Luca Diamanti1, Paola Borrelli2, Raffaele Dubbioso3, Margherita Capasso4, Claudia Morelli5, Christian Lunetta6,7, Antonio Petrucci8, Gabriele Mora9, Paolo Volanti10, Maurizio Inghilleri11, Lucio Tremolizzo12, Jessica Mandrioli13,14, Letizia Mazzini15, Marcella Vedovello16, Gabriele Siciliano17, Massimiliano Filosto18, Sabrina Matà19, Cristina Montomoli20. 1. IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy. luca.diamanti@mondino.it. 2. Laboratory of Biostatistics, Department of Medical, Oral, and Biotechnological Sciences, University G. d'Annunzio Chieti-Pescara, Chieti, Italy. 3. Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy. 4. Neurologic Clinic, SS. Annunziata Hospital, Chieti, Italy. 5. Department of Neurology and Laboratory of Neuroscience, Istituto Auxologico Italiano, IRCCS, Milan, Italy. 6. NEMO Clinical Center, Serena Onlus Foundation, Milano, Italy. 7. NEMO Lab, Milano, Italy. 8. Center for Neuromuscular and Neurological Rare Diseases, Neurology and Neurophysiology Unit, San Camillo Forlanini Hospital, Rome, Italy. 9. ICS Maugeri IRCCS, Milano, Italy. 10. Department of Neurorehabilitation, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Mistretta, Messina, Italy. 11. Neuromuscular Rare Disease Centre, Department Human Neurosciences, University of Rome La Sapienza, Rome, Italy. 12. Neurology, San Gerardo Hospital and University of Milano-Bicocca, Monza, Italy. 13. Department of Biomedical, Metabolic and Neural Science, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy. 14. Neurology Unit, Azienda Ospedaliero Universitaria Di Modena, Modena, Italy. 15. Department of Neurology and ALS Centre, University of Piemonte Orientale, Maggiore Della Carità Hospital, Novara, Italy. 16. Neurology Unit, ASST Papa Giovanni XXIII, Bergamo, Italy. 17. Center for Neuromuscular and Neurological Rare Diseases Neurological Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. 18. Department of Clinical and Experimental Sciences, University of Brescia, NeMO-Brescia Clinical Center for Neuromuscular Diseases, Brescia, Italy. 19. SOD Neurologia 1, Dipartimento Neuromuscolo-Scheletrico E Degli Organi Di Senso, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. 20. Department of Public Health, Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, Pavia, Italy.
Abstract
BACKGROUND: Dysphagia is a common symptom during the trajectory of ALS, and it can significantly impact on the quality of life and prognosis of patients. Nowadays, no specific tool for the screening of dysphagia in ALS is validated, and the approach is heterogeneous across the Italian centres. OBJECTIVE: To validate the DYALS (dysphagia in amyotrophic lateral sclerosis) questionnaire, adapting the DYMUS (dysphagia in multiple sclerosis) questionnaire, for the assessment of dysphagia in ALS patients, in order to uniform the evaluations across the Italian ALS network. METHODS: We included 197 patients diagnosed with ALS following the El Escorial criteria, in sixteen Italian ALS centres between 1st December 2019 and 1st July 2020. For each patient, we collected clinical and demographic data and obtained ALSFRS-r score, ALSAQ-5 score, DYMUS score, and EAT-10 score. RESULTS: Across the 197 patients, the ratio M/F was 113/84, and the median age was 64 years (IQR 56-72.5). Bulbar patients were 20%, and spinal patients 80%. The median ALSFRSr total score of patients was 35 (IQR 28-39). DYALS score was statistically higher in bulbar ALS than in spinal ALS (median = 6, IQR 4.5-9 vs median = 1, IQR 0-5, z = 6.253, p < 0.0001). DYALS questionnaire showed a high internal consistency (Cronbach's alpha = 0.88). There was a statistically significant correlation between DYALS and EAT-10 (rho = 0.90, p < 0.0001). CONCLUSIONS: DYALS scale is reliable, manageable, and easily usable for the screening of dysphagia in ALS. It can be shared with all the Italian ALS centres in order to collect uniform data for therapeutic strategies and clinical trials.
BACKGROUND: Dysphagia is a common symptom during the trajectory of ALS, and it can significantly impact on the quality of life and prognosis of patients. Nowadays, no specific tool for the screening of dysphagia in ALS is validated, and the approach is heterogeneous across the Italian centres. OBJECTIVE: To validate the DYALS (dysphagia in amyotrophic lateral sclerosis) questionnaire, adapting the DYMUS (dysphagia in multiple sclerosis) questionnaire, for the assessment of dysphagia in ALS patients, in order to uniform the evaluations across the Italian ALS network. METHODS: We included 197 patients diagnosed with ALS following the El Escorial criteria, in sixteen Italian ALS centres between 1st December 2019 and 1st July 2020. For each patient, we collected clinical and demographic data and obtained ALSFRS-r score, ALSAQ-5 score, DYMUS score, and EAT-10 score. RESULTS: Across the 197 patients, the ratio M/F was 113/84, and the median age was 64 years (IQR 56-72.5). Bulbar patients were 20%, and spinal patients 80%. The median ALSFRSr total score of patients was 35 (IQR 28-39). DYALS score was statistically higher in bulbar ALS than in spinal ALS (median = 6, IQR 4.5-9 vs median = 1, IQR 0-5, z = 6.253, p < 0.0001). DYALS questionnaire showed a high internal consistency (Cronbach's alpha = 0.88). There was a statistically significant correlation between DYALS and EAT-10 (rho = 0.90, p < 0.0001). CONCLUSIONS: DYALS scale is reliable, manageable, and easily usable for the screening of dysphagia in ALS. It can be shared with all the Italian ALS centres in order to collect uniform data for therapeutic strategies and clinical trials.
Authors: E K Plowman; L C Tabor; R Robison; J Gaziano; C Dion; S A Watts; T Vu; C Gooch Journal: Neurogastroenterol Motil Date: 2015-10-28 Impact factor: 3.598
Authors: G Ruoppolo; I Schettino; V Frasca; E Giacomelli; L Prosperini; C Cambieri; R Roma; A Greco; P Mancini; M De Vincentiis; V Silani; M Inghilleri Journal: Acta Neurol Scand Date: 2013-05-14 Impact factor: 3.209