Nagao Ryunosuke, Mizutani Yasuaki, Kawabata Kazuya, Yoshimoto Junichiro, Inamoto Yoko, Shibata Seiko, Ito Mizuki, Otaka Yohei, Watanabe Hirohisa
Department of Neurology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
Division of Brain Thera Informatics, International Center for Brain Science, Fujita Health University, Toyoake, Aichi, Japan.
Mov Disord Clin Pract. 2025 Aug;12(8):1086-1096. doi: 10.1002/mdc3.70055. Epub 2025 Mar 25.
Dysphagia significantly impacts prognosis in individuals with multiple system atrophy (MSA). While video-based assessments are practical, their limited availability highlights the need for a simple tool such as the Dysphagia Severity Scale (DSS) in clinical practice.
To evaluate the utility of the DSS in assessing dysphagia in MSA patients and its correlations with clinical indices.
We examined 43 MSA patients using the DSS and other clinical measures, including the Unified MSA Rating Scale (UMSARS) and cerebrospinal fluid 5-hydroxyindoleacetic acid levels. As a follow-up, 11 of 43 patients underwent a secondary DSS evaluation. Spearman's correlation and linear mixed models were used to analyze cross-sectional and longitudinal relationships.
DSS scores were significantly correlated with UMSARS Parts 1, 2, and 4, as well as disease duration and blood pressure changes. This indicates that the DSS is sensitive to MSA-related motor and autonomic dysfunctions, and that the DSS could provide a more detailed assessment of swallowing function compared with the UMSARS Part 1 swallowing subscore. Additionally, DSS score was correlated with cerebrospinal fluid 5-hydroxyindoleacetic acid levels. Our longitudinal analysis further supported the role of DSS score as a reliable marker of dysphagia progression over time.
The DSS is a sensitive and practical tool for evaluating dysphagia. Thus, combining the DSS and UMSARS could improve dysphagia monitoring in individuals with MSA. Our data support the use of the DSS as a valuable clinical and research tool in MSA management.
吞咽困难对多系统萎缩（MSA）患者的预后有显著影响。虽然基于视频的评估很实用，但它们的可用性有限，这凸显了在临床实践中需要一种如吞咽困难严重程度量表（DSS）这样的简单工具。
评估DSS在评估MSA患者吞咽困难方面的效用及其与临床指标的相关性。
我们使用DSS和其他临床测量方法对43例MSA患者进行了检查，包括统一MSA评定量表（UMSARS）和脑脊液5-羟吲哚乙酸水平。作为随访，43例患者中的11例接受了二次DSS评估。使用Spearman相关性分析和线性混合模型来分析横断面和纵向关系。
DSS评分与UMSARS第1、2和4部分以及疾病持续时间和血压变化显著相关。这表明DSS对MSA相关的运动和自主神经功能障碍敏感，并且与UMSARS第1部分吞咽子评分相比，DSS可以提供对吞咽功能更详细的评估。此外，DSS评分与脑脊液5-羟吲哚乙酸水平相关。我们的纵向分析进一步支持了DSS评分作为吞咽困难随时间进展的可靠标志物的作用。
DSS是评估吞咽困难的一种敏感且实用的工具。因此，将DSS和UMSARS结合起来可以改善对MSA患者吞咽困难的监测。我们的数据支持将DSS用作MSA管理中有价值的临床和研究工具。
