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Dysphagia pp 165–174Cite as

Dysphagia in Amyotrophic Lateral Sclerosis

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Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

Abstract

Amyotrophic lateral sclerosis is a rapidly progressive neurodegenerative disease involving degeneration of upper and lower motor neurons leading to muscle spasticity, hyperreflexia, atrophy and weakness. Muscles crucial for normal swallowing and respiratory function are impacted resulting in sensorimotor impairments, specifically dysphagia and dystussia in these individuals. Current interventions consist of symptom management, including feeding tube placement, compensatory swallowing strategies, and dietary modifications. Although exercise has historically been contraindicated, preliminary evidence in animal and human research indicate potential benefits of early intervention, mild-moderate intensity exercise to preserve bulbar function for as long as possible. Additional research is warranted to identify efficacious treatment regimens to maintain and improve swallowing and respiratory function in individuals with ALS.

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References

  • Almeida J, Silvestre R, Pinto A, Carvalho M (2012) Exercise and amyotrophic lateral sclerosis. Neurol Sci 33(1):9–15. doi:10.1007/s10072-011-0921-9

    Article  PubMed  Google Scholar 

  • Amin MR, Harris D, Cassel SG, Grimes E, Heiman-Patterson T (2006) Sensory testing in the assessment of laryngeal sensation in patients with amyotrophic lateral sclerosis. Ann Otol Rhinol Laryngol 115(7):528–534

    Article  PubMed  Google Scholar 

  • Andersen PM, Borasio GD, Dengler R, Hardiman O, Kollewe K, Leigh PN, Pradat PF, Silani V, Tomik B (2005) EFNS task force on management of amyotrophic lateral sclerosis: guidelines for diagnosing and clinical care of patients and relatives. Eur J Neurol 12(12):921–938. doi:10.1111/j.1468-1331.2005.01351.x

    Article  PubMed  CAS  Google Scholar 

  • Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ (2008) Validity and reliability of the Eating Assessment Tool (EAT-10). Ann Otol Rhinol Laryngol 117(12):919–924

    Article  PubMed  Google Scholar 

  • Bello-Haas VD, Florence JM, Kloos AD, Scheirbecker J, Lopate G, Hayes SM, Pioro EP, Mitsumoto H (2007) A randomized controlled trial of resistance exercise in individuals with ALS. Neurology 68(23):2003–2007. doi:10.1212/01.wnl.0000264418.92308.a4

    Article  PubMed  Google Scholar 

  • Brooks BR, Miller RG, Swash M, Munsat TL (2001) World Federation of Neurology Research Group on motor neuron diseases. Amyotroph Lateral Scler Other Motor Neuron Disord 1:293–290

    Article  Google Scholar 

  • Carpenter RJ 3rd, McDonald TJ, Howard FM Jr (1978) The otolaryngologic presentation of amyotrophic lateral sclerosis. Otolaryngology 86(3 Pt 1):ORL479–ORL484

    Article  PubMed  Google Scholar 

  • Chen A, Garrett CG (2005) Otolaryngologic presentations of amyotrophic lateral sclerosis. Otolaryngol Head Neck Surg 132(3):500–504

    Article  PubMed  Google Scholar 

  • Chio A, Logroscino G, Hardiman O, Swingler R, Mitchell D, Beghi E, Traynor BG (2008) Prognostic factors in ALS: a critical review. Amyotroph Lateral Scler 1–14. doi:10.1080/17482960802566824

  • Chiò A, Logroscino G, Hardiman O, Swingler R, Mitchell D, Beghi E, Traynor BG, Consortium E (2009) Prognostic factors in ALS: a critical review. Amyotroph Lateral Scler 10(5–6):310–323

    Article  PubMed  PubMed Central  Google Scholar 

  • Chio A, Canosa A, Gallo S, Moglia C, Ilardi A, Cammarosano S, Papurello D, Calvo A (2012) Pain in amyotrophic lateral sclerosis: a population-based controlled study. Eur J Neurol 19(4):551–555. doi:10.1111/j.1468-1331.2011.03540.x

    Article  PubMed  CAS  Google Scholar 

  • Chiò A, Logroscino G, Traynor BJ, Collins J, Simeone JC, Goldstein LA, White LA (2013) Global epidemiology of amyotrophic lateral sclerosis: a systematic review of the published literature. Neuroepidemiology 41(2):118–130. doi:10.1159/000351153

