Tool (OrSAT), and single clinical swallowing-related parameters were also assessed. RESULTS Distinct swallowing disorders were already evident in eight children at inclusion. The most common findings from FEES were pharyngeal secretion pooling, penetration, and aspiration of saliva and food as well as delayed initiation of swallowing. Despite an average increase in motor function, no comparable improvement was found in swallowing function. None of the surveyed clinical scores showed a significant dependence on PAS in a mixed linear model. CONCLUSIONS Valuable information regarding the status of dysphagia can be gathered endoscopically, particularly concerning secretion management and when oral intake is limited. Currently available clinical tools for children with type 1 may represent a change in nutritional status but are not yet mature enough to conclude swallowing ability. Further development is still required.
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Affiliation(s)
- Jana Zang
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Jessika Johannsen
- grid.13648.380000 0001 2180 3484Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jonas Denecke
- grid.13648.380000 0001 2180 3484Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Deike Weiss
- grid.13648.380000 0001 2180 3484Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana-Christiane Koseki
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Almut Nießen
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Frank Müller
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Julie Cläre Nienstedt
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Till Flügel
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Christina Pflug
- grid.13648.380000 0001 2180 3484Department of Voice, Speech and Hearing Disorders, University Dysphagia Center, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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9
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Silva-Carvalho I, Martins A, Casanova MJ, Freitas SV, Meireles L. Cross-Cultural Adaptation and Validation of the European Portuguese Dysphagia Handicap Index. Dysphagia 2022:10.1007/s00455-022-10527-0. [PMID: 36207471 DOI: 10.1007/s00455-022-10527-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/28/2022] [Indexed: 11/03/2022]
Abstract
The Dysphagia Handicap Index (DHI) is a valid Health-related Quality of Life (HRQoL) 25-item questionnaire assessing the physical, functional, and emotional aspects of patients with oropharyngeal dysphagia (OD), of heterogeneous etiologies. The purpose of this study is to translate and validate the European Portuguese-DHI (EP-DHI). This is a prospective study that was carried out at Centro Hospitalar Universitário do Porto (CHUPorto). The generated EP-DHI was administered to 132 patients with OD and 112 healthy control subjects. 132 patients undergoing fiberoptic endoscopic examination of swallowing (FEES). 15 patients were contacted by phone, 2 or 3 weeks later after the first interview to repeat the questionnaire. The validity of concurrent criteria was evaluated by comparing the results of the EP-DHI score with the score attributed to the pathological findings found in FEES and, consequently, Functional Oral Intake Scale (FOIS). The internal consistency of EP-DHI was successful: Cronbach's alpha coefficient for total EP-DHI was 0.874. The test-retest reliability for the total and the three EP-DHI subscales obtained a Pearson's correlation coefficient ranged from 0.990 to 0.712. This study demonstrates that EP-DHI is a valid tool for self-assessment of the handicapping effect of dysphagia on physical, functional, and emotional aspects of patient's quality of life, among an European Portuguese sample.
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Affiliation(s)
- Isabel Silva-Carvalho
- Neurosciences Department, ENT, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal. .,Instituto Superior de Ciências Biomédicas Abel Salazar, Universidade do Porto, R. Jorge de Viterbo Ferreira 228, 4050-313, Porto, Portugal.
| | - Adriana Martins
- Neurosciences Department, ENT, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - Maria Jorge Casanova
- Neurosciences Department, ENT, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - Susana Vaz Freitas
- Neurosciences Department, ENT, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.,Escola Superior de Saúde, Instituto Politécnico do Porto, R. Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal.,Laboratório de Inteligência Artificial e Apoio à Decisão (LIAAD) - INESC TEC, Rua Dr. Roberto Frias, Porto, Portugal
| | - Luís Meireles
- Neurosciences Department, ENT, Centro Hospitalar Universitário do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
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10
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Wada A, Kawakami M, Yamada Y, Kaji K, Hijikata N, Liu F, Otsuka T, Tsuji T. Relationship Between Pneumonia and Dysphagia in Patients With Multiple System Atrophy. Front Neurol 2022; 13:904852. [PMID: 35860494 PMCID: PMC9289225 DOI: 10.3389/fneur.2022.904852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionDysphagia is one of the most clinically significant disabilities in patients with multiple system atrophy (MSA), because it can cause aspiration pneumonia, which is potentially fatal. In this study, the Neuromuscular disease Swallowing Status Scale (NdSSS), which was developed to evaluate dysphagia in patients with neuromuscular diseases, was used to evaluate patients with MSA. In addition, correlation between a history of pneumonia and swallowing function was evaluated.MethodsStudy 1: Reliability, concurrent validity, and responsiveness of the NdSSS in patients with MSA. In 81 patients for whom evaluation items could be collected, the NdSSS was tested for its interrater and intrarater reliability using weighted kappa statistics. Concurrent validity was assessed by correlating the NdSSS with existing scales (Functional Oral Intake Scale (FOIS), Functional Intake LEVEL Scale (FILS), and the unified MSA rating scale (UMSARS)) using Spearman's rank correlation coefficients. Sixty-three patients were evaluated by videofluorographic (VF) swallowing examination. To evaluate concurrent validity, Spearman's rank correlation coefficients were calculated between the NdSSS and VF swallowing assessments. Additionally, scale responsiveness was determined using the standardized response mean (SRM) in 23 patients who could be followed up to assess their long-term course. Study 2: Cross-sectional survey of swallowing function and history of pneumonia. Data regarding history of pneumonia, UMSARS, NdSSS, age, sex, MSA subtype, and disease duration were retrospectively obtained from the medical records of 113 patients with MSA. Differences in these parameters and NdSSS stage between those with and without a history of pneumonia were examined using the Mann-Whitney test or chi-squared test. Furthermore, clinical factors related to a history of pneumonia were examined by binomial logistic regression analysis.ResultsThe NdSSS showed satisfactory reliability, concurrent validity, and responsiveness. A history of pneumonia was related to the severity of MSA, age, MSA subtype, and NdSSS stage. Binomial logistic regression analysis showed that NdSSS stage (odds ratio (OR), 0.490; 95% confidence interval (CI), 0.301–0.797, p = 0.001) and MSA subtype (OR, 4.031; 95% CI, 1.225–13.269, p = 0.021) were significantly associated with a history of pneumonia.ConclusionsIn patients with MSA, the NdSSS has sufficient reliability, concurrent validity, and responsiveness for assessing dysphagia. Patients with a history of pneumonia have more severe dysphagia. We found that the pneumonia risk was related to NdSSS stage and MSA-p (predominantly parkinsonism). Meticulous care to prevent aspiration is needed from early stages of the disease.
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Affiliation(s)
- Ayako Wada
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
- *Correspondence: Michiyuki Kawakami
| | - Yuka Yamada
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kentaro Kaji
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Nanako Hijikata
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Fumio Liu
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tomoyoshi Otsuka
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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11
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Esophageal dysphagia in neuromuscular disorder patients with validity and reliability study of the brief esophageal dysphagia questionnaire. Acta Neurol Belg 2022; 122:315-324. [PMID: 33389721 DOI: 10.1007/s13760-020-01563-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is important to evaluate the esophageal phase of swallowing with an easy and rapid screening test. We aimed both to assess the prevalence of ED in NMD and to perform validity and reliability study of the brief easophageal dysphagia questionnaire (BEDQ) screening test in NMD patients. This prospective cross-sectional clinical study was performed on NMD patients. Demographic features and disease characteristics were recorded. Endoscopic evaluation for oropharyngeal dysphagia (OD) and high-resolution esophageal manometry for ED were performed. In addition, the BEDQ and the 10-item eating assessment tool (EAT-10) were used to all subjects. Cronbach's α and principle components factor analysis (PFCA) with varimax rotation were used for reliability. The Chicago Classification version 3 (CCv3) level (high-resolution esophageal manometry) and EAT-10 was used for validity. A total of 50 patients were included in the study. Thirty-four (68%) patients were diagnosed with myasthenia gravis and 16 (32%) patients were diagnosed with myopathy. Esophageal dysphagia according to the CCv3 was found in 33 (66%) of patients. While the Cronbach's α was excellent as 0.937 for test overall the T-BEDQ scale. The PCFA included all scale items and resulted in a single factor (eigenvalue = 5.72, 71.5%). The all BEDQ scores were demonstrated good correlation with EAT-10 score and very good correlation with CCv3 level. Evaluation of swallowing in patients with NMD should include not only the oropharyngeal phase of swallowing, but also esophageal phase. For this purpose, the BEDQ can be used as a rapid, valid, and reliable test for the evaluation of ED.
