Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, PA.
Myositis Center, University of Pittsburgh Medical Center, PA.
Am J Speech Lang Pathol. 2024 Nov 4;33(6):2793-2804. doi: 10.1044/2024_AJSLP-24-00061. Epub 2024 Oct 11.
Evidence surrounding swallowing impairment in sporadic inclusion body myositis (IBM) is based on nonstandardized and nonvalidated assessment methods. We investigated (a) IBM's impact on swallowing function and oral intake status using well-tested assessment frameworks; (b) changes in swallowing over time; and (c) age, sex, and swallowing impairment severity's influence on oral intake status.
We conducted a secondary analysis of Modified Barium Swallow Impairment Profile (MBSImP) and Functional Oral Intake Scale (FOIS) data from 13 patients with IBM (seven females; = 60.2 [±13.6] years) and 13 age- and sex-matched healthy controls. We compared MBSImP Overall Impression (OI), Oral Total (OT), Pharyngeal Total (PT), and FOIS scores between groups. Specific to the IBM cohort, we analyzed repeated OT and PT scores and calculated whether age, sex, and OT and PT scores predicted FOIS scores.
The IBM cohort demonstrated poorer OI scores across six swallowing components than healthy controls (each < .05). Unlike OT scores ( = .84), PT ( = .033) and FOIS ( < .001) scores were worse in the IBM cohort. Repeated OI scores revealed changes in three swallowing components (each < .05), but repeated OT ( = .16) and PT ( = .30) scores did not significantly change. Age, sex, and OT and PT scores did not influence FOIS scores (each > .05).
Pharyngeal impairments were most prominent in the IBM cohort, and their oral intake status was adversely affected. Our preliminary data showcase the application of robust assessment methods to investigate swallowing function in IBM, enhancing standardization and comparability across studies.
有关散发性包涵体肌炎（IBM）吞咽障碍的证据基于非标准化和未经验证的评估方法。我们使用经过充分验证的评估框架研究了：（a）IBM 对吞咽功能和口腔摄入状况的影响；（b）随时间推移吞咽功能的变化；（c）年龄、性别和吞咽障碍严重程度对口腔摄入状况的影响。
我们对 13 名 IBM 患者（7 名女性；平均年龄 60.2[±13.6]岁）和 13 名年龄和性别匹配的健康对照者的改良钡吞咽障碍影像分析（MBSImP）和功能性口腔摄入量表（FOIS）数据进行了二次分析。我们比较了两组间 MBSImP 总体印象（OI）、口腔总得分（OT）、咽部总得分（PT）和 FOIS 得分。具体针对 IBM 队列，我们分析了重复的 OT 和 PT 得分，并计算了年龄、性别以及 OT 和 PT 得分是否可以预测 FOIS 得分。
IBM 队列在六个吞咽组成部分的 OI 评分均显著差于健康对照组（均 <.05）。与 OT 评分（ =.84）不同，PT（ =.033）和 FOIS（ <.001）评分在 IBM 队列中更差。重复的 OI 评分显示三个吞咽组成部分的变化（均 <.05），但重复的 OT（ =.16）和 PT（ =.30）评分没有显著变化。年龄、性别以及 OT 和 PT 评分均不会影响 FOIS 评分（均 >.05）。
IBM 队列中咽期障碍最为突出，其口腔摄入状况受到不利影响。我们的初步数据展示了使用可靠的评估方法来研究 IBM 中的吞咽功能，增强了研究间的标准化和可比性。
