Ashley A Waito1,2, Lauren C Tabor-Gray3,4, Catriona M Steele1,2, Emily K Plowman3,5,6. 1. Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada. 2. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. 3. Swallowing Systems Core, University of Florida, Gainesville, Florida. 4. Phil Smith Neuroscience Institute, Holy Cross Hospital, Fort Lauderdale, Florida. 5. Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, Florida. 6. Department of Neurology, University of Florida, Gainesville, Florida.
Abstract
BACKGROUND: Swallowing inefficiency is a prevalent but understudied problem in individuals with Amyotrophic Lateral Sclerosis (ALS). Although reduced pharyngeal constriction has been identified as a mechanism contributing to swallowing inefficiency following stroke, this relationship has not been empirically tested in the ALS population. This study sought to characterize profiles of swallowing efficiency in a sample of ALS patients and investigate relationships between pharyngeal constriction and swallowing efficiency. METHODS: Twenty-six adults with ALS underwent videofluoroscopic swallowing studies, involving 3 mL-thin, 20 mL-thin, and 3 mL-pudding boluses. Full-length recordings were segmented into bolus clips and randomized for analysis. We recorded the total number of swallows per bolus and obtained normalized pixel-based measures of pharyngeal constriction area and post-swallow residue in the vallecular and pyriform sinuses. Linear mixed models with Spearman's correlations were used to determine relationships between pharyngeal constriction and swallowing efficiency, with added factors of bolus volume and thickness. KEY RESULTS: Individuals with ALS demonstrated reduced pharyngeal constriction and increased vallecular and pyriform sinus residue, compared to norms. Reduced pharyngeal constriction had a significant effect on the presence of vallecular and pyriform sinus residue as well as the number of swallows per bolus. Increased bolus thickness was associated with increased vallecular residue, while increased bolus volume was associated with reduced pharyngeal constriction. Results were significant at P < 0.05. CONCLUSIONS & INFERENCES: Our results suggest that reduced pharyngeal constriction is a significant physiological parameter related to swallow inefficiency in ALS. Future work is needed to corroborate these preliminary results and investigate factors to mitigate such impairments.
BACKGROUND:Swallowing inefficiency is a prevalent but understudied problem in individuals with Amyotrophic Lateral Sclerosis (ALS). Although reduced pharyngeal constriction has been identified as a mechanism contributing to swallowing inefficiency following stroke, this relationship has not been empirically tested in the ALS population. This study sought to characterize profiles of swallowing efficiency in a sample of ALSpatients and investigate relationships between pharyngeal constriction and swallowing efficiency. METHODS: Twenty-six adults with ALS underwent videofluoroscopic swallowing studies, involving 3 mL-thin, 20 mL-thin, and 3 mL-pudding boluses. Full-length recordings were segmented into bolus clips and randomized for analysis. We recorded the total number of swallows per bolus and obtained normalized pixel-based measures of pharyngeal constriction area and post-swallow residue in the vallecular and pyriform sinuses. Linear mixed models with Spearman's correlations were used to determine relationships between pharyngeal constriction and swallowing efficiency, with added factors of bolus volume and thickness. KEY RESULTS: Individuals with ALS demonstrated reduced pharyngeal constriction and increased vallecular and pyriform sinus residue, compared to norms. Reduced pharyngeal constriction had a significant effect on the presence of vallecular and pyriform sinus residue as well as the number of swallows per bolus. Increased bolus thickness was associated with increased vallecular residue, while increased bolus volume was associated with reduced pharyngeal constriction. Results were significant at P < 0.05. CONCLUSIONS & INFERENCES: Our results suggest that reduced pharyngeal constriction is a significant physiological parameter related to swallow inefficiency in ALS. Future work is needed to corroborate these preliminary results and investigate factors to mitigate such impairments.
Authors: Jordan R Green; Yana Yunusova; Mili S Kuruvilla; Jun Wang; Gary L Pattee; Lori Synhorst; Lorne Zinman; James D Berry Journal: Amyotroph Lateral Scler Frontotemporal Degener Date: 2013-07-30 Impact factor: 4.092
Authors: Kate L Osman; Sabrina Kohlberg; Alexis Mok; Ryan Brooks; Lori A Lind; Katelyn McCormack; Andries Ferreira; Matan Kadosh; Mary K Fagan; Elizabeth Bearce; Nicole L Nichols; Joan R Coates; Teresa E Lever Journal: Dysphagia Date: 2019-07-12 Impact factor: 3.438
Authors: Ashley A Waito; Emily K Plowman; Carly E A Barbon; Melanie Peladeau-Pigeon; Lauren Tabor-Gray; Kelby Magennis; Raele Robison; Catriona M Steele Journal: J Speech Lang Hear Res Date: 2020-04-18 Impact factor: 2.297
Authors: Eduardo Sánchez-Sánchez; Ylenia Avellaneda-López; Esperanza García-Marín; Guillermo Ramírez-Vargas; Jara Díaz-Jimenez; Francisco Javier Ordonez Journal: Int J Environ Res Public Health Date: 2021-02-22 Impact factor: 3.390
Authors: Carly E A Barbon; Douglas B Chepeha; Andrew J Hope; Melanie Peladeau-Pigeon; Ashley A Waito; Catriona M Steele Journal: J Speech Lang Hear Res Date: 2020-08-05 Impact factor: 2.297