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12
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Hijikata N, Kawakami M, Wada A, Ikezawa M, Kaji K, Chiba Y, Ito M, Fujino E, Otsuka T, Liu M. Assessment of dysarthria with Frenchay dysarthria assessment (FDA-2) in patients with Duchenne muscular dystrophy. Disabil Rehabil 2022; 44:1443-1450. [PMID: 32772581 DOI: 10.1080/09638288.2020.1800108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study was to test the psychometric properties of the Japanese version of Frenchay Dysarthria Assessment (FDA-2) and to use this tool to describe the features of speech in patients with Duchenne muscular dystrophy (DMD). MATERIALS AND METHODS The Japanese version of FDA-2 was culturally adapted, and reliability and validity were examined in 22 and 50 patients, respectively. The Japanese version of FDA-2 was administered to 51 patients with DMD. Multiple regression analysis was performed to identify factors related to FDA-2 scores. RESULTS Inter-/intra-rater reliabilities (ICCs) and internal consistency (Cronbach's α) for total scores were 0.76, 0.97, and 0.94 respectively. For construct validity, two-way ANOVA showed a significant interaction between the disorders and FDA-2 sections (p < 0.05). In DMD patients, the item of tongue at rest was most severely affected, reflecting tongue hypertrophy. Multiple regression analysis identified age, swallowing status, and ventilator use as significantly related. CONCLUSIONS The results showed that the Japanese version of FDA-2 has satisfactory reliability and validity. The present study demonstrated the features of dysarthria and related factors in patients with DMD.Implications for rehabilitationIn Duchenne muscular dystrophy (DMD), an absent or defective dystrophin protein causes progressive weakness of respiratory and oropharyngeal muscles, both of which are crucial contributors to speech production.This study shows that the Japanese version of FDA-2 has satisfactory reliability and validity compared to original version.The Japanese version of FDA-2 characterizes dysarthria in patients with DMD in this cohort.
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Affiliation(s)
- Nanako Hijikata
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan.,Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Michiyuki Kawakami
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Ayako Wada
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Maki Ikezawa
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Kentaro Kaji
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Yasuhiro Chiba
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Miyuki Ito
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Eri Fujino
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Tomoyoshi Otsuka
- Department of Rehabilitation Medicine, National Hospital Organization Higashisaitama National Hospital, Saitama, Japan
| | - Meigen Liu
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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13
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Validation and psychometric properties of the Turkish version of Neuromuscular disease Swallowing Status Scale (NdSSS) in patients with oro-pharygo-esophageal dysphagia in neuromuscular disorders. Acta Gastroenterol Belg 2022; 85:21-27. [PMID: 35304990 DOI: 10.51821/85.1.8929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective Dysphagia is one of the most disabling conditions arising from neuromuscular disorders(NMD). There is no specific methods to use in the evaluation of dysphagia in NMD patients. We aimed both to evaluate the applicability of the Neuromuscular Disease Swallowing Status Scale (NdSSS) for dysphagia in all phases of swallowing in various NMD patients and to investigate psychometric properties of this scale. Methods Patients with NMD were enrolled. Functional Oral Intake Scale (FOIS), Fiberoptic Endoscopic Evaluation of Swallowing (FEES), NdSSS and High-Resolution Esophageal Manometry (HRM) were performed on all subjects within 72 hours. While the convergent and concurrent validities were used as validation method, Cohen's kappa and Cronbach's alpha coefficient were calculated for inter-rater reliability. The correlation between FOIS, PAS and HRM diagnosis according to Chicago version 3.0 (CCv3) were analyzed. Results 115 NMD patients were included. There was good correlation between NdSSS and FOIS and PAS scores (Spearman's rank correlation coefficient (r):0.927, r:0.927 and r:-0.836, r:0.841, respectively). Also, there was a positive good correlation between NdSSS and CCv3 evaluating disorders of esophageal peristalsis (r:0.677-0.679, p=0.001). When evaluated separately, there were good correlation between NdSSS levels; and PAS (r:-0.648-0.656); and CCv3 (r:0.514-0.573) levels for ALS. For Myasthenia gravis there was a good correlation between NdSSS levels; and CCv3 (r:0.577-0.622); FOIS (r:0.508-0.521); and PAS (r:-0.504-0.519) scores. Also, for myopathy; a very good(CCv3(0.976-0.982)) and good(FOIS (0.511-0.581) and (PAS (-0.516-0.550)) correlations were defined for myopathy. Conclusion The NdSSS was found applicable to detect both oropharyngeal and esophageal dysphagia risk in patients with NMD and is a valid and reliable swallowing screening tool that can evaluate oro-pharyngo-esophageal dysphagia in NMD patients.
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14
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Ismail MK, Shrestha S. Gastrointestinal Complications of Neuromuscular Disorders. Neuromuscul Disord 2022. [DOI: 10.1016/b978-0-323-71317-7.00004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Validation of the DYALS (dysphagia in amyotrophic lateral sclerosis) questionnaire for the evaluation of dysphagia in ALS patients. Neurol Sci 2021; 43:3195-3200. [PMID: 34853898 DOI: 10.1007/s10072-021-05775-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Dysphagia is a common symptom during the trajectory of ALS, and it can significantly impact on the quality of life and prognosis of patients. Nowadays, no specific tool for the screening of dysphagia in ALS is validated, and the approach is heterogeneous across the Italian centres. OBJECTIVE To validate the DYALS (dysphagia in amyotrophic lateral sclerosis) questionnaire, adapting the DYMUS (dysphagia in multiple sclerosis) questionnaire, for the assessment of dysphagia in ALS patients, in order to uniform the evaluations across the Italian ALS network. METHODS We included 197 patients diagnosed with ALS following the El Escorial criteria, in sixteen Italian ALS centres between 1st December 2019 and 1st July 2020. For each patient, we collected clinical and demographic data and obtained ALSFRS-r score, ALSAQ-5 score, DYMUS score, and EAT-10 score. RESULTS Across the 197 patients, the ratio M/F was 113/84, and the median age was 64 years (IQR 56-72.5). Bulbar patients were 20%, and spinal patients 80%. The median ALSFRSr total score of patients was 35 (IQR 28-39). DYALS score was statistically higher in bulbar ALS than in spinal ALS (median = 6, IQR 4.5-9 vs median = 1, IQR 0-5, z = 6.253, p < 0.0001). DYALS questionnaire showed a high internal consistency (Cronbach's alpha = 0.88). There was a statistically significant correlation between DYALS and EAT-10 (rho = 0.90, p < 0.0001). CONCLUSIONS DYALS scale is reliable, manageable, and easily usable for the screening of dysphagia in ALS. It can be shared with all the Italian ALS centres in order to collect uniform data for therapeutic strategies and clinical trials.
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Berti B, Fanelli L, de Sanctis R, Onesimo R, Palermo C, Leone D, Carnicella S, Norcia G, Forcina N, Coratti G, Giorgio V, Cerchiari A, Lucibello S, Finkel R, Pane M, Mercuri E. Oral and Swallowing Abilities Tool (OrSAT) for Type 1 SMA Patients: Development of a New Module. J Neuromuscul Dis 2021; 8:589-601. [PMID: 34024771 PMCID: PMC8385514 DOI: 10.3233/jnd-200614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe the development of a new tool specifically designed to record oral abilities, swallowing and, more generally, feeding in young type 1 SMA patients, to be used during the first 24 months of life.The tool is composed by a checklist and a separate section summarizing the functional abilities into levels of feeding/swallowing impairment. The checklist includes 12 questions assessing aspects thought to be clinically meaningful for a type 1 SMA population and developmentally appropriate for infants during the first months of life. Each item is graded with a score of 0 or 1, depending on the child's ability to perform the activity. As some items are age-dependent, the number of items to be used, and therefore the maximum score, changes with increasing age. The levels of feeding/swallowing impairment include four levels that can be identified using easily identifiable clinical criteria.In an attempt to validate the tool in an untreated population we applied it to 24 type 1 SMA patients (age range: 2.3-24.1 months, mean: 10.8) in whom the same information collected by the new tool had been previously recorded using a less-structured format.When patients were classified in three groups according to the Dubowitz decimal classification, there was a significant difference both at baseline and at follow-up (p < 0.001). The items assessing fatigue during the nursing sessions were the most frequently impaired even in infants who did not have any other obvious clinical sign of swallowing difficulties.
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Affiliation(s)
- Beatrice Berti
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lavinia Fanelli
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberto de Sanctis
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Roberta Onesimo
- Pediatric Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Concetta Palermo
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Daniela Leone
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sara Carnicella
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giulia Norcia
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicola Forcina
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giorgia Coratti
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Valentina Giorgio
- Pediatric Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonella Cerchiari
- Speech Language Pathology Unit, Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Simona Lucibello
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Richard Finkel
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Marika Pane
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Child Neurology and Psychiatry, Catholic University of Rome, Italy
| | - Eugenio Mercuri
- Centro Clinico Nemo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Child Neurology and Psychiatry, Catholic University of Rome, Italy
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17
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Lee J, Madhavan A, Krajewski E, Lingenfelter S. Assessment of dysarthria and dysphagia in patients with amyotrophic lateral sclerosis: Review of the current evidence. Muscle Nerve 2021; 64:520-531. [PMID: 34296769 DOI: 10.1002/mus.27361] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/21/2021] [Accepted: 06/27/2021] [Indexed: 11/11/2022]
Abstract
Bulbar dysfunction is a common presentation of amyotrophic lateral sclerosis (ALS) and significantly impacts quality of life of people with ALS (PALS). The current paper reviews measurements of dysarthria and dysphagia specific to ALS to identify efficient and valid assessment measures. Using such assessment measures will lead to improved management of bulbar dysfunction in ALS. Measures reviewed for dysarthria in PALS are organized into three categories: acoustic, kinematic, and strength. A set of criteria are used to evaluate the effectiveness of the measures' identification of speech impairments, measurement of functional verbal communication, and clinical applicability. Assessments reviewed for dysphagia in PALS are organized into six categories: patient reported outcomes, dietary intake, pulmonary function and airway defense capacity, bulbar function, dysphagia/aspiration screens, and instrumental evaluations. Measurements that have good potential for clinical use are highlighted in both topic areas. Additionally, areas of improvement for clinical practice and research are identified and discussed. In general, no single speech measure fulfilled all the criteria, although a few measures were identified as potential diagnostic tools. Similarly, few objective measures that were validated and replicated with large sample sizes were found for diagnosis of dysphagia in PALS. Importantly, clinical applicability was found to be limited; thus, a collaborative team focused on implementation science would be helpful to improve the clinical uptake of assessments. Overall, the review highlights the need for further development of clinically viable and efficient measurements that use a multidisciplinary approach.
