From DYMUS to DYPARK: Validation of a Screening Questionnaire for Dysphagia in Parkinson’s Disease

Abstract

Dysphagia is a common debilitating symptom in people with Parkinson’s Disease (PD), adequate screening of swallowing disorders is fundamental. The DYMUS questionnaire has shown very good characteristics for the screening of dysphagia in Multiple Sclerosis, and it might also prove useful for screening dysphagia in PD. The primary aim was to test and validate the DYMUS questionnaire in PD patients. This is an observational multicentric study involving 103 patients affected by PD. All subjects filled in the DYMUS and the Eating Assessment Tool (EAT-10) questionnaires. A subgroup of patients (n = 53) underwent a fiber-optic endoscopic evaluation of swallowing (FEES) and their dysphagia was scored by means of the Dysphagia Outcome Severity Scale (DOSS). DYMUS showed a relatively high level of internal consistency (Cronbach’s alpha 0.79). A significant positive correlation was found between the DYMUS and the EAT-10 scores (p < 0.001), while a negative correlation was found between the DYMUS and the DOSS scores (p < 0.001). DYMUS showed a good sensitivity and specificity compared to FEES for detecting dysphagia (area under the curve: 0.82, p < 0.001). The ROC curve analysis showed that a DYMUS score ≥ 6 represents a reliable cut-off for the risk of dysphagia. The DYMUS questionnaire proved to be a reliable screening tool to detect dysphagia in patients suffering from PD. It is easy to understand, it can be self-administered and therefore adequate for adoption in the clinical practice with the more convenient name of DYPARK.

Assessment and treatment of neurogenic dysphagia in stroke and Parkinson's disease

“…Despite the lack of agreement and the low levels of evidence, several other tests have also been used for dysphagia screening: the Swallowing Disturbance Questionnaire [27] and the Munich Dysphagia Test-Parkinson's disease [28] in Parkinson's disease; the Gugging Swallowing Screen [29] and the Toronto Bedside Swallowing Screening Test [30] in stroke. Recently, the Dysphagia in Multiple Sclerosis (DYMUS) questionnaire has been tested with satisfactory results in Parkinson's disease under the name of Dysphagia in Parkinson's disease (DYPARK) questionnaire [31 ▪ ].…”