    Article  PubMed  PubMed Central  Google Scholar 

  • Dalbello-Haas V, Florence JM, Krivickas LS (2008) Therapeutic exercise for people with amyotrophic lateral sclerosis or motor neuron disease. Cochrane Database Syst Rev 2:CD005229. doi:10.1002/14651858.CD005229.pub2

    Article  Google Scholar 

  • Deforges S, Branchu J, Biondi O, Grondard C, Pariset C, Lecolle S, Lopes P, Vidal PP, Chanoine C, Charbonnier F (2009) Motoneuron survival is promoted by specific exercise in a mouse model of amyotrophic lateral sclerosis. J Physiol 587(Pt 14):3561–3572. doi:10.1113/jphysiol.2009.169748

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Desport JC, Preux PM, Truong CT, Courat L, Vallat JM, Couratier P (2000) Nutritional assessment and survival in ALS patients. Amyotroph Lateral Scler Other Motor Neuron Disord 1(2):91–96

    Article  CAS  PubMed  Google Scholar 

  • Doeltgen SH, Ong E, Scholten I, Cock C, Omari T (2017) Biomechanical quantification of Mendelsohn maneuver and effortful swallowing on pharyngoesophageal function. Otolaryngol Head Neck Surg 194599817708173. doi:10.1177/0194599817708173

  • D'Ottaviano FG, Linhares Filho TA, Andrade HM, Alves PC, Rocha MS (2013) Fiberoptic endoscopy evaluation of swallowing in patients with amyotrophic lateral sclerosis. Braz J Otorhinolaryngol 79(3):349–353. doi:10.5935/1808-8694.20130061

    Article  PubMed  Google Scholar 

  • Easterling C, Antinoja J, Cashin S, Barkhaus PE (2013) Changes in tongue pressure, pulmonary function, and salivary flow in patients with amyotrophic lateral sclerosis. Dysphagia 28(2):217–225. doi:10.1007/s00455-012-9436-7

    Google Scholar 

  • Ertekin C, Aydogdu I, Yuceyar N, Kiylioglu N, Tarlaci S, Uludag B (2000) Pathophysiological mechanisms of oropharyngeal dysphagia in amyotrophic lateral sclerosis. Brain 123 ( Pt 1):125–140

    Google Scholar 

  • Fattori B, Grosso M, Bongioanni P, Nacci A, Cristofani R, AlSharif A, Licitra R, Matteucci F, Rossi B, Rubello D, Ursino F, Mariani G (2006) Assessment of swallowing by oropharyngoesophageal scintigraphy in patients with amyotrophic lateral sclerosis. Dysphagia 21(4):280–286. doi:10.1007/s00455-006-9052-5

    Article  PubMed  Google Scholar 

  • Gaziano J (2015) Prevalence, timing and source of aspiration in individuals with ALS. Dysphagia Research Society, Chicago, IL

    Google Scholar 

  • Goeleven A, Robberecht W, Sonies B, Carbonez A, Dejaeger E (2006) Manofluorographic evaluation of swallowing in amyotrophic lateral sclerosis and its relationship with clinical evaluation of swallowing. Amyotroph Lateral Scler 7(4):235–240. doi:10.1080/17482960600664870

    Article  PubMed  Google Scholar 

  • Greenwood DI (2013) Nutrition management of amyotrophic lateral sclerosis. Nutr Clin Pract 28(3):392–399. doi:10.1177/0884533613476554

    Article  PubMed  Google Scholar 

  • Higo R, Tayama N, Watanabe T, Nitou T (2002) Videomanofluorometric study in amyotrophic lateral sclerosis. Laryngoscope 112(5):911–917. doi:10.1097/00005537-200205000-00024

    Article  PubMed  Google Scholar 

  • Higo R, Tayama N, Nito T (2004) Longitudinal analysis of progression of dysphagia in amyotrophic lateral sclerosis. Auris Nasus Larynx 31(3):247–254. doi:10.1016/j.anl.2004.05.009

    Article  PubMed  Google Scholar 

  • Hillel AD, Miller R (1989) Bulbar amyotrophic lateral sclerosis: patterns of progression and clinical management. Head & neck 11 (1):51–59

    Google Scholar 

  • Hind JA, Nicosia MA, Roecker EB, Carnes ML, Robbins J (2001) Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults. Arch Phys Med Rehabil 82(12):1661–1665. doi:10.1053/apmr.2001.28006