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Affiliation(s)
- Jimin Lee
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Aarthi Madhavan
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Elizabeth Krajewski
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Sydney Lingenfelter
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park, Pennsylvania, USA
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18
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Nutritional, Gastrointestinal and Endo-Metabolic Challenges in the Management of Children with Spinal Muscular Atrophy Type 1. Nutrients 2021; 13:nu13072400. [PMID: 34371910 PMCID: PMC8308588 DOI: 10.3390/nu13072400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 12/18/2022] Open
Abstract
The management of patients with spinal muscular atrophy type 1 (SMA1) is constantly evolving. In just a few decades, the medical approach has switched from an exclusively palliative therapy to a targeted therapy, transforming the natural history of the disease, improving survival time and quality of life and creating new challenges and goals. Many nutritional problems, gastrointestinal disorders and metabolic and endocrine alterations are commonly identified in patients affected by SMA1 during childhood and adolescence. For this reason, a proper pediatric multidisciplinary approach is then required in the clinical care of these patients, with a specific focus on the prevention of most common complications. The purpose of this narrative review is to provide the clinician with a practical and usable tool about SMA1 patients care, through a comprehensive insight into the nutritional, gastroenterological, metabolic and endocrine management of SMA1. Considering the possible horizons opened thanks to new therapeutic frontiers, a nutritional and endo-metabolic surveillance is a crucial element to be considered for a proper clinical care of these patients.
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19
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Bartolome G, Starrost U, Schröter-Morasch H, Schilling B, Fischbacher L, Kues L, Graf S, Ziegler W. Validation of the munich swallowing score (mucss) in patients with neurogenic dysphagia: A preliminary study. NeuroRehabilitation 2021; 49:445-457. [PMID: 34180423 DOI: 10.3233/nre-210011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND The Munich Swallowing Score (MUCSS) is a clinician rated scale for the assessment of the functional level of swallowing saliva/secretions, food and liquids. The MUCSS consists of two eight-point subscales, MUCSS-Saliva and MUCSS-Nutrition. In a previous article, content validity and interrater reliability were described. OBJECTIVE The aim of the present study was to investigate criterion validity and sensitivity to change of the MUCSS. METHODS The research was conducted at a tertiary care academic hospital. Data were collected retrospectively in a cohort of 100 acute and subacute neurologic patients. Criterion validity was judged by comparison to the Gugging Swallowing Screen (GUSS), the Barthel Index (BI), Early Rehabilitation Barthel Index (ERI), Extended Barthel Index (EBI) and also by comparison to three physiological scales drawn from FEES videos: The Penetration - Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale (YPR) and the Murray Secretion Scale (MSS). Changes in oral intake and saliva swallowing were followed up for three months. RESULTS Between MUCSS and scores directly reflecting dysphagic symptoms (GUSS, PAS, YPR, MSS, ERI), strong to moderate correlations were found, weaker but statistically significant associations were seen with global measures of disability (BI isolated, EBI-subscale cognitive functions). MUCSS was sensitive to positive change of saliva swallowing and oral intake during the recovery period. CONCLUSIONS These preliminary data suggest that the MUCCS is a valid scale and may be appropriate for documenting clinical change in swallowing abilities of patients with neurogenic dysphagia.
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Affiliation(s)
- G Bartolome
- Department of Early Rehabilitation and Physical Medicine, Academic Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - U Starrost
- Department of Early Rehabilitation and Physical Medicine, Academic Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - H Schröter-Morasch
- Department of Early Rehabilitation and Physical Medicine, Academic Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - B Schilling
- Department of Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - L Fischbacher
- Department of Early Rehabilitation and Physical Medicine, Academic Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - L Kues
- Department of Early Rehabilitation and Physical Medicine, Academic Hospital Bogenhausen, Munich Municipal Hospital Group, Munich, Germany
| | - S Graf
- Department of Otorhinolaryngology/Phoniatrics, Klinikum rechts der Isar, Technical University Munich, Munich, Germany
| | - W Ziegler
- Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University, Munich, Germany
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20
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Audag N, Liistro G, Goubau C, Vandervelde L, Poncin W, Toussaint M, Van den Bergh P, Reychler G. Screening for oropharyngeal dysphagia in adult patients with neuromuscular diseases using the Sydney Swallow Questionnaire. Muscle Nerve 2021; 64:277-284. [PMID: 33890683 DOI: 10.1002/mus.27254] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION/AIMS Oropharyngeal dysphagia is common in patients with neuromuscular diseases (NMDs). Its early recognition is vital for proper management. We tested a large cohort of adult NMD patients for oropharyngeal dysphagia using the Sydney Swallow Questionnaire (SSQ). We also looked for possible differences in characteristics of oropharyngeal dysphagia in various NMD groups and diseases. Finally, we compared results of this screening with those from their corresponding medical records for eventual "clinical history" of dysphagia. METHODS We asked patients to fill in the SSQ during follow-up outpatient visits at our neuromuscular reference center. A total score above the cutoff score of 118.5 out of 1700 was indicative of oropharyngeal dysphagia. RESULTS Of the 304 adult patients assessed for eligibility, 201 NMD patients (96 women and 105 men, aged 49.0 ± 16.2 years) were included and tested in this study. Oropharyngeal dysphagia was detected in 45% of all the NMD patients when using the SSQ, whereas only 12% had a positive medical record for dysphagia. The median SSQ scores for patients with myotonic syndromes (including myotonic dystrophy type 1), with amyotrophic lateral sclerosis, and with facioscapulohumeral dystrophy were above the cutoff score. The SSQ scores obtained revealed distinct oropharyngeal dysphagia characteristics in the different NMD groups and diseases. DISCUSSION The SSQ tests positively for oropharyngeal dysphagia in a higher proportion of NMD patients compared with their medical records. The distinct oropharyngeal dysphagia characteristics we revealed in different NMD groups and diseases may help to elaborate adapted clinical approaches in the management of oropharyngeal dysphagia.
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Affiliation(s)
- Nicolas Audag
- Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL & Dermatologie, Groupe Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, Brussels, Belgium.,Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Haute École Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
| | - Giuseppe Liistro
- Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Christophe Goubau
- Unité de Pneumologie pédiatrique, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Centre de Référence Neuromusculaire, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | | | - William Poncin
- Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL & Dermatologie, Groupe Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, Brussels, Belgium.,Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | | | - Peter Van den Bergh
- Centre de Référence Neuromusculaire, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - Gregory Reychler
- Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL & Dermatologie, Groupe Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, Brussels, Belgium.,Secteur de Kinésithérapie et Ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Haute École Léonard de Vinci, Parnasse-ISEI, Brussels, Belgium
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21
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Incidence and Risk Factors of Postoperative Dysphagia in Severe Aortic Stenosis. TOPICS IN GERIATRIC REHABILITATION 2021. [DOI: 10.1097/tgr.0000000000000318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Bakhtiyari J, Tohidast SA, Mansuri B, Azimi H, Ebadi A. The Persian version of the Functional Oral Intake Scale (FOIS-P): a validation study on stroke patients with dysphagia. LOGOP PHONIATR VOCO 2021; 47:133-138. [PMID: 33724141 DOI: 10.1080/14015439.2021.1896778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE The present study aimed to validate the Persian version of the Functional Oral Intake Scale (FOIS-P) for stroke patients. MATERIALS AND METHODS The current study was conducted in two phases: (1) translation and cross-cultural adaptation of the FOIS into Persian and (2) validation of the FOIS-P. Phase 1 included forward translation, synthesis, back-ward translation, expert panel, and pretesting. To validate the FOIS-P, inter-rater reliability, cross-validity, and sensitivity to change of the scale were investigated. To evaluate the inter-rater reliability of the FOIS-P, two speech-language pathologists, who were blind to the study aims and procedure, applied the FOIS-P to assess the oral intake of 60 stroke survivors. The cross-validity was assessed by investigating the correlation between the FOIS scores and the Video Fluoroscopy Swallowing Study (VFSS). Also, we applied the FOIS-P on 60 patients with stroke at three different times to investigate the sensitivity to change. RESULTS Inter-rater reliability of the FOIS-P was excellent according to Cohen's Kappa calculation (K = 0.89, p<.001). Investigation of cross-validity showed that there were significant correlations between the FOIS scores and presence of dysphagia, presence of aspiration, and severity of dysphagia (p<.001). The changes of the FOIS-P scores over follow-ups revealed that the FOIS-P was sensitive to the patient's oral intake changes. CONCLUSIONS The FOIS-P is a valid and reliable tool for assessing oral intake in stroke survivors with dysphagia. Hence, the FOIS-P may be suitable for clinical and research in the field of stroke.
