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Progression of Oropharyngeal Dysphagia in Patients with Multiple System Atrophy

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Abstract

We investigated the progression of oropharyngeal dysphagia in patients with multiple system atrophy (MSA), with particular emphasis on MSA subtype variation. Fifty-nine MSA patients (31 MSA-P, 21 MSA-C, and 7 MSA-PC) who had undergone at least one videofluoroscopic swallowing study (VFSS) to evaluate dysphagia symptoms were included. Clinical data and VFSS findings were retrospectively evaluated using the videofluoroscopic dysphagia scale (VDS), and the results of each MSA subtype group were compared. The median latency to onset of diet modification from onset of MSA symptoms was 5.995 (95% CI 4.890–7.099) years in all MSA patients, 5.036 (95% CI 3.605–6.467) years in MSA-P, and 6.800 (95% CI 6.078–7.522) years in MSA-C (P = 0.035). The latency to onset of diet modification from onset of dysphagia symptoms was 2.715 (95% CI 2.132–3.298) years in all MSA patients, 2.299 (95% CI 1.194–3.403) years in MSA-P, and 5.074 (95% CI 2.565–7.583) years in MSA-C (P = 0.039). The latencies to onset of tube feeding from onset of MSA symptoms and dysphagia symptoms were 7.003 (95% CI 6.738–7.268) years and 3.515 (95% CI 2.123–4.907) years, respectively, in all MSA patients, without significant difference between subtypes. In the patients who underwent VFSS follow-up for ≥ 1 year, 6 oral VDS items significantly worsened; only two pharyngeal items exhibited significant changes. Patients with MSA-P commenced diet modification earlier than patients with MSA-C, despite no significant difference in the latency to onset of tube feeding. Deterioration of dysphagia may be more pronounced in the oral function of MSA patients.

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Funding

This study was not supported by any grant or funding.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-gu, Seoul, 03080, Republic of Korea

    Hui Jae Do, Han Gil Seo, Hyun Haeng Lee, Byung-Mo Oh & Tai Ryoon Han

  2. Department of Neurology, Seoul National University College of Medicine, Seoul National University Hospital, Jongno-gu, Seoul, Republic of Korea

    Yoon Kim, Aryun Kim, Han-Joon Kim & Beomseok Jeon

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  1. Hui Jae Do
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  2. Han Gil Seo
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  3. Hyun Haeng Lee
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  4. Byung-Mo Oh
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  5. Yoon Kim
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  9. Tai Ryoon Han
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Correspondence to Han Gil Seo.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the Helsinki declaration and its later amendments or comparable ethical standards.

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Do, H.J., Seo, H.G., Lee, H.H. et al. Progression of Oropharyngeal Dysphagia in Patients with Multiple System Atrophy. Dysphagia 35, 24–31 (2020). https://doi.org/10.1007/s00455-019-09990-z

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