    Article  PubMed  CAS  Google Scholar 

  • Hoffman MR, Mielens JD, Ciucci MR, Jones CA, Jiang JJ, McCulloch TM (2012) High-resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver. Dysphagia 27(3):418–426. doi:10.1007/s00455-011-9385-6

    Article  PubMed  PubMed Central  Google Scholar 

  • Hutcheson K, Barringer D, Knott JK, Lin H, Weber RS, Fuller C, Lazarus C, May AH, Patterson JM, Roe J, Starmer HM, Lewin JS (2015) Dynamic imaging grade of swallowing toxicity (digest): scale development and validation. Paper Presented at the Dysphagia Research Society

    Google Scholar 

  • Jang HJ, Leigh JH, Seo HG, Han TR, Oh BM (2015) Effortful swallow enhances vertical hyolaryngeal movement and prolongs duration after maximal excursion. J Oral Rehabil 42(10):765–773. doi:10.1111/joor.12312

    Article  PubMed  CAS  Google Scholar 

  • Katzberg HD, Benatar M (2011) Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev 1:Cd004030. doi:10.1002/14651858.CD004030.pub3

    Article  Google Scholar 

  • Kleim JA, Jones TA (2008) Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. J Speech Lang Hear Res 1:225

    Article  Google Scholar 

  • Kleim JA, Hogg TM, VandenBerg PM, Cooper NR, Bruneau R, Remple M (2004) Cortical synaptogenesis and motor map reorganization occur during late, but not early, phase of motor skill learning. J Neurosci 24(3):628–633. doi:10.1523/jneurosci.3440-03.2004

    Article  PubMed  CAS  Google Scholar 

  • Klor B, Milianti F (1999) Rehabilitation of neurogenic dysphagia with percutaneous endoscopic gastronomy. Dysphagia 14(3):162–164

    Article  CAS  PubMed  Google Scholar 

  • Kühnlein P, Gdynia H-J, Sperfeld A-D, Lindner-Pfleghar B, Ludolph AC, Prosiegel M, Riecker A (2008) Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol 4(7):366–375. doi:10.1038/ncpneuro0853

    Article  PubMed  Google Scholar 

  • Kuhnlein P, Gdynia HJ, Sperfeld AD, Lindner-Pfleghar B, Ludolph AC, Prosiegel M, Riecker A (2008) Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol 4(7):366–374. doi:10.1038/ncpneuro0853

    Article  PubMed  Google Scholar 

  • Leder SB, Novella S, Patwa H (2004) Use of fiberoptic endoscopic evaluation of swallowing (FEES) in patients with amyotrophic lateral sclerosis. Dysphagia 19(3):177–181. doi:10.1007/s00455-004-0009-2

    Article  PubMed  Google Scholar 

  • Lo Re G, Galia M, La Grutta L, Russo S, Runza G, Taibbi A, D'Agostino T, Lo Greco V, Bartolotta TV, Midiri M, Cardinale AE, De Maria M, Lagalla R (2007) Digital cineradiographic study of swallowing in patients with amyotrophic lateral sclerosis. Radiol Med 112(8):1173–1187. doi:10.1007/s11547-007-0214-9

    Article  PubMed  CAS  Google Scholar 

  • Logemann J, Kahrilas PJ, Cheng J, Pauloski BR, Gibbons P, Rademaker AW, Lin S (1992) Closure mechanisms of laryngeal vestibule during swallow. Am J Physiol 262:338–344

    Google Scholar 

  • Luchesi KF, Kitamura S, Mourao LF (2013) Management of dysphagia in Parkinson's disease and amyotrophic lateral sclerosis. CoDAS 25(4):358–364

    Article  PubMed  Google Scholar 

  • Luchesi KF, Kitamura S, Mourao LF (2014a) Higher risk of complications in odynophagia-associated dysphagia in amyotrophic lateral sclerosis. Arq Neuropsiquiatr 72(3):203–207

    Article  PubMed  Google Scholar 

  • Luchesi KF, Kitamua S, Mourao LF (2014b) Amyotrophic lateral sclerosis survival analysis: swallowing and non-oral feeding. NeuroRehabilitation 35(3):535–542. doi:10.3233/nre-141149

    Article  PubMed  CAS  Google Scholar 

  • Mazzini L, Corra T, Zaccala M, Mora G, Del Piano M, Galante M (1995) Percutaneous endoscopic gastrostomy and enteral nutrition in amyotrophic lateral sclerosis. J Neurol 242(10):695–698

