El Fassi Nadia, Pavy le Traon Anne, Mouchon Emmanuelle, Rascol Olivier, Meissner Wassilios G, Foubert-Saumier Alexandra, Gallois Yohan, Tessier Samuel, Ory-Magne Fabienne, Woisard Virginie A, Fabbri Margherita
Department of ENT Hospital of Larrey Toulouse France.
French Reference Center for Multiple System Atrophy, Neurology Department Toulouse university hospital and Institute of Metabolic and Cardiovascular Diseases INSERM UMR 1297 Toulouse France.
Mov Disord Clin Pract. 2023 Apr 12;10(6):974-979. doi: 10.1002/mdc3.13734. eCollection 2023 Jun.
Multiple System Atrophy (MSA) dysphagia is routinely assessed by the Unified Multiple System Atrophy Rating Scale (UMSARS) part I-item 2.
To compare the UMSARS part I-item 2 with an ear/nose/throat (ENT) expert physician assessment.
We retrospectively analyzed the data of MSA patients who underwent an ENT assessment (nasofibroscopic and radioscopic exam) and an annual UMSARS assessment. Deglutition Handicap Index (DHI) and pulmonary/nutrition complications were collected.
Seventy-five MSA patients were included. The ENT assessment revealed more severe dysphagia compared to the UMSARS part I-item 2 score ( = 0.003). A higher proportion of patients with impaired protective mechanisms showed severe UMSARS-based dysphagia ( = 0.005). Patients with choking and oral/pharyngeal transit defects and nutritional complications were equally distributed across UMSARS part I-item 2 scores. Worse UMSARS part I-item 2 scores had worse DHI scores.
The UMSARS-based assessment of dysphagia does not capture key aspects of pharyngo-laryngeal dysfunction reflecting swallowing efficiency.
多系统萎缩（MSA）吞咽困难通常通过统一多系统萎缩评定量表（UMSARS）第一部分第2项进行评估。
比较UMSARS第一部分第2项与耳鼻喉（ENT）专科医生的评估结果。
我们回顾性分析了接受耳鼻喉评估（鼻纤维镜和放射检查）及年度UMSARS评估的MSA患者的数据。收集吞咽障碍指数（DHI）以及肺部/营养并发症情况。
纳入75例MSA患者。与UMSARS第一部分第2项评分相比，耳鼻喉评估显示吞咽困难更为严重（=0.003）。具有受损保护机制的患者中，较高比例表现出基于UMSARS的严重吞咽困难（=0.005）。出现呛咳、口腔/咽部转运缺陷及营养并发症的患者在UMSARS第一部分第2项评分中分布均匀。UMSARS第一部分第2项评分越差，DHI评分越差。
基于UMSARS的吞咽困难评估未涵盖反映吞咽效率的咽喉功能障碍的关键方面。