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Affiliation(s)
- Jalal Bakhtiyari
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyed Abolfazl Tohidast
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Hadi Azimi
- English Language Teaching Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
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23
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Validation of the Italian Version of the Functional Oral Intake Scale (FOIS-It) Against Fiberoptic Endoscopic Evaluation of Swallowing and Nutritional Status. Dysphagia 2021; 37:137-147. [PMID: 33591464 PMCID: PMC8844182 DOI: 10.1007/s00455-021-10257-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/27/2021] [Indexed: 12/13/2022]
Abstract
The Functional Oral Intake Scale (FOIS) is a reliable and valid tool to assess functional oral intake of food and liquids in patients with oropharyngeal dysphagia (OD). Its validity was established for stroke patients against Videofluoroscopic Swallowing Study in English and Chinese and against Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in German. FOIS was cross-culturally validated into Italian (FOIS-It), but construct validity against instrumental assessment and nutritional status was not investigated. The study aims at contributing to the validation of the FOIS-It, by performing convergent and known-group validity against FEES and nutritional status in patients with OD of different etiologies. Overall, 220 adult patients with OD of etiological heterogeneity were recruited. FOIS-It score and Body Mass Index (BMI) were collected. FEES was performed to assess swallowing safety and efficiency based on the Penetration-Aspiration Scale (PAS) and the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS). Moderate to weak associations with PAS (ρ = - .37, p < .01), YPRSRS in the pyriform sinuses (ρ = - .20, p < .01), and BMI (ρ = .24, p < .01) were detected with Spearman's correlation. FOIS-It distribution was compared with the Mann-Whitney U and Kruskal-Wallis tests. Significantly lower FOIS-It scores were detected among patients with penetration/aspiration (PAS > 2) and penetration (PAS > 2 ≤ 5) for all consistencies (p < .01), aspiration (PAS > 5) of liquids and semisolids (p < .001), residue in the pyriform sinuses (YPRSRS > 3) with semisolids (p < .001) and solids (p = .02), and malnutrition (BMI ≤ 18.5; p = .019). FOIS-It appears as a valid tool to assess functional oral intake against FEES' measures of swallowing safety and efficiency and nutritional status in patients with OD of etiological heterogeneity.
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24
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Sarmet M, Mangilli LD, Costa GP, Paes JPRS, Codeço VM, Million JL, Maldaner V. The relationship between pulmonary and swallowing functions in patients with neuromuscular diseases followed up by a tertiary referral center: a cross-sectional study. LOGOP PHONIATR VOCO 2021; 47:117-124. [PMID: 33586591 DOI: 10.1080/14015439.2021.1879254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Respiratory muscle weakness is common in patients with neuromuscular diseases (NMD). This puts them at risk for dysphagia and other pulmonary complications. OBJECTIVES To investigate the relationship between pulmonary function and swallowing in NMD. MATERIALS AND METHODS In this cross-sectional study, medical records of patients undergoing treatment at the Tertiary Referral Center for Neuromuscular Diseases of Hospital de Apoio de Brasília, Brazil, were reviewed. Respiratory function was assessed through spirometry (FVC and FEV1 measured) and swallowing assessed by the Dysphagia Risk Evaluation Protocol and the Functional Oral Intake Scale. RESULTS Two hundred and twenty-two patients were included. Dysphagia was present in 46.8% of patients and impairment of pulmonary function in 64.0%. The mean FVC observed was 66.9% and FEV1 was 66.0%, indicating restrictive lung disease. A correlation between the decline of pulmonary and swallowing functions was observed in patients with NMDs (FVC vs. DREP, R = 0.46; FVC vs. FOIS, R = 0.42; FEV1 vs. DREP, R = 0.42; FEV1 vs. FOIS, R = 0.40, p<.01). FVC and FEV1 values tend to be lower in patients with dysphagia in the context of NMD. CONCLUSIONS A positive correlation between pulmonary function and swallowing outcomes was observed in patients with NMD. Despite respiratory and swallowing impairment being widely present in the population with NMD, they require different treatments according to the disease's pathophysiology. Future studies should be conducted to explore the disease-specific relationship between pulmonary function and swallowing in patients with NMD.
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Affiliation(s)
- Max Sarmet
- Departments of Speech Therapy and Physical Therapy, Hospital de Apoio de Brasília, Tertiary Referral Center of Neuromuscular Diseases, Brasília, Brazil.,Graduate Department of Health Sciences and Technologies, University of Brasília (UnB), Brasília, Brazil
| | | | - Geovanna Pereira Costa
- Undergraduate Program, College of Medicine, Escola Superior de Ciências da Saúde, Brasília, Brazil
| | | | - Vitor Martins Codeço
- Department of Thoracic Diseases, Hospital Regional da Asa Norte, Brasília, Brazil
| | - Janae Lyon Million
- Department of Human Biology, University of California, Santa Cruz, CA, USA
| | - Vinicius Maldaner
- Departments of Speech Therapy and Physical Therapy, Hospital de Apoio de Brasília, Tertiary Referral Center of Neuromuscular Diseases, Brasília, Brazil.,Undergraduate Program, College of Medicine, Escola Superior de Ciências da Saúde, Brasília, Brazil
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25
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Zhou Y, Chen J, Gong X, Lu Z, Hua H, Zhu X, Shi P, Li X, Zhou S, Wang Y, Qian T. Nutrition status survey of type 2 and 3 spinal muscular atrophy in Chinese population. Nutr Neurosci 2021; 25:1488-1494. [PMID: 33487140 DOI: 10.1080/1028415x.2020.1871212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To evaluate the nutritional status of children with SMA types II and III in a Chinese population. METHODS We performed a retrospective medical record review of prospectively collected data from children with SMA types II and III in a single centre. We analysed data including clinical parameters, anthropometrics, and 24-hour dietary intake records in our clinic. RESULTS We analysed the anthropometric data from 86 children with 69 (80%) SMAII and 17 (20%) SMAIII; 47 (55%) were female, mean age was 5.22 ± 3.73 years. The WAZ of the SMAII (n = 69) and SMAIII (n = 17) were -0.48 (IQR -1.69, 0.57) vs -0.53 (IQR -1.60, 0.55), P = 0.926; the HAZ were -0.62 (IQR -1.4, 0.3) vs -0.6 (IQR -1.61, 0.4), P=0.72; the BMIZ were -0.51 (IQR -1.53, 0.99) vs -0.08 (IQR -1.625, 1.125), P = 0.537.The dietary intake of 51 children was compared to the Chinese Dietary Reference Intakes (DRIs). The actual energy intake in SMAII was similar to the DRIs, but which in SMAIII was less than the DRIs (1312.4 ± 329.5 kcal vs. 1655 ± 640.1 kcal, P = 0.028). The protein intake in SMAII and SMAIII was higher than the DRIs (55 ± 16.3 g/d vs 30.2 ± 4.6 g/d, P < 0.05; 56.8 ± 18.1 g/d vs 41.5 ± 17.5 g/d, p = 0.22), and calcium intake was lower than the recommendation (507.7 ± 177.8 mg/d vs 731.7 ± 123.4 mg/d, P < 0.05; 478.4 ± 207.4 mg/d vs 478.4 ± 207.4 mg/d, P = 0.01). Swallowing on the Neuromuscular Disease Status Scale was 7.41 ± 0.5. CONCLUSIONS Children with SMAII and SMAIII were at risk for malnutrition and low calcium intake.
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Affiliation(s)
- Yiyao Zhou
- Department of clinical nutrition, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Jieyu Chen
- Department of clinical nutrition, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xiaoyan Gong
- Department of clinical nutrition, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Zhongying Lu
- Department of clinical nutrition, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Haimei Hua
- Department of clinical nutrition, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xiaomei Zhu
- Department of neurology, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Peng Shi
- Department of statistic and data management, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Xihua Li
- Department of neurology, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Shuizhen Zhou
- Department of neurology, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yi Wang
- Department of neurology, Children's Hospital of Fudan University, Shanghai, People's Republic of China
| | - Tian Qian
- Department of clinical nutrition, Children's Hospital of Fudan University, Shanghai, People's Republic of China
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26
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Argov Z, de Visser M. Dysphagia in adult myopathies. Neuromuscul Disord 2020; 31:5-20. [PMID: 33334661 DOI: 10.1016/j.nmd.2020.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 10/30/2020] [Accepted: 11/02/2020] [Indexed: 12/11/2022]
Abstract
Dysphagia (impaired swallowing) is not a rare problem in various neuromuscular disorders, both in the pediatric and the adult patient population. On many occasions such patients are first presented to other medical specialists or health professionals. Disorders of deglutition are probably underrecognized in patients with a neuromuscular disease as a result of patient's and doctor's delay. This review will focus on dysphagia in adults suffering from a myopathy. Dysphagia in myopathies usually affects the oropharyngeal phases which rely mostly on voluntary muscle activity of the mouth, pharynx and upper esophageal sphincter. Dysphagia is known to contribute to a reduction of quality of life and may also lead to increased morbidity and mortality. The review includes an overview on symptomatology and tools of assessments, and elaborates on dysphagia in specific hereditary and acquired myopathies.
