Grasso Maria Grazia, Gamberini Giulia, Patti Francesco, D'Amico Emanuele, Bergamaschi Roberto, Berra Eliana, Giusti Antonella, Cuccaro Alessandro, Messmer Uccelli Michele, Solaro Claudio
IRCCS Santa Lucia Foundation, Rome, Italy.
Department of Rehabilitation "M.L.Novarese" Hospital, Moncrivello, VC, Italy.
Dysphagia. 2021 Apr;36(2):192-197. doi: 10.1007/s00455-020-10119-w. Epub 2020 Apr 30.
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.
多发性硬化症(MS)是指包括脑和脊髓在内的中枢神经系统的慢性炎症。在临床实践中,评估MS患者是否存在吞咽困难对神经科医生来说是一项挑战。本研究的目的是基于纤维内镜检查,验证患者报告量表DYMUS评分与使用吞咽困难结果严重程度评分(DOSS)得出的客观症状之间的关系。数据收集于一项多中心研究。纳入了215例MS患者,无论其是否自我报告有吞咽困难。DOSS显示122例受试者(56.7%)存在吞咽困难。与无吞咽困难的受试者相比,吞咽困难的存在与更严重的残疾、更长的病程以及疾病的进展形式有关。DYMUS评分为0与DOSS为6密切相关(敏感性100%),而DYMUS评分>2与自我报告量表的DOSS<7相关(特异性82%)。DYMUS问卷可以作为一种有用的临床工具,用于筛查那些应接受客观检查并转诊至耳鼻喉科医生的患者。