Tomik Jerzy, Sowula Klaudia, Ceranowicz Piotr, Dworak Mateusz, Stolcman Kamila
ENT Department, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Krakow, Poland.
Department of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Krakow, Poland.
J Clin Med. 2020 Jul 21;9(7):2314. doi: 10.3390/jcm9072314.
Esophageal manometry (EM) could serve as an objective method for the detection of esophageal peristalsis in patients with amyotrophic lateral sclerosis (ALS). In this group of patients, biofeedback training (BT) using the EM procedure is a promising method for the rehabilitation of swallowing function. A total of 20 ALS patients with clinical evidence of dysphagia and who met WFN criteria were recruited for this study. The standard transnasal EM with solid-state transducers was performed, and swallows with water and saliva were initiated in all subjects and repeated at 30-s intervals. The median upper esophageal contractile amplitude, duration, and velocity results during the wet and dry swallows were evaluated and compared in both the ALS and the control groups. In ALS patients, in contrast to the control, significant abnormalities in all EM parameters were recorded, which implies a specific pattern of esophageal peristalsis. Twelve months after BT, the body mass index (BMI) of ALS patients who underwent BT (ALSBT) was compared to the BMI of those who did not (ALS1)-compared to the ALS1 group, ALSBT patients showed a slightly smaller drop in BMI value. We presume that BT using EM can be a promising tool for the improvement of the swallowing mechanism in ALS patients.
食管测压（EM）可作为检测肌萎缩侧索硬化症（ALS）患者食管蠕动的一种客观方法。在这类患者中，采用EM程序的生物反馈训练（BT）是吞咽功能康复的一种有前景的方法。本研究共招募了20例有吞咽困难临床证据且符合世界神经病学联合会（WFN）标准的ALS患者。采用带有固态传感器的标准经鼻EM进行检测，所有受试者均开始用水和唾液吞咽，并以30秒的间隔重复进行。评估并比较了ALS组和对照组在湿咽和干咽过程中食管上括约肌收缩幅度、持续时间和速度的中位数结果。与对照组相比，ALS患者的所有EM参数均出现明显异常，这意味着食管蠕动存在特定模式。BT治疗12个月后，将接受BT治疗的ALS患者（ALSBT）的体重指数（BMI）与未接受BT治疗的患者（ALS1）的BMI进行比较——与ALS1组相比，ALSBT患者的BMI值下降幅度略小。我们推测，采用EM的BT可能是改善ALS患者吞咽机制的一种有前景的工具。
