Banno Haruhiko, Katsuno Masahisa, Suzuki Keisuke, Tanaka Seiya, Suga Noriaki, Hashizume Atsushi, Mano Tomoo, Araki Amane, Watanabe Hirohisa, Fujimoto Yasushi, Yamamoto Masahiko, Sobue Gen
Department of Neurology Nagoya University Graduate School of Medicine 65 Tsurumai-cho, Showa-ku Nagoya 466-8550 Japan.
Innovation Centre for Clinical Research National Centre for Geriatrics and Gerontology 7-430 Morioka Obu 474-8511 Japan.
Ann Clin Transl Neurol. 2017 May 24;4(8):534-543. doi: 10.1002/acn3.425. eCollection 2017 Aug.
We examined the characteristics of dysphagia in spinal and bulbar muscular atrophy, a hereditary neuromuscular disease causing weakness of limb, facial, and oropharyngeal muscles via a videofluoroscopic swallowing study, and investigated the plausibility of using these outcome measures for quantitative analysis.
A videofluoroscopic swallowing study was performed on 111 consecutive patients with genetically confirmed spinal and bulbar muscular atrophy and 53 age- and sex-matched healthy controls. Swallowing of 3-mL liquid barium was analyzed by the worksheet.
Of more than 40 radiographic findings, the most pertinent abnormal findings in patients with spinal and bulbar muscular atrophy, included (residue just behind the tongue base) and ( < 0.001 for each) compared with healthy controls. Quantitative analyses showed that and the were significantly worse in these patients ( ≤ 0.005 for each) than in controls. In patients with spinal and bulbar muscular atrophy, was observed more frequently in those without subjective dysphagia.
Dysphagia of spinal and bulbar muscular atrophy was characterized by impaired tongue movement in the oral phase and nasal penetration followed by pharyngeal residues, which resulted in multiple swallowing sessions and laryngeal penetration. Although major limitations of reproducibility and radiation exposure still exist with videofluoroscopy, and the might serve as potential outcome measures in clinical studies.
我们通过视频荧光吞咽造影研究，检查了脊髓性延髓肌萎缩症（一种遗传性神经肌肉疾病，可导致肢体、面部和口咽肌肉无力）患者吞咽困难的特征，并探讨了将这些结果指标用于定量分析的合理性。
对111例经基因确诊的脊髓性延髓肌萎缩症患者及53例年龄和性别匹配的健康对照者进行了视频荧光吞咽造影研究。使用工作表分析了3毫升液体钡剂的吞咽情况。
在40多项影像学检查结果中，脊髓性延髓肌萎缩症患者最相关的异常表现包括（舌根后方残留）和（每项<0.001），与健康对照者相比。定量分析显示，这些患者的和明显比对照组差（每项≤0.005）。在脊髓性延髓肌萎缩症患者中，在无主观吞咽困难的患者中更频繁地观察到。
脊髓性延髓肌萎缩症的吞咽困难表现为口腔期舌运动受损、鼻反流伴咽部残留，导致多次吞咽动作及喉反流。尽管视频荧光吞咽造影仍存在可重复性和辐射暴露等主要局限性，但和可能作为临床研究中的潜在结果指标。
