Umay Ebru, Sakin Yusuf Serdar, Ates Mehlika Panpallı, Alicura Sibel, Gundogdu Ibrahim, Ozturk Erhan Arif, Koc Guray
Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, 06170, Altindag, Ankara, Turkey.
Department of Gastroenterology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey.
Acta Neurol Belg. 2022 Apr;122(2):315-324. doi: 10.1007/s13760-020-01563-4. Epub 2021 Jan 3.
Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is important to evaluate the esophageal phase of swallowing with an easy and rapid screening test. We aimed both to assess the prevalence of ED in NMD and to perform validity and reliability study of the brief easophageal dysphagia questionnaire (BEDQ) screening test in NMD patients. This prospective cross-sectional clinical study was performed on NMD patients. Demographic features and disease characteristics were recorded. Endoscopic evaluation for oropharyngeal dysphagia (OD) and high-resolution esophageal manometry for ED were performed. In addition, the BEDQ and the 10-item eating assessment tool (EAT-10) were used to all subjects. Cronbach's α and principle components factor analysis (PFCA) with varimax rotation were used for reliability. The Chicago Classification version 3 (CCv3) level (high-resolution esophageal manometry) and EAT-10 was used for validity. A total of 50 patients were included in the study. Thirty-four (68%) patients were diagnosed with myasthenia gravis and 16 (32%) patients were diagnosed with myopathy. Esophageal dysphagia according to the CCv3 was found in 33 (66%) of patients. While the Cronbach's α was excellent as 0.937 for test overall the T-BEDQ scale. The PCFA included all scale items and resulted in a single factor (eigenvalue = 5.72, 71.5%). The all BEDQ scores were demonstrated good correlation with EAT-10 score and very good correlation with CCv3 level. Evaluation of swallowing in patients with NMD should include not only the oropharyngeal phase of swallowing, but also esophageal phase. For this purpose, the BEDQ can be used as a rapid, valid, and reliable test for the evaluation of ED.
食管吞咽困难(ED)在神经肌肉疾病(NMD)中常被低估,通过简单快速的筛查试验评估吞咽的食管阶段很重要。我们旨在评估NMD中ED的患病率,并对NMD患者进行简短食管吞咽困难问卷(BEDQ)筛查试验的效度和信度研究。这项前瞻性横断面临床研究是在NMD患者中进行的。记录人口统计学特征和疾病特征。对口咽吞咽困难(OD)进行内镜评估,对ED进行高分辨率食管测压。此外,对所有受试者使用BEDQ和10项饮食评估工具(EAT-10)。采用Cronbach's α和具有方差最大化旋转的主成分因子分析(PFCA)来评估信度。使用芝加哥分类第3版(CCv3)水平(高分辨率食管测压)和EAT-10来评估效度。共有50名患者纳入研究。34名(68%)患者被诊断为重症肌无力,16名(32%)患者被诊断为肌病。根据CCv3,33名(66%)患者存在食管吞咽困难。总体测试中,T-BEDQ量表的Cronbach's α为0.937,非常出色。PCFA包含了所有量表项目,并产生了一个单一因子(特征值 = 5.72,71.5%)。所有BEDQ评分与EAT-10评分显示出良好的相关性,与CCv3水平显示出非常好的相关性。对NMD患者吞咽的评估不仅应包括吞咽的口咽阶段,还应包括食管阶段。为此,BEDQ可作为评估ED的快速、有效且可靠的测试。