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Affiliation(s)
- Zohar Argov
- Department of Neurology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands.
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27
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Neuhaus SB, Wallgren-Pettersson C, Bönnemann CG, Schara U, Servais L. 250th ENMC International Workshop: Clinical trial readiness in nemaline myopathy 6-8 September 2019, Hoofdorp, the Netherlands. Neuromuscul Disord 2020; 30:866-875. [PMID: 32919842 DOI: 10.1016/j.nmd.2020.08.356] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 08/10/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Sarah B Neuhaus
- Neuromuscular and Neurogenetic Disorders of Childhood Section, Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, 20892, U.S.A
| | - Carina Wallgren-Pettersson
- The Folkhälsan Institute of Genetics and the Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, 20892, U.S.A
| | - Ulrike Schara
- Department of Pediatric Neurology, Centre for Neuromuscular Disorders in Children and Adolecents, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Laurent Servais
- Division of Child Neurology, Centre de Références des Maladies Neuromusculaires, Department of Pediatrics, University Hospital Liège & University of Liège, Liège, Belgium; MDUK Neuromuscular Centre, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.
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28
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Umemoto G, Fujioka S, Arahata H, Kawazoe M, Sakae N, Sasagasako N, Furuya H, Tsuboi Y. Relationship between tongue pressure and functional oral intake scale diet type in patients with neurological and neuromuscular disorders. Clin Neurol Neurosurg 2020; 198:106196. [PMID: 32980799 DOI: 10.1016/j.clineuro.2020.106196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 08/23/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Patients with neurological and neuromuscular disorders (NNMD) frequently experience swallowing disorders that increase aspiration pneumonia risk and therefore require specialized diets or tube feeding. Diet type level usually is assessed by video fluoroscopic swallowing study (VFSS). To identify a simpler assessment method, we examined the association between diet type (based on the Functional Oral Intake Scale [FOIS]) diet type and maximum tongue pressure (MTP). METHODS From 2011-2020, FOIS diet type level and MTP were assessed in a sample of 927 patients. Of these patients, 186 had Parkinson's disease (PD), 69 had Parkinson-related disease (PRD), 61 had multiple system atrophy (MSA), 42 had spinocerebellar degeneration (SCD), 147 had amyotrophic lateral sclerosis (ALS), 180 had myotonic dystrophy type 1 (DM1), and 242 had Duchenne muscular dystrophy (DMD). VFSS was conducted while patients swallowed water and foods containing barium. MTP measurements were collected the same day. Participants' diet type level was adjusted based on the VFSS, with some participants requiring multiple examinations. Relationships between diet type level and MTP were tested using univariate and Spearman rank correlation analyses. RESULTS Mean MTP for the entire NNMD group (25.5 ± 13.1 kPa) was lower than that of healthy elderly individuals, as determined in previous reports. The highest MTP was found in the MSA group (32.2 ± 15.7 kPa) and the lowest in the DM1 group (19.1 ± 9.0 kPa). Diet type level was highest in the MSA group (5.8 ± 1.4) and lowest in the DMD group (5.2 ± 1.7). A significant correlation was observed between diet type level and MTP (R = 0.384, p < 0.001). The optimum MTP cutoff values-detected using ROC curves to predict a requirement to change to a dysphagia diet-was highest in the DMD group (29.0 kPa) and lowest in the ALS group (12.3 kPa). CONCLUSIONS The decision to change NNMD patients to a dysphagia diet can be made based on MTP. Modifying a patient's oral diet (FOIS level ≤ 5) should be considered for those with a MTP of 10-25 kPa, with the cutoff value varying by disease.
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Affiliation(s)
- George Umemoto
- Swallowing Disorders Center, Fukuoka University Hospital, Fukuoka, Japan; Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan.
| | - Shinsuke Fujioka
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hajime Arahata
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Miki Kawazoe
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Nobutaka Sakae
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Naokazu Sasagasako
- Department of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, Japan
| | - Hirokazu Furuya
- Department of Neurology, Faculty of Medicine, Kochi University, Kochi, Japan
| | - Yoshio Tsuboi
- Department of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Romero-Gangonells E, Virgili-Casas MN, Dominguez-Rubio R, Povedano M, Pérez-Saborit N, Calvo-Malvar N, Barceló MA. Evaluation of Dysphagia in Motor Neuron Disease. Review of Available Diagnostic Tools and New Perspectives. Dysphagia 2020; 36:558-573. [PMID: 32797289 DOI: 10.1007/s00455-020-10170-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 08/06/2020] [Indexed: 11/26/2022]
Abstract
Oropharyngeal dysphagia (OD) is highly prevalent (up to 80%) in patients with motor neuron disease (MND), influencing the prognosis of the disease. The clinical assessment of dysphagia is complex. There are assessment scales and screening questionnaires, but they have not been tested in patients with MND. In a sample of 46 patients with MND, the sensitivity and specificity of the EAT-10 and SwalQoL questionnaires, as well as the ALS-SS and FOIS scales, were tested and compared to the gold standard technique (videofluoroscopy, VFS). The patients were stratified using the DOSSc variable according to the video fluoroscopic examination with (n = 37) or without (n = 8) signs of dysphagia, and the results were compared with the scores obtained in the dysphagia questionnaires. None of the studied questionnaires was more sensitive than the others, but one stood out for its high specificity (= 1): the SwalQoL revised FS. The symptom frequency section of the SwalQoL questionnaire with some modifications, (SwalQoL revised FS) may be a useful tool in the clinical assessment of dysphagia because it's capable to detect the patients that really don't have dysphagia. The ALS-SS showed the greatest validity as a severity scale of dysphagia among the sample studied. A specific questionnaire for screening for dysphagia in MND needs to be developed. Until that time, the proposal is to use a combination of the existing questionnaires for other pathologies (EAT-10 and SwalQoL) and the specific scale for MND, the ALS-SS, to make an accurately clinical assessment of OD in MND patients before to perform a videofluoroscopy.
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Affiliation(s)
- Elisabet Romero-Gangonells
- Functional Motor Neuron Unit (UFMN), Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Spain
- Department of Endocrinology and Clinical Nutrition, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - M Núria Virgili-Casas
- Functional Motor Neuron Unit (UFMN), Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Spain
- Department of Endocrinology and Clinical Nutrition, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Raúl Dominguez-Rubio
- Functional Motor Neuron Unit (UFMN), Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Spain
| | - Mònica Povedano
- Functional Motor Neuron Unit (UFMN), Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
- IDIBELL (Institut D'Investigació Biomèdica de Bellvitge), L'Hospitalet de Llobregat, Spain
| | - Núria Pérez-Saborit
- Department of Image Diagnosis and Nuclear Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Nahum Calvo-Malvar
- Department of Image Diagnosis and Nuclear Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain
| | - Maria A Barceló
- Functional Motor Neuron Unit (UFMN), Department of Neurology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain.
- Research Group On Statistics, Econometrics and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, 17003, Girona, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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Validation of the German Version of Functional Oral Intake Scale (FOIS-G) for Flexible Endoscopic Evaluation of Swallowing (FEES). Dysphagia 2020; 36:130-139. [PMID: 32342178 PMCID: PMC7803872 DOI: 10.1007/s00455-020-10114-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/15/2020] [Indexed: 12/21/2022]
Abstract
The Functional Oral Intake Scale (FOIS) is the most frequently used scale for the evaluation of functional oral intake by dysphagia patients. FOIS was validated using data from Videofluoroscopic Swallowing Study (VFSS). Until now, a validated German version of FOIS for Flexible Endoscopic Evaluation of Swallowing (FEES) is lacking. The aim of this study was a cross-cultural validation of the German version of FOIS (FOIS-G) for FEES. The translation of the original FOIS was carried out according to the Translation, Review, Adjudication, Pretesting, Documentation (TRAPD) translation methodology. For the validation process, six experienced language therapists (SLT) retrospectively analyzed charts of 93 stroke patients. Inclusion criteria were comprised of stroke, clinical examination by an SLT within 24 h of admission, and FEES within 72 h of admission. The validity was calculated by comparison with Modified Rankin Scale (MRS), Barthel Index (BI), the Penetration-Aspiration-Scale (PAS), and a water swallow test. Spearman rank correlation of all paired raters ranged from rs = 0.96 to rs = 0.99, and percentage agreement ranged from 81 to 94%. The overall agreement between all raters was calculated by Fleiss kappa (0.83) (s.e. 0.02). There is a significant correlation between the BI and the MRS with the FOIS-G (rs = 0.301, p = 0.003 for BI; rs = – 0.366, p < 0.001 for MRS), between the PAS and the FOIS-G (rs = − 0.758, p < 0.001), as well as between the 70 ml-water-test and the FOIS-G (rs = 0.470, p < 0.001). FOIS-G is a valid instrument for the evaluation of the functional oral intake of food and liquids in dysphagia patients.
