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RESEARCH PRODUCT
The importance of the reproducibility of oropharyngeal swallowing in amyotrophic lateral sclerosis. An electrophysiological study
Luca MainardiMariangela BerlangieriGiulia BertinoEnrico AlfonsiMauro FresiaElena AlvisiGiuseppe CosentinoArrigo MogliaFilippo BrighinaBrigida FierroGiorgio SandriniR De IccoFrancesca Valentinosubject
MaleNeurologyElectromyographyAudiology0302 clinical medicineAmyotrophic lateral sclerosisDeglutition Disorder030223 otorhinolaryngologySimilarity indexmedicine.diagnostic_testdigestive oral and skin physiologyDysphagiaMiddle AgedDysphagiaSensory Systemsmedicine.anatomical_structureNeurologyAnesthesiaSuprahyoid musclesFemalemedicine.symptomCase-Control StudieHumanAdultmedicine.medical_specialtyReproducibility of Result03 medical and health sciencesstomatognathic systemSwallowingALS; Deglutition; Dysphagia; Electrophysiological evaluation of swallowing; Motor neuron disease; Similarity index; Adult; Aged; Amyotrophic Lateral Sclerosis; Case-Control Studies; Deglutition Disorders; Electromyography; Female; Humans; Male; Middle Aged; Pharynx; Reproducibility of Results; Deglutition; Sensory Systems; Neurology; Neurology (clinical); Physiology (medical)Physiology (medical)otorhinolaryngologic diseasesmedicineHumansMotor neuron diseaseAgedbusiness.industryElectromyographyPharynxAmyotrophic Lateral SclerosisReproducibility of Resultsmedicine.diseaseElectrophysiological evaluation of swallowingDeglutitionCase-Control StudiesPharynxNeurology (clinical)ALSbusinessSensory SystemDeglutition Disorders030217 neurology & neurosurgeryOropharyngeal dysphagiaAmyotrophic Lateral Sclerosidescription
Abstract Objective To investigate electrophysiologically the reproducibility of oropharyngeal swallowing in patients with ALS. Methods We enrolled 26 ALS patients, both with and without clinical signs of dysphagia, and 30 age-matched controls. The reproducibility of the electrophysiological signals related to the oral phase (electromyographic activity of the submental/suprahyoid muscles) and the pharyngeal phase (laryngeal-pharyngeal mechanogram) of swallowing across repeated swallows was assessed. To do this we computed two similarity indexes (SI) by using previously described mathematical algorithms. Results The reproducibility of oropharyngeal swallowing was significantly reduced both in patients with and in those without clinical signs of dysphagia, with more marked alterations being detected in the dysphagic group. The SI of both phases of swallowing, oral and pharyngeal, correlated significantly with dysphagia severity and disease severity. Conclusions In ALS different pathophysiological mechanisms can alter the stereotyped motor behaviors underlying normal swallowing, thus reducing the reproducibility of the swallowing act. A decrease in swallowing reproducibility could be a preclinical sign of dysphagia and, beyond a certain threshold, a pathological hallmark of oropharyngeal dysphagia. Significance Electrophysiological assessment is a simple and useful tool for the early detection of swallowing abnormalities, and for the management of overt dysphagia in ALS.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2017-01-01 |