Neurological Sciences

, Volume 40, Issue 2, pp 399–404 | Cite as

Taste changes in amyotrophic lateral sclerosis and effects on quality of life

  • Claudia TarlariniEmail author
  • Lucia Catherine Greco
  • Andrea Lizio
  • Francesca Gerardi
  • Valeria Ada Sansone
  • Christian Lunetta
Original Article


The primary aim of the study is to evaluate possible taste changes in a cohort of amyotrophic lateral sclerosis patients (pALS) with dysphagia, focusing on eventual psychological and quality of life (QoL) implications. The second aim is to evaluate the changes of QoL following the use of a specific device that provides food flavour. Thirty-two ALS patients were recruited and divided into two groups: subjects feeding only through enteral tube (ET) and subjects still eating by oral way (OW). A specific set of questionnaires was selected and adapted to investigate possible changes of taste and the impact on psychological status and QoL. Moreover, a specific device that provides food flavours in a safety manner was applied to all patients. We found a perceived reduction of taste in ALS patients, in particular in the ET group. All patients showed a strong interest in the preservation of taste, and its loss negatively related to their QoL. The use of the flavour device improved the perceived QoL showing no side effects, even in the ET group. For the first time, our study revealed changes in taste perception in a cohort of ALS patients and the negative consequences that these changes have on psychological status and QoL. Furthermore, the positive effects of the device used to provide flavours suggest a possible rehabilitative effect, which should be better evaluated and confirmed in further studies.


Amyotrophic lateral sclerosis Dysphagia Enteral feeding Quality of life Taste loss 


Compliance with ethical standards

All subjects or their caregivers gave written informed consent to the procedures previously approved by our medical ethical committees.


