Dysphagia in amyotrophic lateral sclerosis: Quantification of bulbar motor dysfunction

Abstract

Background Dysphagia as a sequel and possible early sign of amyotrophic lateral sclerosis (ALS) is caused by progressive impaired bulbar motor function. Objective To evaluate bulbar motor dysfunction in patients suffering from ALS compared to a healthy reference group. Methods A clinical study and prospective group comparison was designed. Patients and healthy volunteers were examined in the outpatient clinic of our university medical center. Ten patients with ALS and 20 healthy volunteers were included. All participants underwent a flexible endoscopic evaluation of swallowing (FEES) and a manometric measurement of the maximal sub‐palatal atmospheric pressure generated by suction as well as of the prevalent pressure during swallowing. Additionally, the Sydney Swallow Questionnaire (SSQ) was completed by all participants to score the self‐rated extent of dysphagia. Results Comparing maximal suction pressures, the group of patients showed significantly lower values (p < .001). There was a significant correlation between reduced pressures and the degree of dysphagia (SSQ score) (r = −0.73). Conclusions As the oral cavity is an easily accessible compartment of the upper digestive tract, manometric measurements might serve as a simple instrument in order to detect or to monitor bulbar motor dysfunction. Oral manometry may facilitate early detection and monitoring of dysphagia in ALS. Larger studies are required to confirm our findings.

Comparison of Slow and Forced Vital Capacity on Ability to Evaluate Respiratory Function in Bulbar-Involved Amyotrophic Lateral Sclerosis

“…Second, bulbar assessments were performed by traditional methods, such as symptom assessments and ALSFRS-R, Roads scores in our study. We expect future studies will use novel technologies such as automatic speech recognition technology for speech assessments ( 26 ) and oral manometry for swallowing assessments ( 27 ). Additionally, our study was conducted in a single center.…”

Fiberoptic endoscopic evaluation of swallowing in patients with amyothrophic lateral sclerosis: an integrative literature review

“…The search initially retrieved 1,570 articles, 14 of which [17][18][19][20][21][22][23][24][25][26][27][28][29][30] were selected for analysis after applying the eligibility criteria, as shown in Figure 1.…”

“…Heyduck, Weidenmüller, Göricke, Frank, Olthoff, 2021, Germany 29 To evaluate bulbar motor dysfunction in patients suffering from ALS compared to a healthy reference group. -Sydney Swallow Questionnaire: in ALS patients a total mean (±SD) score of 399 (±391) was consistent with impaired swallowing.…”

“…There was a wide variation in food consistency and volume offered during the exam. The sequence and number of trials were mentioned in only five studies 19;20;25; 29; 30 , and the utensils used for offering food were reported in five studies (20-ml syringe and spoon 19;20 , only spoon 17,29 , and spoon and cup 27 ). Six studies 22-24;26;27;28 neither reported the type of food nor made it clear whether they used any type of dye.…”

“…The findings showed that there was not a standardized protocol on FEES-related aspects in ALS [17][18][19][20][21][22][23][24][25][26][27][28][29][30] . There was a wide variation both in terminology and standardization of food volume and consistency.…”