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Reduced pharyngeal constriction is associated with impaired swallowing efficiency in Amyotrophic Lateral Sclerosis (ALS)

Waito, Ashley A. ; Tabor‐Gray, Lauren C. ; Steele, Catriona M. ; Plowman, Emily K.

Neurogastroenterology and motility, 2018-12, Vol.30 (12), p.e13450-n/a [Periódico revisado por pares]

England: Wiley Subscription Services, Inc

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  • Título:
    Reduced pharyngeal constriction is associated with impaired swallowing efficiency in Amyotrophic Lateral Sclerosis (ALS)
  • Autor: Waito, Ashley A. ; Tabor‐Gray, Lauren C. ; Steele, Catriona M. ; Plowman, Emily K.
  • Assuntos: Adult ; Aged ; Amyotrophic Lateral Sclerosis ; Amyotrophic Lateral Sclerosis - complications ; Amyotrophic Lateral Sclerosis - physiopathology ; Deglutition - physiology ; deglutition disorders ; Deglutition Disorders - etiology ; Deglutition Disorders - physiopathology ; Efficiency ; Female ; Humans ; Male ; Middle Aged ; pharyngeal constriction ; Pharynx ; Pharynx - pathology ; Pharynx - physiopathology ; Population studies ; post‐swallow residue ; Swallowing ; videofluoroscopy
  • É parte de: Neurogastroenterology and motility, 2018-12, Vol.30 (12), p.e13450-n/a
  • Notas: Funding information
    This work was supported in part by doctoral research funding provided by the University of Toronto and the Toronto Rehabilitation Institute as well as an R01 grant (DC011020) from the National Institute on Deafness and Other Communication Disorders.
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    LT collected the data, contributed to data analysis, and edited the final manuscript.
    CS assisted with design of the research study, contributed essential data analysis tools, and edited the final manuscript.
    AW analyzed and interpreted the data, and wrote the final manuscript.
    EP provided funding for the study, assisted with research design, assisted with data collection, contributed essential resources, and edited the final manuscript.
    Author Contributions
  • Descrição: Background Swallowing inefficiency is a prevalent but understudied problem in individuals with Amyotrophic Lateral Sclerosis (ALS). Although reduced pharyngeal constriction has been identified as a mechanism contributing to swallowing inefficiency following stroke, this relationship has not been empirically tested in the ALS population. This study sought to characterize profiles of swallowing efficiency in a sample of ALS patients and investigate relationships between pharyngeal constriction and swallowing efficiency. Methods Twenty‐six adults with ALS underwent videofluoroscopic swallowing studies, involving 3 mL‐thin, 20 mL‐thin, and 3 mL‐pudding boluses. Full‐length recordings were segmented into bolus clips and randomized for analysis. We recorded the total number of swallows per bolus and obtained normalized pixel‐based measures of pharyngeal constriction area and post‐swallow residue in the vallecular and pyriform sinuses. Linear mixed models with Spearman's correlations were used to determine relationships between pharyngeal constriction and swallowing efficiency, with added factors of bolus volume and thickness. Key Results Individuals with ALS demonstrated reduced pharyngeal constriction and increased vallecular and pyriform sinus residue, compared to norms. Reduced pharyngeal constriction had a significant effect on the presence of vallecular and pyriform sinus residue as well as the number of swallows per bolus. Increased bolus thickness was associated with increased vallecular residue, while increased bolus volume was associated with reduced pharyngeal constriction. Results were significant at P < 0.05. Conclusions & Inferences Our results suggest that reduced pharyngeal constriction is a significant physiological parameter related to swallow inefficiency in ALS. Future work is needed to corroborate these preliminary results and investigate factors to mitigate such impairments. This study was conducted to (a) characterize swallowing efficiency and pharyngeal constriction in a sample of individuals with ALS; and (b) explore reduced pharyngeal constriction as a potential mechanism for swallowing inefficiency. Our results showed a high prevalence of inefficient swallowing in the sample, and identified that reductions in pharyngeal constriction are associated with inefficient swallowing (ie, postswallow pharyngeal residue, multiple swallows).
  • Editor: England: Wiley Subscription Services, Inc
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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