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The Dysphagia in Multiple Sclerosis Questionnaire Correlates with Fiber-Optic Endoscopic Examination for Detecting Swallowing Deficits in MS

Abstract

Multiple sclerosis (MS) refers to chronic inflammation of the central nervous system including the brain and spinal cord. Assessing for the presence of dysphagia in subjects with MS represents a challenge for neurologists in clinical practice. The aim of the present study was to verify the relationship between DYMUS scores, a patient-reported scale, and objective symptoms using the Dysphagia Outcome Severity Score (DOSS), based on fiber-optic endoscopy. Data were collected in a multicenter study. Two hundred and fifteen MS patients were enrolled, irrespective of self-reported dysphagia. DOSS revealed dysphagia in 122 subjects (56.7%). Compared with non-dysphagic subjects, the presence of dysphagia was related to more severe disability, longer disease duration, and a progressive form of the disease. A DYMUS score of 0 strongly correlated with a DOSS of 6 (sensitivity 100%) while DYMUS score of > 2 correlated with a DOSS < 7 (specificity 82%) of the self-reported scale. The DYMUS questionnaire can be a useful clinical tool for red-flagging patients who should undergo objective testing and referral to a otorhinolaryngologist.

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References

  1. Guan XL, Wang H, Huang HS, Meng L. Prevalence of dysphagia in multiple sclerosis: a systematic review and meta-analysis. Neurol Sci. 2015;36(5):671–81.

    Article  Google Scholar 

  2. Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444–522.

    CAS  Article  Google Scholar 

  3. De Pauw A, Dejaeger E, D’hooghe B, Carton H. Dysphagia in multiple sclerosis. Clin Neurol Neurosurg. 2002;104(4):345–51.

    Article  Google Scholar 

  4. Abraham SS, Yun PT. Laryngopharyngeal dysmotility in multiple sclerosis. Dysphagia. 2002;17(1):69–74.

    Article  Google Scholar 

  5. Keage M, Delatycki M, Corben L, Vogel A. A systematic review of self-reported swallowingassessments in progressive neurological disorders. Dysphagia. 2015;30(1):27–46.

    Article  Google Scholar 

  6. O’Neil KH, Purdy M, Falk J, Gallo L. The dysphagia outcome and severity scale. Dysphagia. 1999;14(3):139–45.

    Article  Google Scholar 

  7. Calcagno P, Ruoppolo G, Grasso MG, De Vincentiis M, Paolucci S. Dysphagia in multiple sclerosis-prevalence and prognostic factors. Acta Neurol Scand. 2002;105(1):40–3.

    CAS  Article  Google Scholar 

  8. Bergamaschi R, Crivelli P, Rezzani C, Patti F, Solaro C, Rossi P, Restivo D, Maimone D, Romani A, Bastianello S, Tavazzi E, D'Amico E, Montomoli C, Cosi V. The DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. J Neurol Sci. 2008;269(1–2):49–53.

    CAS  Article  Google Scholar 

  9. Bergamaschi R, Rezzani C, Minguzzi S, Amato MP, Patti F, Marrosu MG, Bonavita S, Grasso MG, Ghezzi A, Rottoli M, Gasperini C, Restivo D, Maimone D, Rossi P, Stromillo ML, Montomoli C, Solaro C, DYMUS Group. Validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. Funct Neurol. 2009;24(3):159–62.

    PubMed  Google Scholar 

  10. Alfonsi E, Bergamaschi R, Cosentino G, Ponzio M, Montomoli C, Restivo DA, Brighina F, Ravaglia S, Prunetti P, Bertino G, Benazzo M, Fontana D, Moglia A. Electrophysiological patterns of oropharyngeal swallowing in multiple sclerosis. Clin Neurophysiol. 2013;124(8):1638–45.

    CAS  Article  Google Scholar 

  11. Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M, Fujihara K, Havrdova E, Hutchinson M, Kappos L, Lublin FD, Montalban X, O'Connor P, Sandberg-Wollheim M, Thompson AJ, Waubant E, Weinshenker B, Wolinsky JS. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292–330.

    Article  Google Scholar 

  12. Tassorelli C, Bergamaschi R, Buscone S, Bartolo M, Furnari A, Crivelli P, Alfonsi E, Alberici E, Bertino G, Sandrini G, Nappi G. Dysphagia in multiple sclerosis: from pathogenesis to diagnosis. Neurol Sci. 2008 Dec;29(4):360–3.

    Article  Google Scholar 

  13. Solaro C, Rezzani C, Trabucco E, Amato MP, Zipoli V, Portaccio E, Giannini M, Patti F, D'Amico E, Frau J, Lorefice L, Bonavita S, Della Corte M, Grasso MG, Finamore L, Ghezzi A, Annovazzi P, Rottoli M, Gasperini C, Restivo D, Maimone D, Rossi P, Stromillo ML, Bergamaschi R. Prevalence of patient-reported dysphagia in multiple sclerosis patients: an Italian multicenter study (using the DYMUS questionnaire). J Neurol Sci. 2013;331(1–2):94–7.

    CAS  Article  Google Scholar 

  14. Prosiegel M, Schelling A, Wagner-Sonntag E. Dysphagia and multiple sclerosis. Int MS J. 2004;11(1):22–31.

    CAS  PubMed  Google Scholar 

  15. Fernandes AMF, de Campos Duprat A, Eckley CA, da Silva L, Ferreira RB, Tilbery CP. Oropharyngeal dysphagia in patients with multiple sclerosis: do the disease classification scales reflect dysphagia severity? Braz J Otorhinolaryngol. 2013;79(4):460–5.

    Article  Google Scholar 

  16. Beckmann Y, Gürgör N, Çakır A, Arıcı Ş, İncesu TK, Seçil Y, Ertekin C. Electrophysiological evaluation of dysphagia in the mild or moderate patients with multiple sclerosis: a concept of subclinical dysphagia. Dysphagia. 2015;30(3):296–303.

    Article  Google Scholar 

  17. Giusti A, Giambuzzi M. Management of dysphagia in patients affected by multiple sclerosis: state of the art. Neurological Sciences. 2008;29(S4):364–366.

    Article  Google Scholar 

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Funding

The study was funded by Italian MS Society Research Foundation (Grant No. 2009/R/15).

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Correspondence to Maria Grazia Grasso MD.

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The authors declare that they have no conflicts of interest regards this Original Paper and no primary interest may be influenced by a secondary interest such as financial gain or personal rivalry. All authors made significant contributions to this study.

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Grasso, M.G., Gamberini, G., Patti, F. et al. The Dysphagia in Multiple Sclerosis Questionnaire Correlates with Fiber-Optic Endoscopic Examination for Detecting Swallowing Deficits in MS. Dysphagia 36, 192–197 (2021). https://doi.org/10.1007/s00455-020-10119-w

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Keywords

  • Multiple sclerosis
  • Dysphagia
  • DYMUS questionnaire
  • Dysphagia outcome severity score
  • Fiberoptic endoscopy
  • Deglutition disorders