    Article  CAS  PubMed  Google Scholar 

  • McHorney CA, Bricker DE, Kramer AE, Rosenbek JC, Robbins J, Chignell KA, Logemann JA, Clarke C (2000) The SWAL-QOL outcomes tool for oropharyngeal dysphagia in adults: I. Conceptual foundation and item development. Dysphagia 15(3):115–121

    Article  CAS  PubMed  Google Scholar 

  • Mehta P, Antao V, Kaye W, Sanchez M, Williamson D, Bryan L, Muravov O, Horton K (2014) Prevalence of amyotrophic lateral sclerosis—United States, 2010–2011. MMWR Surveill Summ 63(7):1–13

    Google Scholar 

  • Miller RG, Jackson CE, Kasarskis EJ, England JD, Forshew D, Johnston W, Kalra S, Katz JS, Mitsumoto H, Rosenfeld J, Shoesmith C, Strong MJ, Woolley SC (2009) Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: multidisciplinary care, symptom management, and cognitive/behavioral impairment (an evidence-based review): report of the quality standards Subcommittee of the American Academy of Neurology. Neurology 73(15):1227–1233. doi:10.1212/WNL.0b013e3181bc01a4

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Molfenter SM, Leigh C, Steele CM (2014) Event sequence variability in healthy swallowing: building on previous findings. Dysphagia 29(2):234–242. doi:10.1007/s00455-013-9501-x

    Article  PubMed  PubMed Central  Google Scholar 

  • Nichols NL, Van Dyke J, Nashold L, Satriotomo I, Suzuki M, Mitchell GS (2013) Ventilatory control in ALS. Respir Physiol Neurobiol 189(2):429–437. doi:10.1016/j.resp.2013.05.016

    Article  PubMed  PubMed Central  Google Scholar 

  • Ohmae Y, Logemann JA, Kaiser P, Hanson DG, Kahrilas PJ (1996) Effects of two breath-holding maneuvers on oropharyngeal swallow. Ann Otol Rhinol Laryngol 105(2):123–131

    Article  CAS  PubMed  Google Scholar 

  • Pattee G, Plowman EK, Brooks B (2015) Practice patterns across ALS Centers in bulbar assessment: survey results and future directions. In: North Eastern ALS Consortium Annual Meeting. Clearwater, Florida

    Google Scholar 

  • Pearson WG Jr, Molfenter SM, Smith ZM, Steele CM (2013) Image-based measurement of post-swallow residue: the normalized residue ratio scale. Dysphagia 28(2):167–177. doi:10.1007/s00455-012-9426-9

    Article  PubMed  Google Scholar 

  • Pinto S, Swash M, de Carvalho M (2012) Respiratory exercise in amyotrophic lateral sclerosis. Amyotroph Lateral Scler 13(1):33–43. doi:10.3109/17482968.2011.626052

    Article  PubMed  Google Scholar 

  • Plowman EK (2014) Nutrition and feeding tube placement for people with ALS: best practice in clinical decision making. Dysphagia Cafe https://dysphagiacafe.com/2014/10/23/nutrition-and-feeding-tube-placement-for-people-with-als-best-practice-in-clinical-decision-making/

    Google Scholar 

  • Plowman EK (2015) Is there a role for exercise in the management of bulbar dysfunction in amyotrophic lateral sclerosis? J Speech Lang Hear Res 58(4):1151–1166. doi:10.1044/2015_jslhr-s-14-0270

    Article  PubMed  Google Scholar 

  • Plowman EK, Watts SA, Tabor L, Robison R, Gaziano J, Domer AS, Richter J, Vu T, Gooch C (2015) Impact of expiratory strength training in amyotrophic lateral sclerosis. Muscle Nerve 54(1):48–53. doi:10.1002/mus.24990

    Article  Google Scholar 

  • Plowman EK, Watts SA, Robison R, Tabor L, Dion C, Gaziano J, Vu T, Gooch C (2016a) Voluntary cough airflow differentiates safe versus unsafe swallowing in amyotrophic lateral sclerosis. Dysphagia. doi:10.1007/s00455-015-9687-1

  • Plowman EK, Tabor LC, Robison R, Wymer J (2016b) Delineating mechanisms of dysphagia in ALS. Amyotroph Lateral Scler Frontotemporal Degener 17(1)

    Google Scholar 

  • Plowman EK, Tabor LC, Robison R, Gaziano J, Dion C, Watts SA, Vu T, Gooch C (2016c) Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil 28(1):85–90. doi:10.1111/nmo.12700

