Swallowing impairments in Amyotrophic Lateral Sclerosis and Myotonic Dystrophy type 1: Looking for the portrait of dysphagic patient in neuromuscular diseases
Affiliations: [a] Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, “Politecnica delle Marche” University, Ancona, Italy
| [b] Department of Neuroscience, Neurorehabilitation Clinic, AziendaOspedaliero-Universitaria Ospedali Riuniti di Ancona, Ancona, Italy
| [c] Center of Epidemiology, Biostatistics and Medical Information Technology, “Politecnica delle Marche” University, Ancona, Italy
| [d] Department of Experimental and Clinical Medicine, Neurological Clinic, “Politecnica delle Marche” University, Ancona, Italy
Correspondence:
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Address for correspondence: Elisa Andrenelli, MD., Department of Experimental and Clinical Medicine, Neurorehabilitation, Clinic, “Politecnica delle Marche” University, Via Tronto 10a, 60020, Ancona, AN, Italy. E-mail: elisa.andrenelli@gmail.com.
Abstract: BACKGROUND:Dysphagia is a critical symptom of Neuromuscular Diseases and is often associated with considerable morbidity and mortality. OBJECTIVE:This study is designed to investigate the prevalence of dysphagia and to identify different clinical profiles of swallowing disorders in Myotonic Dystrophy type 1 (DM1) and Amyotrophic Lateral Sclerosis (ALS), the most common Neuromuscular Diseases in the adult age. METHODS:Consecutive DM1 and ALS patients from 2013 to 2015 referred to a Centre for Neuromuscular Disease were enrolled. A comprehensive assessment of swallowing function with a Clinical Swallowing Examination and Fluid and Food Trials was performed. RESULTS:157 patients were included: 86 ALS, 71 DM1. The dysphagic patients affected by ALS and DM1 (79% and 86% of the respective samples) showed two different profiles. ALS patients with dysphagia were older and underweight. They experienced a global dysfunction of the oral and pharyngeal phases with more difficulty in swallowing thin liquids. Conversely, DM1 patients with dysphagia were younger and tended to obesity. Most of them showed impairment of oral phase and had more frequently difficulty in swallowing solid bolus. CONCLUSION:The recognition of specific clinical profiles supports and guides the detection of swallowing disorders in patients with neuromuscular diseases.
