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Progression of Oropharyngeal Dysphagia in Patients with Multiple System Atrophy

  • Hui Jae Do
  • Han Gil SeoEmail author
  • Hyun Haeng Lee
  • Byung-Mo Oh
  • Yoon Kim
  • Aryun Kim
  • Han-Joon Kim
  • Beomseok Jeon
  • Tai Ryoon Han
Original Article


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.


Multiple system atrophy Dysphagia Deglutition Deglutition disorders Neurodegenerative diseases 



This study was not supported by any grant or funding.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

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.

Informed Consent

This study did not need the informed consent because it was a retrospective study with ethical approval.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Rehabilitation Medicine, Seoul National University College of MedicineSeoul National University HospitalJongno-guRepublic of Korea
  2. 2.Department of Neurology, Seoul National University College of MedicineSeoul National University HospitalJongno-guRepublic of Korea

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