    Article  PubMed  CAS  Google Scholar 

  • Plowman EK, Tabor LC, Wymer J, Pattee G (2017) The evaluation of bulbar dysfunction in amyotrophic lateral sclerosis: survey of clinical practice patterns in the United States. Amyotroph Lateral Scler Frontotemporal Degener 18(5–6):351–357. doi:10.1080/21678421.2017.1313868

    Article  PubMed  Google Scholar 

  • Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL (1996) A penetration-aspiration scale. Dysphagia 11(2):93–98

    Article  CAS  PubMed  Google Scholar 

  • Ruoppolo G, Schettino I, Frasca V, Giacomelli E, Prosperini L, Cambieri C, Roma R, Greco A, Mancini P, De Vincentiis M, Silani V, Inghilleri M (2013) Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings. Acta Neurol Scand 128(6):397–401. doi:10.1111/ane.12136

    Article  PubMed  CAS  Google Scholar 

  • Scott A, Austin H (1994) Nasogastric feeding in the management of severe dysphagia in motor neuron disease. Palliat Med 8:45–49

    Article  CAS  PubMed  Google Scholar 

  • Solazzo A, Monaco L, Vecchio LD, Reginelli A, Iacobellis F, Capasso R, Tamburrini S, Berritto D, Barillari MR, Monsurro MR, Di Martino N, Grassi R (2014) Earliest videofluoromanometric pharyngeal signs of dysphagia in ALS patients. Dysphagia 29(5):539–544. doi:10.1007/s00455-014-9542-9

    Article  PubMed  Google Scholar 

  • Strand EA, Miller RM, Yorkston KM, Hillel AD (1996) Management of oral-pharyngeal dysphagia symptoms in amyotrophic lateral sclerosis. Dysphagia 11(2):129–139

    Article  CAS  PubMed  Google Scholar 

  • Tabor L, Gaziano J, Watts S, Robison R, Plowman EK (2016a) Defining swallowing-related quality of life profiles in individuals with amyotrophic lateral sclerosis. Dysphagia. doi:10.1007/s00455-015-9686-2

  • Tabor LC, Rosado KM, Robison R, Hegland K, Humbert IA, Plowman EK (2016b) Respiratory training in an individual with amyotrophic lateral sclerosis. Ann Clin Transl Neurol 3(10):819–823. doi:10.1002/acn3.342

    Article  PubMed  PubMed Central  Google Scholar 

  • Tabor L, Robison R, Wymer J, Plowman EK (2017) Mechanisms of airway protection in individuals with ALS. Paper presented at the T32 Neuromuscular Plasticity Training Symposium, Gainesville, FL, March 2017

    Google Scholar 

  • Waito AA, Valenzano TJ, Peladeau-Pigeon M, Steele CM (2017) Trends in research literature describing dysphagia in Motor Neuron Diseases (MND): a scoping review. Dysphagia. doi:10.1007/s00455-017-9819-x

  • Watts SA, Tabor L, Plowman EK (2016) To cough or not to cough? Examining the potential utility of cough testing in the clinical evaluation of swallowing. Curr Phys Med Rehabil Rep 4(4):262–276. doi:10.1007/s40141-016-0134-5

    Article  PubMed  PubMed Central  Google Scholar 

  • Wijesekera LC, Leigh PN (2009) Amyotrophic lateral sclerosis. Orphanet J Rare Dis 4:3. doi:10.1186/1750-1172-4-3

    Article  PubMed  PubMed Central  Google Scholar 

  • Yunusova Y, Green J, Lindstrom M, Ball L, Pattee G, Zinman L (2010) Kinematics of Disease Progression in Bulbar ALS. Journal of communication disorders 43 (1):6. doi:10.1016/j.jcomdis.2009.07.003

  • Zarei S, Carr K, Reiley L, Diaz K, Guerra O, Altamirano PF, Pagani W, Lodin D, Orozco G, Chinea A (2015) A comprehensive review of amyotrophic lateral sclerosis. Surg Neurol Int 6:171. doi:10.4103/2152-7806.169561

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Emily K. Plowman Ph.D., C.C.C.-S.L.P. .

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Tabor, L.C., Plowman, E.K. (2017). Dysphagia in Amyotrophic Lateral Sclerosis. In: Ekberg, O. (eds) Dysphagia. Medical Radiology(). Springer, Cham. https://doi.org/10.1007/174_2017_137

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