  1. 1.
    Brown RH, Al-Chalabi A (2017) Amyotrophic lateral sclerosis. N Engl J Med 377(2):162–172CrossRefGoogle Scholar
  2. 2.
    Rowland LP, Shneider NA (2001) Amyotrophic lateral sclerosis. N Engl J Med 344:1688–1700CrossRefGoogle Scholar
  3. 3.
    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):397–401CrossRefGoogle Scholar
  4. 4.
    Muscaritoli M, Kushta I, Molfino A, Inghileri M, Sabatelli M et al (2012) Nutritional and metabolic support in patients with amyotrophic lateral sclerosis. Nutrition 28(10):959–966CrossRefGoogle Scholar
  5. 5.
    Onesti E, Schettino I, Gori MC, Frasca V, Ceccanti M et al (2017) Dysphagia in amyiotrophic lateral sclerosis: impact of patients behavior, diet adaptation and riluzole management. Front Neurol 8:94CrossRefGoogle Scholar
  6. 6.
    Chiocca JC, Olmos JA, Salis GB, Soifer LO, Higa R et al (2005) Prevalence, clinical spectrum and atypical symptoms of gastro-oesophageal reflux in Argentina: a nationwide population-based study. Aliment Pharmacol Ther 22(4):331–342CrossRefGoogle Scholar
  7. 7.
    Cho YS, Choi MG, Jeong JJ, Chung WC, Lee IS, Kim SW, Han SW, Choi KY, Chung IS (2005) Prevalence and clinical spectrum of gastroesophageal reflux: a population-based study in Asan-si, Korea. Am J Gastroenterol 100(4):747–753CrossRefGoogle Scholar
  8. 8.
    Eslick GD, Talley NJ (2008) Dysphagia: epidemiology, risk factors and impact on quality of life—a population-based study. Aliment Pharmacol Ther 27(10):971–979CrossRefGoogle Scholar
  9. 9.
    Ruth M, Mansson I et al (1991) The prevalence of symptoms suggestive of esophageal disorders. Scand J Gastroenterol 26(1):73–81CrossRefGoogle Scholar
  10. 10.
    Watson DI, Lally CJ (2009) Prevalence of symptoms and use of medication for gastroesophageal reflux in an Australian community. World J Surg 33(1):88–94CrossRefGoogle Scholar
  11. 11.
    Ziolkowski BA, Pacholec A et al (2013) Objawy alarmowe, czynniki ryzyka wystąpienia raka przewodu pokarmowego i gotowość do udziału w endoskopowych badaniach przesiewowych. [Alarm symptoms, risk factors for digestive tract cancer and readiness to participate in an endoscopic screening program]. Prz Gastroenterol 8(2):108–114Google Scholar
  12. 12.
    Cho SY, Choung RS, Saito YA, Schleck CD, Zinsmeister AR, Locke GR III, Talley NJ (2015) Prevalence and risk factors for dysphagia: a USA community study. Neurogastroenterol Motil 27(2):212–219CrossRefGoogle Scholar
  13. 13.
    Katzberg HD, Benatar M (2011) Enteral tube feeding for amyotrophic lateral sclerosis/motor neuron disease. Cochrane Database Syst Rev 19(1):CD004030Google Scholar
  14. 14.
    Stavroulakis T, Walsh T, Shaw PJ, McDermott CJ et al (2013) Gastrostomy use in motor neurone disease (MND): a review, meta-analysis and survey of current practice. Amyotroph Lateral Scler Frontotemporal Degener 14(2):96–104CrossRefGoogle Scholar
  15. 15.
    Pellettier CA (2007) Chemosense, aging and oropharyngeal dysphagia: a review. Top Geriatr Rehabil 23(3):249–268Google Scholar
  16. 16.
    Imoscopi A, Inelmen EM, Sergi G, Miotto F, Manzato E (2012) Taste loss in elderly: epidemiology, causes and consequences. Aging Clin Exp Res 24(6):570–579PubMedGoogle Scholar
  17. 17.
    Cedarbaum JM, Stambler N, Malta E, Fuller C, Hilt D et al (1999) The ALSFRS-R: a revised ALS functional rating scale that incorporates assessments of respiratory function. BDNF ALS Study Group (Phase III). J Neurol Sci 169(1–2):13–21Google Scholar
  18. 18.
    McGreevy J (2014) Characteristics of taste and smell alterations in patients treated for lung cancer: translation of and results using a symptom-specific questionnaire. Support Care Cancer 22(10):2635–2644CrossRefGoogle Scholar
  19. 19.
    Kanatas AN, Rogers SN (2004) A national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 86(1):6–10CrossRefGoogle Scholar
  20. 20.
    Kanatas AN, Mehanna HM, Lowe D, Rogers SN (2009) A second national survey of health-related quality of life questionnaires in head and neck oncology. Ann R Coll Surg Engl 91(5):420–425CrossRefGoogle Scholar
  21. 21.
    Ekberg O, Hamdy S, Woisard V, Wuttge-Hanning A et al (2001) Social and psychological burden of dysphagia: its impact on diagnosis and treatment. Dysphagia 17(2):139–146CrossRefGoogle Scholar
  22. 22.
    Heckmann JG, Stossel C, Lang CJG, Neundorfer B, Tomandl B, Hummel T (2005) Taste disorder in acute stroke. Stroke 36:1690–1694CrossRefGoogle Scholar
  23. 23.
    Kim JS, Choi-Kwon S, Kwon SU, Kwon JH (2009) Taste perception abnormalities after acute stroke in postmenopausal women. J Clin Neurosci 16:797–801CrossRefGoogle Scholar
  24. 24.
    Steinbach S, Hundt W, Vaitl A, Heinrich P, Förster S, Bürger K, Zahnert T (2010) Taste in mild cognitive impairment and Alzheimer’s disease. J Neurol 257:238–246CrossRefGoogle Scholar
  25. 25.
    Shah M, Deeb J, Fernando M, Noyce A, Visentin E, Findley LJ, Hawkes CH (2009) Abnormality of taste and smell in Parkinson’s disease. Parkinsonism Relat Disord 15:232–237CrossRefGoogle Scholar
  26. 26.
    Scinska A, Sienkiewicz-Jarosz H, Kuran W, Ryglewicz D et al (2004) Depressive symptoms and taste reactivity in humans (2004). Physiol Behav 82:899–904CrossRefGoogle Scholar
  27. 27.
    Maurer J, Hipp M, Schäfer C, Kölbl O (2011) Dysphagia. Impact on quality of life after radio(chemo)therapy of head and neck cancer. Strahlenther Onkol 187(11):744–749CrossRefGoogle Scholar
  28. 28.
    Vanderberghe-Descamps M, Sulmont-Rossè C, Septier C, Feron G et al (2017) Using food comfortability to compare food’s sensory characteristics expectations of elderly people with or without oral health problems. J Texture Stud 48(4):280–287CrossRefGoogle Scholar
  29. 29.
    Mazzini L, Corra T, Zaccala M, Mora G, Del Piano M et al (1995) Percutaneous endoscopic gastrostomy and enteral nutrition in amyotrophic lateral sclerosis. J Neurol 242(10):695–698CrossRefGoogle Scholar
  30. 30.
    Mitsumoto H, Davidson M, Moore D, Gad N, Brandis M, Ringel S, Rosenfeld J, Shefner JM, Strong MJ, Sufit R, Anderson FA, the ALS CARE Study Group (2003) Percutaneous endoscopic gastrostomy (PEG) in patients with ALS and bulbar dysfunction. Amyotroph Lateral Scler Other Motor Neuron Disord 4(3):177–185CrossRefGoogle Scholar
  31. 31.
    Padersen AM, Bardow A, Jensen SB et al (2002) Saliva and gastrointestinal functions of taste, mastication, swallowing and digestion. Oral Dis 8(3):117–129CrossRefGoogle Scholar

Copyright information

© Fondazione Società Italiana di Neurologia 2018

Authors and Affiliations

  1. 1.Neuromuscular Omnicentre (NEMO)-Fondazione Serena OnlusMilanItaly
  2. 2.Neurorehabilitation Unit, Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly

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