Brandão Bárbara Carolina, Galdino Alline de Sousa, Lourenção Luciano Garcia, Trindade Glaucia Santana, Silva Magali Aparecida Orate Menezes da, Silva Roberta Gonçalves da
Faculdade de Medicina de São José do Rio Preto - FAMERP - São José do Rio Preto (SP), Brasil.
Universidade Federal do Rio Grande - FURG - Rio Grande (RS), Brasil.
Codas. 2018 Mar 5;30(1):e20170056. doi: 10.1590/2317-1782/20182017056.
Describe and correlate bulbar functionality with laryngeal penetration and/or laryngotracheal aspiration for different food consistencies in Motor Neuron Disease (MND).
Study participants were 18 individuals diagnosed with MND regardless of the type and time of onset of disease. The Amyotrophic Lateral Sclerosis Functional Rating Scale - Revised/BR (ALSFRS-R/BR) was applied, and only the bulbar parameter, which includes speech, salivation and swallowing, was analyzed, with scores raging from 0 (disability) to 12 (normal functionality). Swallowing videofluoroscopy was performed using the Penetration-Aspiration Scale (PAS) described by Rosenbek et al. (1996). The Pearson correlation test was used for data analysis.
According to food consistency, the PAS level ranged from 1 to 5 for puree consistency, 1 to 4 for thickened liquid, and 1 to 3 for liquid, and no laryngotracheal aspiration was observed. Negative correlation between bulbar functionality and laryngeal penetration was observed for all food consistencies (pasty: r=-0.487, p=0.041; thickened liquid: r=-0.442, p=0.076; liquid r=0.460, p=0.073), but statistically significant difference was found only for the puree consistency, that is, individuals with poor bulbar functionality presented higher levels of laryngeal penetration.
Negative correlation was observed between bulbar functionality and laryngeal penetration in MND. The bulbar parameters of the ALSFRS-R/BR are significant for predicting risk of laryngotracheal aspiration for pasty consistency in MND.
描述运动神经元病(MND)患者不同食物黏稠度下延髓功能与喉穿透和/或喉气管误吸的情况,并进行相关性分析。
研究参与者为18例确诊为MND的患者,不考虑疾病类型和发病时间。应用肌萎缩侧索硬化功能评定量表修订版/巴西版(ALSFRS-R/BR),仅分析包括言语、流涎和吞咽的延髓参数,评分范围为0(残疾)至12(功能正常)。采用Rosenbek等人(1996年)描述的穿透-误吸量表(PAS)进行吞咽电视荧光透视检查。数据分析采用Pearson相关检验。
根据食物黏稠度,泥状食物的PAS水平为1至5,增稠液体为1至4,液体为1至3,未观察到喉气管误吸。所有食物黏稠度下均观察到延髓功能与喉穿透之间呈负相关(糊状食物:r=-0.487,p=0.041;增稠液体:r=-0.442,p=0.076;液体:r=-0.460,p=0.073),但仅泥状食物的差异具有统计学意义,即延髓功能差的个体喉穿透水平较高。
MND患者延髓功能与喉穿透之间呈负相关。ALSFRS-R/BR的延髓参数对于预测MND患者糊状食物的喉气管误吸风险具有重要意义。