Skip to main content
SpringerLink
Log in

Earliest Videofluoromanometric Pharyngeal Signs of Dysphagia in ALS Patients

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

The aim of this study was to find whether there are manometric pharyngeal changes that may have diagnostic and prognostic relevance in the amyotrophic lateral sclerosis (ALS) patient who does not show changes in contrast-medium oropharyngeal transit in a videofluoroscopic swallowing study. Ten ALS patients, with an ALS Severity Scale Score of at least 7, no need to change dietary habit, no aspiration and/or penetration, and no other changes in contrast-medium oropharyngeal transit, were collected from our institution’s database of videofluoromanometric swallowing studies. They were included in the study together with a group of 11 healthy volunteers. For each subject, 12 manometric items—7 for the pharyngeal phase and 5 for UES functionality—were evaluated. Statistically significant differences between the ALS patients and the healthy volunteers were found for pharyngeal contraction time of the upper region (median = 1,120, range = 880–1,420 vs. median = 970, range = 800–1,140), pharyngeal contraction time of the intermediate region (median = 1140, range = 960–1,360 vs. median = 770, range = 280–1,180), pharyngeal contraction time of the lower region (median = 1,320, range = 920–1,760 vs. median = 800, range = 620–1,780), and residual pressure after the relaxation of the UES (median = 2.2, range = −20.2 to 27.8 vs. median = −5.7, range = −2.9 to 8.4). A videofluoromanometric swallowing study may show an increase in the pharyngeal contraction time and in residual pressure after relaxation of the UES in ALS patients without videofluoroscopic changes in contrast-medium oropharyngeal transit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Wijesekera LC, Leigh PN. Amyotrophic lateral sclerosis. Orphanet J Rare Dis. 2009;4:3.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Roche JC, Rojas-Garcia R, Scott KM, Scotton W, Ellis CE, Burman R, Wijesekera L, Turner MR, Leigh PN, Shaw CE, Al-Chalabi A. A proposed staging system for amyotrophic lateral sclerosis. Brain. 2012;135(Pt 3):847–52.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Worms PM. The epidemiology of motor neuron diseases: a review of recent studies. J Neurol Sci. 2001;191:3–9.

    Article  PubMed  CAS  Google Scholar 

  4. Kiernan MC, Vucic S, Cheah BC, Turner MR, Eisen A, Hardiman O, Burrell JR, Zoing MC. Amyotrophic lateral sclerosis. Lancet. 2011;377(9769):942–55.

    Article  PubMed  CAS  Google Scholar 

  5. Solazzo A, Del Vecchio L, Reginelli A, Monaco L, Sagnelli A, Monsorrò M, et al. Search for compensation postures with videofluoromanometric investigation in dysphagic patients affected by amyotrophic lateral sclerosis. Radiol Med. 2011;116:1083–94.

    Article  PubMed  CAS  Google Scholar 

  6. Goeleven A, Robberecht W, Sonies B, Carbonez A, Dejaeger E. Manofluorographic evaluation of swallowing in amyotrophic lateral sclerosis and its relationship with clinical evaluation of swallowing. Amyotrophic Lateral Sclerosis. 2006;7:241–6.

    Article  Google Scholar 

  7. Kawai S, Tsukuda M, Mochimatsu I, Enomoto H, Kagesato Y, Hirose H, Kuroiwa Y, Suzuki Y. A study of the early stage of dysphagia in amyotrophic lateral sclerosis. Dysphagia. 2003;18(1):1–8.

    Article  PubMed  Google Scholar 

  8. Tamburrini S, Solazzo A, Sagnelli A, Del Vecchio L, Reginelli A, Monsorrò M, Grassi R. Amyotrophic lateral sclerosis: sonographic evaluation of dysphagia. Radiol Med. 2010;115:784–93.

    Article  PubMed  CAS  Google Scholar 

  9. Kühnlein P, Gdynia HJ, Sperfeld AD, Lindner-Pfleghar B, Ludolph AC, Prosiegel M, Riecker A. Diagnosis and treatment of bulbar symptoms in amyotrophic lateral sclerosis. Nat Clin Pract Neurol. 2008;4:366–74.

    Article  PubMed  Google Scholar 

  10. Tomik J, Tomik B, Skladzien J, Gajec S, Strek P, Oles K, Gawlik J, Wiatr M. Analysis of oropharyngeal phase of swallowing in patients with amyotrophic lateral sclerosis. Przegl Lek. 2009;66:905–8.

    PubMed  Google Scholar 

  11. Higo R, Tayama N, Nito T. Longitudinal analysis of progression of dysphagia in amyotrophic lateral sclerosis. Auris Nasus Larynx. 2004;31:247–54.

    Article  PubMed  Google Scholar 

  12. Gates J, Hartnell GG, Gramigna GD. Videofluoroscopy and swallowing studies for neurologic disease: a primer. Radiographics. 2006;26:e22.