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Choi YA, Suh DI, Chae JH, Shin HI. Trajectory of change in the swallowing status in spinal muscular atrophy type I. Int J Pediatr Otorhinolaryngol 2020; 130:109818. [PMID: 31945686 DOI: 10.1016/j.ijporl.2019.109818] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study aimed to elucidate the change in progressive swallowing dysfunction from birth up to 2 years of age to provide clinical insights into the management of swallowing difficulty in patients with spinal muscular atrophy (SMA) type I. METHODS Data of 11 patients with SMA type I were retrospectively reviewed. The Neuromuscular Disease Swallowing Status Scale (NdSSS) scores and videofluoroscopic swallowing study (VFSS) were used. RESULTS Swallowing function deteriorated in patients with SMA type I at an approximate age of 6 months. Tube feeding was initiated at the median age of 6 months (interquartile range, 3-7 months). The transition period for switching the feeding route from totally oral to tube feeding varied widely among patients (5-12 months). In four patients, aspiration was observed in VFSS, even when nutrition was provided orally. In two patients, the evidence of laryngeal aspiration was obtained via the VFSS during the very early stages of the disease at 3 and 4 months. Conversely, in one patient, total oral feeding was maintained for up to 12 months, and evidence of aspiration was not observed in the VFSS. CONCLUSION An individualized approach is essential, as the timeline of deterioration of swallowing function varies widely in patients with SMA type I.
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Affiliation(s)
- Young-Ah Choi
- Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jong-Hee Chae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, College of Medicine, Seoul National University, Republic of Korea.
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Rong P. Automated Acoustic Analysis of Oral Diadochokinesis to Assess Bulbar Motor Involvement in Amyotrophic Lateral Sclerosis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:59-73. [PMID: 31940257 DOI: 10.1044/2019_jslhr-19-00178] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The purpose of this article was to validate a novel acoustic analysis of oral diadochokinesis (DDK) in assessing bulbar motor involvement in amyotrophic lateral sclerosis (ALS). Method An automated acoustic DDK analysis was developed, which filtered out the voice features and extracted the envelope of the acoustic waveform reflecting the temporal pattern of syllable repetitions during an oral DDK task (i.e., repetitions of /tɑ/ at the maximum rate on 1 breath). Cycle-to-cycle temporal variability (cTV) of envelope fluctuations and syllable repetition rate (sylRate) were derived from the envelope and validated against 2 kinematic measures, which are tongue movement jitter (movJitter) and alternating tongue movement rate (AMR) during the DDK task, in 16 individuals with bulbar ALS and 18 healthy controls. After the validation, cTV, sylRate, movJitter, and AMR, along with an established clinical speech measure, that is, speaking rate (SR), were compared in their ability to (a) differentiate individuals with ALS from healthy controls and (b) detect early-stage bulbar declines in ALS. Results cTV and sylRate were significantly correlated with movJitter and AMR, respectively, across individuals with ALS and healthy controls, confirming the validity of the acoustic DDK analysis in extracting the temporal DDK pattern. Among all the acoustic and kinematic DDK measures, cTV showed the highest diagnostic accuracy (i.e., 0.87) with 80% sensitivity and 94% specificity in differentiating individuals with ALS from healthy controls, which outperformed the SR measure. Moreover, cTV showed a large increase during the early disease stage, which preceded the decline of SR. Conclusions This study provided preliminary validation of a novel automated acoustic DDK analysis in extracting a useful measure, namely, cTV, for early detection of bulbar ALS. This analysis overcame a major barrier in the existing acoustic DDK analysis, which is continuous voicing between syllables that interferes with syllable structures. This approach has potential clinical applications as a novel bulbar assessment.
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Affiliation(s)
- Panying Rong
- Department of Speech-Language-Hearing: Sciences & Disorders, Dole Human Development Center, The University of Kansas, Lawrence
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33
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Gozzer MM, Cola PC, Onofri SMM, Merola BN, Silva RGD. Achados videoendoscópicos da deglutição em diferentes consistências de alimento na Esclerose Lateral Amiotrófica. Codas 2020; 32:e20180216. [DOI: 10.1590/2317-1782/20192018216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 04/26/2019] [Indexed: 12/14/2022] Open
Abstract
RESUMO Objetivo Este estudo teve por objetivo comparar os achados videoendoscópicos da deglutição orofaríngea em distintas consistências de alimento na Esclerose Lateral Amiotrófica (ELA). Método Estudo clínico retrospectivo com amostra de conveniência. Foram incluídos 20 indivíduos com diagnóstico de ELA e disfagia orofaríngea confirmada por avaliação clínica e objetiva de deglutição, independentemente do tipo, bulbar ou esquelética, e tempo de diagnóstico neurológico, 13 do sexo masculino e sete do sexo feminino, faixa etária variando de 34 a 78 anos, média de 57 anos. Foram analisados os achados da videoendoscopia de deglutição (VED) nas consistências líquida (N=18), líquida espessada (N=19) e pastosa (N=20) no volume de cinco ml. Os achados sobre escape oral posterior, resíduos faríngeos, penetração laríngea e/ou aspiração foram comparados nas três consistências de alimento e a análise estatística utilizou o teste ANOVA de Friedman. Resultados Não foi encontrada alteração na sensibilidade laríngea nessa população. Não houve diferença estatística significativa entre as consistências de alimento na presença de escape oral posterior, penetração e/ou aspiração. Houve diferença estatística significativa somente com resíduos faríngeos na consistência líquida espessada e pastosa na ELA. Conclusão Dentre os achados videoendoscópicos da deglutição na ELA, somente o resíduo faríngeo teve maior frequência na dependência da consistência de alimento.
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Affiliation(s)
- Marina Mendes Gozzer
- Universidade Estadual Júlio de Mesquita Filho, Brasil; Universidade Estadual Júlio de Mesquita Filho, Brasil
| | - Paula Cristina Cola
- Universidade Estadual Júlio de Mesquita Filho, Brasil; Universidade Estadual Júlio de Mesquita Filho, Brasil; Universidade de Marília, Brasil
| | | | - Beatriz Novaes Merola
- Universidade Estadual Júlio de Mesquita Filho, Brasil; Universidade Estadual Júlio de Mesquita Filho, Brasil
| | - Roberta Gonçalves da Silva
- Universidade Estadual Júlio de Mesquita Filho, Brasil; Universidade Estadual Júlio de Mesquita Filho, Brasil
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Suh JH, Park D, Kim IS, Kim H, Shin CM, Ryu JS. Feasibility of high-resolution manometry for decision of feeding methods in patients with amyotrophic lateral sclerosis. Medicine (Baltimore) 2019; 98:e15781. [PMID: 31169677 PMCID: PMC6571283 DOI: 10.1097/md.0000000000015781] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
As amyotrophic lateral sclerosis (ALS) progresses, dysphagia gets worse due to the weakening of pharyngeal musculature. As oral feeding becomes more difficult or dangerous due to worsening dysphagia, tracheal aspiration, or undernutrition, the necessity for tube feeding becomes increasingly important. This study aims to establish a standard pressure point by applying pharyngeal pressure using high-resolution manometry (HRM) to start tube feeding in patients with ALS.This study was designed as a retrospective analysis of prospectively collected data. Forty-one patients with ALS and 20 healthy subjects were participated. Both groups were evaluated using HRM, videofluoroscopic swallowing study (VFSS), and pulmonary function test. The swallowing pressure along the velopharynx (VP), tongue base (TB), pre-upper esophageal sphincter (UES), lower pharynx, and cricopharyngeus, as well as minimal UES pressure were measured using HRM.There was significantly positive correlation between the pressure of cricopharyngeus and forced expiratory volume in 1 second (FEV1). And there were significant correlations between results of VFSS and FEV1, FEV1%, forced vital capacity (FVC), and FVC%. There was a significant difference in the pressure of TB and cricopharyngeus between the control group and the ALS patient group. The pressures of VP, TB, lower pharynx, and cricopharyngeus have a significant correlation with the recommended feeding type by VFSS.Because it is possible to use HRM to quantitatively assess pharyngeal and respiratory weaknesses and it is more sensitive than other evaluation tools, the cutoff value of HRM parameters may be used to decide the feeding type in patients with ALS.
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Affiliation(s)
- Jee Hyun Suh
- Department of Rehabilitation Medicine, Bobath Children's Clinic, Yongin, Gyeonggi-do
| | - Donghwi Park
- Department of Rehabilitation Medicine, Daegu Fatima Hospital, Daegu
| | | | | | - Cheol Min Shin
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-si, Gyeonggi-do, South Korea
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Yunusova Y, Plowman EK, Green JR, Barnett C, Bede P. Clinical Measures of Bulbar Dysfunction in ALS. Front Neurol 2019; 10:106. [PMID: 30837936 PMCID: PMC6389633 DOI: 10.3389/fneur.2019.00106] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/28/2019] [Indexed: 12/31/2022] Open
Abstract
Bulbar impairment represents a hallmark feature of Amyotrophic Lateral Sclerosis (ALS) that significantly impacts survival and quality of life. Speech and swallowing dysfunction are key contributors to the clinical heterogeneity of ALS and require well-timed and carefully coordinated interventions. The accurate clinical, radiological and electrophysiological assessment of bulbar dysfunction in ALS is one of the most multidisciplinary aspects of ALS care, requiring expert input from speech-language pathologists (SLPs), neurologists, otolaryngologists, augmentative alternative communication (AAC) specialists, dieticians, and electrophysiologists—each with their own evaluation strategies and assessment tools. The need to systematically evaluate the comparative advantages and drawbacks of various bulbar assessment instruments and to develop integrated assessment protocols is increasingly recognized. In this review, we provide a comprehensive appraisal of the most commonly utilized clinical tools for assessing and monitoring bulbar dysfunction in ALS based on the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) evaluation framework. Despite a plethora of assessment tools, considerable geographical differences exist in bulbar assessment practices and individual instruments exhibit considerable limitations. The gaps identified in the literature offer unique opportunities for the optimization of existing and development of new tools both for clinical and research applications. The multicenter validation and standardization of these instruments will be essential for guideline development and best practice recommendations.
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Affiliation(s)
- Yana Yunusova
- Department of Speech Language Pathology, University of Toronto, Toronto, ON, Canada.,Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Volcal Tract Visualization Lab, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Emily K Plowman
- Swallowing Systems Core, Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, United States
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA, United States.,Speech and Hearing Biosciences and Technology Program, Harvard University, Cambridge, MA, United States
| | - Carolina Barnett
- Division of Neurology, Department of Medicine, University of Toronto and University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Peter Bede
- Computational Neuroimaging Group, Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
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Audag N, Goubau C, Toussaint M, Reychler G. Screening and evaluation tools of dysphagia in adults with neuromuscular diseases: a systematic review. Ther Adv Chronic Dis 2019; 10:2040622318821622. [PMID: 30728931 PMCID: PMC6357297 DOI: 10.1177/2040622318821622] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 10/22/2018] [Indexed: 12/11/2022] Open
Abstract
Background: The purpose of this systematic review was to summarize the different dysphagia screening and evaluation tools, and to identify their measurement properties in adults with neuromuscular diseases (NMDs). Methods: A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy was conducted across three databases (PubMed, CINAHL and ScienceDirect). Measurement properties of each tools and the Quality Index, developed by Downs and Black, were considered for the different investigated studies. Results: The search strategy produced 2221 articles. After removal of duplicates and full-text analysis, 19 studies were included. Most of the publications focused on amyotrophic lateral sclerosis (ALS; n = 10) and Duchenne muscular dystrophy (DMD; n = 4). A total of 12 tools, listed as instrumental and noninstrumental examinations, were retrieved. A total of five of them used videofluoroscopic swallow study (VFSS). Measurement properties of the tools are not completely described in detail in many studies. The neuromuscular disease swallowing status scale, a noninstrumental tool, is the only one that assessed all measurement properties in ALS patients. The median score reported for the Quality Index was 16. Conclusions: This systematic review identified 12 different tools for the screening and evaluation of dysphagia in adults with NMD. Majority of the studies presented VFSS as a valid and reliable examination to assess dysphagia in ALS and DMD. Other tools were mainly evaluated in ALS patients, but further studies are needed to complete their measurement properties. In other NMDs, no firm conclusion can be made because of insufficient data and heterogeneity of NMDs.
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Affiliation(s)
- Nicolas Audag
- Service de Médecine Physique, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Christophe Goubau
- Unité de Pneumologie Pédiatrique, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Gregory Reychler
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
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Pattee GL, Plowman EK, (Focht) Garand KL, Costello J, Brooks BR, Berry JD, Smith RA, Atassi N, Chapin JL, Yunusova Y, McIlduff CE, Young E, Macklin EA, Locatelli ER, Silani V, Heitzman D, Wymer J, Goutman SA, Gelinas DF, Perry B, Nalipinski P, Stipancic K, O'Brien M, Sullivan SL, Pioro EP, Gargiulo G, Green JR. Provisional best practices guidelines for the evaluation of bulbar dysfunction in amyotrophic lateral sclerosis. Muscle Nerve 2019; 59:531-536. [DOI: 10.1002/mus.26408] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/24/2018] [Accepted: 01/02/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | - Emily K. Plowman
- Department of Speech, Language and Hearing SciencesUniversity of Florida Gainesville FL U.S.A
| | | | - John Costello
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | | | | | | | | | - Jennifer L. Chapin
- Department of Speech, Language and Hearing SciencesUniversity of Florida Gainesville FL U.S.A
| | - Yana Yunusova
- Department of Speech‐Language PathologyUniversity of Toronto Toronto ON CANADA
| | | | - Eufrosina Young
- State University of New YorkDepartment of Neurology Syracuse NY U.S.A
| | | | | | - Vincenzo Silani
- Istituto Auxologico Italiano, IRCCS, Department of Neurology and Laboratory of Neuroscience, Department of Pathophysiology and Transplantation, “Dino Ferrari” CenterUniversità degli studi di Milano Milan 20122 Italy
| | | | - James Wymer
- University of Florida, Rehabilitation Science Gainesville FL U.S.A
| | | | | | - Bridget Perry
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | | | - Kaila Stipancic
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | - Meghan O'Brien
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
| | | | - Erik P. Pioro
- Cleveland ClinicDepartment of Neurology Cleveland OH U.S.A
| | - Gisella Gargiulo
- National Scientific and Technical Research Council Buenos Aires Argentina
| | - Jordan R. Green
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, U.S.A., ALS Augmentative Communication ProgramBoston Children's Hospital Boston MA U.S.A
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Yi YG, Shin HI. Psychometrics of the Functional Oral Intake Scale for Infants. Front Pediatr 2019; 7:156. [PMID: 31058124 PMCID: PMC6482161 DOI: 10.3389/fped.2019.00156] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 04/02/2019] [Indexed: 01/04/2023] Open
Abstract
This study aimed to investigate the reliability and validity of the Functional Oral Intake Scale (FOIS) for infants. Infants (age, <1 year) who underwent a videofluoroscopic swallowing study (VFSS) were included in this retrospective study. Their nutrition records at the time of the VFSS were separately evaluated by two raters using the five-point FOIS for infants. Categorical swallowing and aspiration impairment scale data were also obtained from the VFSS. The inter-rater reliability of the FOIS for infants was high (95.5% absolute agreement) among the 201 evaluated infants, and this scale was significantly correlated with aspiration severity in the VFSS. We also investigated whether infants with partial oral feeding (POF) at the FOIS evaluation had achieved full oral feeding within 1 year of the evaluation and used this information to estimate whether the caloric contribution, as well as consistency of oral feeding, affected the feeding outcomes. This analysis included 33 infants who were receiving both oral and tube feeding (i.e., POF). Among them, 26 infants achieved full oral feeding (FOF) without tube feeding after 1 year. Their initial contribution from oral feeding was higher than that in infants who still maintained POF after 1 year (28.46 ± 22.79 vs. 6.00 ± 5.45%, p < 0.001). The five-point FOIS for infants, which reflected the expansion of their oral diet with growth, had adequate reliability and validity. The caloric contribution as well as consistency of oral feeding could be used to distinguish FOIS levels 2 and 3, which correspond to the POF status in infants.
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Affiliation(s)
- You Gyoung Yi
- Department of Rehabilitation Medicine, Veterans Medical Research Institute, Veterans Health Service Medical Center, Seoul, South Korea.,Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Battel I, Calvo I, Walshe M. Cross-Cultural Validation of the Italian Version of the Functional Oral Intake Scale. Folia Phoniatr Logop 2018; 70:117-123. [DOI: 10.1159/000490792] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 06/10/2018] [Indexed: 11/19/2022] Open
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Bos I, Wynia K, Almansa J, Drost G, Kremer B, Kuks J. The prevalence and severity of disease-related disabilities and their impact on quality of life in neuromuscular diseases. Disabil Rehabil 2018. [DOI: 10.1080/09638288.2018.1446188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Isaac Bos
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Klaske Wynia
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Josué Almansa
- Department of Community and Occupational Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gea Drost
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Berry Kremer
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jan Kuks
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Trends in Research Literature Describing Dysphagia in Motor Neuron Diseases (MND): A Scoping Review. Dysphagia 2017; 32:734-747. [PMID: 28664472 DOI: 10.1007/s00455-017-9819-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 06/21/2017] [Indexed: 12/11/2022]
Abstract
Dysphagia in motor neuron diseases (MNDs) is highly complex, affecting all stages of swallowing and leading to impaired swallowing safety and efficiency. In order to explore the degree to which research is capturing the symptom of dysphagia in MND, we conducted a scoping review of the existing literature. The primary aims of this review were to identify common themes within the literature on dysphagia in MND, explore patterns and trends in research focus, and identify if any imbalances exist between the research themes related to dysphagia description and management. A comprehensive search strategy yielded 1690 unique articles for review. Following relevance screening, a total of 157 articles were included in the synthesis. Relevant data and keywords were extracted from each article and grouped into themes. Frequency estimates were calculated for each theme to identify trends across research literature. Swallowing impairment in MNDs is described in a variety of ways across current research. The most commonly reported theme was Aspiration/Penetration, mentioned in 73.2% of all included articles; a significant imbalance was identified between reports of swallowing safety and efficiency (p = 0.008). The most frequently reported theme related to dysphagia management was Enteral Nutrition, and very few studies have reported on the efficacy of Rehabilitation/Compensatory recommendations. It is suggested that researchers and clinicians remain mindful of imbalances and gaps in research, and aim to characterize dysphagia in MNDs in a comprehensive manner. Further research investigating discrete, measureable changes in swallowing pathophysiology would be beneficial to delineate the key factors contributing to impaired swallowing safety and efficiency.
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Audag N, Goubau C, Toussaint M, Reychler G. Screening and evaluation tools of dysphagia in children with neuromuscular diseases: a systematic review. Dev Med Child Neurol 2017; 59:591-596. [PMID: 27935021 DOI: 10.1111/dmcn.13354] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 12/14/2022]
Abstract
AIM Dysphagia is frequent in paediatric patients with neuromuscular diseases (pNMD). Its detection is important for initiating early diagnosis and treatment as well as for minimizing related complications. The aim of this study was to review the literature on dysphagia screening and evaluation tools in pNMD. METHOD A systematic review was performed on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (PubMed, CINAHL, and ScienceDirect) were searched. Measurement properties of tools and the quality index developed by Downs and Black were considered. RESULTS Our search yielded four studies and four different tools for paediatric patients with Duchenne muscular dystrophy (DMD). The Sydney Swallow Questionnaire, surface electromyography, Neuromuscular Disease Swallowing Status Scale, and videofluoroscopic swallow study showed interesting properties for DMD. No data were available for other NMD and children under 9 years. The mean total score for the quality index was 17.5. INTERPRETATION We did not identify any superior validated tools, either for screening or for evaluation of dysphagia, and no widely accepted protocol. Further studies are needed to identify the simplest assessment with the best psychometric properties for pNMD. We recommend establishing a specific tool for pNMD.
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Affiliation(s)
- Nicolas Audag
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Goubau
- Unité de Pneumologie Pédiatrique, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Gregory Reychler
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
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Yamada Y, Kawakami M, Wada A, Otsuka T, Muraoka K, Liu M. A comparison of swallowing dysfunction in Becker muscular dystrophy and Duchenne muscular dystrophy. Disabil Rehabil 2017; 40:1421-1425. [PMID: 28288529 DOI: 10.1080/09638288.2017.1298680] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Swallowing dysfunction has been reported in Duchenne muscular dystrophy (DMD), but has not been studied in Becker muscular dystrophy (BMD). The aims of this study were to report the characteristics of swallowing dysfunction in BMD compared with DMD. MATERIALS AND METHODS The study participants were 18 patients with BMD and 18 patients with DMD. All the patients were examined using videofluorography during swallowing of 5 mL of fluid. The penetration-aspiration scale (P-A scale) and the videofluorographic dysphagia scale (VDS) were used to evaluate dysphagia. RESULTS Swinyard functional ability stage was not significantly different between the BMD and DMD groups. Rate of aspiration, P-A scale score, and total VDS score did not differ across groups, but the VDS item score for laryngeal elevation was lower in the BMD group than in the DMD group (median scores 4.5 and 9, respectively; p < 0.001). In the BMD group, total VDS score significantly correlated with Swinyard stage (r = 0.78, p < 0.001), but not with age or lung function. CONCLUSION Patients with BMD have swallowing problems similar to those observed in patients with DMD when matched according to physical functional status. These patients should be evaluated and followed-up for the duration of their disease. Implications for rehabiliation Dysphagia is one of the most critical problems in patients with progressive neuromuscular disease but dysphagia in patients with Becker muscular dystrophy (BMD) was not well known. Eighteen patients with BMD and 18 patients with Duchenne muscular dystrophy were examined with videofluorography. Patients with BMD have swallowing problems similar to those observed in patients with DMD.
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Affiliation(s)
- Yuka Yamada
- a Department of Rehabilitation Medicine , National Higashisaitama Hospital , Saitama , Japan.,b Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Michiyuki Kawakami
- b Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Ayako Wada
- a Department of Rehabilitation Medicine , National Higashisaitama Hospital , Saitama , Japan.,b Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Tomoyoshi Otsuka
- a Department of Rehabilitation Medicine , National Higashisaitama Hospital , Saitama , Japan.,b Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Kaori Muraoka
- b Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan
| | - Meigen Liu
- b Department of Rehabilitation Medicine , Keio University School of Medicine , Tokyo , Japan
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Goselink RJM, Schreuder THA, Mul K, Voermans NC, Pelsma M, de Groot IJM, van Alfen N, Franck B, Theelen T, Lemmers RJ, Mah JK, van der Maarel SM, van Engelen BG, Erasmus CE. Facioscapulohumeral dystrophy in children: design of a prospective, observational study on natural history, predictors and clinical impact (iFocus FSHD). BMC Neurol 2016; 16:138. [PMID: 27530735 PMCID: PMC4988042 DOI: 10.1186/s12883-016-0664-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/04/2016] [Indexed: 12/19/2022] Open
Abstract
Background Facioscapulohumeral muscular dystrophy (FSHD; OMIM 158900 & 158901) is a progressive skeletal muscle dystrophy, characterized by an autosomal dominant inheritance pattern. One of the major unsolved questions in FSHD is the marked clinical heterogeneity, ranging from asymptomatic individuals to severely affected patients with an early onset. An estimated 10 % of FSHD patients have an early onset (onset before 10 years of age) and are traditionally classified as infantile FSHD. This subgroup is regarded as severely affected and extra-muscular symptoms, such as hearing loss and retinopathy, are frequently described. However, information on the prevalence, natural history and clinical management of early onset FSHD is currently lacking, thereby hampering adequate patient counselling and management. Therefore, a population-based prospective cohort study on FSHD in children is highly needed. Methods/design This explorative study aims to recruit all children (aged 0–17 years) with a genetically confirmed diagnosis of FSHD in The Netherlands. The children will be assessed at baseline and at 2-year follow-up. The general aim of the study is the description of the clinical features and genetic characteristics of this paediatric cohort. The primary outcome is the motor function as measured by the Motor Function Measure. Secondary outcomes include quantitative and qualitative description of the clinical phenotype, muscle imaging, genotyping and prevalence estimations. The ultimate objective will be a thorough description of the natural history, predictors of disease severity and quality of life in children with FSHD. Discussion The results of this population-based study are vital for adequate patient management and clinical trial-readiness. Furthermore, this study is expected to provide additional insight in the epigenetic and environmental disease modifying factors. In addition to improve counselling, this could contribute to unravelling the aetiology of FSHD. Trial registration clinicaltrials.gov NCT02625662.
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Affiliation(s)
- Rianne J M Goselink
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - Tim H A Schreuder
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Karlien Mul
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maaike Pelsma
- Department of Rehabilitation, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Imelda J M de Groot
- Department of Rehabilitation, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nens van Alfen
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas Franck
- Department of Clinical audiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas Theelen
- Department of Op Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Richard J Lemmers
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Jean K Mah
- Department of Paediatric Neurology, Alberta Children's Hospital, Calgary, Canada
| | | | - Baziel G van Engelen
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Corrie E Erasmus
- Department of Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
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Riva N, Agosta F, Lunetta C, Filippi M, Quattrini A. Recent advances in amyotrophic lateral sclerosis. J Neurol 2016; 263:1241-54. [PMID: 27025851 PMCID: PMC4893385 DOI: 10.1007/s00415-016-8091-6] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 02/12/2016] [Indexed: 10/28/2022]
Abstract
ALS is a relentlessly progressive and fatal disease, with no curative therapies available to date. Symptomatic and palliative care, provided in a multidisciplinary context, still remains the cornerstone of ALS management. However, our understanding of the molecular mechanisms underlying the disease has advanced greatly over the past years, giving new hope for the development of novel diagnostic and therapeutic approaches. Here, we have reviewed the most recent studies that have contributed to improving both clinical management and our understanding of ALS pathogenesis.
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Affiliation(s)
- Nilo Riva
- Neuropathology Unit, INSPE and Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Via Olgettina 48, 20132, Milan, Italy.
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Christian Lunetta
- NEuroMuscular Omnicentre (NEMO), Niguarda Ca Granda Hospital, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Milan, Italy
| | - Angelo Quattrini
- Neuropathology Unit, INSPE and Division of Neuroscience, Department of Neurology, Institute of Experimental Neurology, San Raffaele Scientific Institute, Via Olgettina 48, 20132, Milan, Italy
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