    Article  PubMed  Google Scholar 

  13. Rugiu MG. Role of videofluoroscopy in evaluation of neurologic dysphagia. Acta Otorhinolaryngol Ital. 2007;27:306–16.

    PubMed  CAS  PubMed Central  Google Scholar 

  14. Hillel AD, Miller R. Bulbar amyotrophic lateral sclerosis: patterns of progression and clinical management. Head Neck. 1989;11:51–9.

    Article  PubMed  CAS  Google Scholar 

  15. Ott DJ, Pikna LA. Clinical and videofluoroscopic evaluation of swallowing disorders. AJR Am J Roentgenol. 1993;161:507–13.

    Article  PubMed  CAS  Google Scholar 

  16. Solazzo A, Monaco L, Del Vecchio L, Tamburrini S, Iacobellis F, Berritto D, Pizza NL, Reginelli A, Di Martino N, Grassi R. Investigation of compensatory postures with videofluoromanometry in dysphagia patients. World J Gastroenterol. 2012;18:2973–8.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cappabianca S, Reginelli A, Monaco L, Del Vecchio L, Di Martino N, Grassi R. Combined videofluoroscopy and manometry in the diagnosis of oropharyngeal dysphagia: examination technique and preliminary experience. Radiol Med. 2008;113:923–40.

    Article  PubMed  CAS  Google Scholar 

  18. Mattioli S, Lugaresi M, Zannoli R, Brusori S, d’Ovidio F, Braccaioli L. Pharyngoesophageal manometry with an original balloon sensor probe for the study of oropharyngeal dysphagia. Dysphagia. 2003;18:242–8.

  19. McConnel FM, Cerenko D, Mendelsohn MS. Manofluorographic analysis of swallowing. Otolaryngol Clin North Am. 1988;21:625–35.

    PubMed  CAS  Google Scholar 

  20. McConnel FM, Cerenko D, Jackson RT, Guffin TN Jr. Timing of major events of pharyngeal swallowing. Arch Otolaryngol Head Neck Surg. 1988;114:1413–8.

    Article  PubMed  CAS  Google Scholar 

  21. Daggett A, Logemann I, Rademaker A, Pauloski B. Laryngeal penetration during deglutition in normal subjects of various ages. Dysphagia. 2006;21:270–4.

    Article  PubMed  Google Scholar 

  22. Robbins J. Swallowing in ALS and motor neuron disorders. Neurol Clin. 1987;5:213–29.

    PubMed  CAS  Google Scholar 

  23. Strand EA, Miller RM, Yorkston KM, Hillel AD. Management of oral pharyngeal dysphagia symptoms in amyotrophic lateral sclerosis. Dysphagia. 1996;11:129–39.

    Article  PubMed  CAS  Google Scholar 

  24. Briani C, Marcon M, Ermani M, Costantini M, Bottin R, Iurilli V, Zaninotto G, Primon D, Feltrin G, Angelini C. Radiological evidence of subclinical dysphagia in motor neuron disease. J Neurol. 1998;245(4):211–6.

    Article  PubMed  CAS  Google Scholar 

  25. Watts CR, Vanryckeghem M. Laryngeal dysfunction in Amyotrophic Lateral Sclerosis: a review and case report. BMC Ear Nose Throat Disord. 2001;1:1.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Barbiera F, Condello S, De Palo A, Todaro D, Mandracchia C, De Cicco D. Role of videofluorography swallow study in management of dysphagia in neurologically compromised patients. Radiol Med. 2006;111:818–27.

    Article  PubMed  CAS  Google Scholar 

  27. Lo Re G, Galia M, La Grutta L, Russo S, Runza G, Taibbi A, D’Agostino T, Lo Greco V, Bartolotta TV, Midiri M, Cardinale AE, De Maria M, Lagalla R. Digital cineradiographic study of swallowing in patients with amyotrophic lateral sclerosis. Radiol Med. 2007;112(8):1173–87.

Download references

Conflict of interest

All author’s state there is no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138, Naples, Italy

    Antonio Solazzo, Alfonso Reginelli, Francesca Iacobellis, Raffaella Capasso, Daniela Berritto & Roberto Grassi

  2. Department of General and Gastrointestinal Surgery, Second University of Naples, Piazza Miraglia 2, 80138, Naples, Italy

    Luigi Monaco & Natale Di Martino

  3. Department of Pathology of the Head and Neck, Oral Cavity and Audio-Verbal Communication, Second University of Naples, Piazza Miraglia 2, 80138, Naples, Italy

    Lucia Del Vecchio

  4. UOC Diagnostic Imaging, PO Pellegrini, Via Portamedina alla Pignasecca 41, 80134, Naples, Italy

    Stefania Tamburrini

  5. Division of Phoniatrics and Audiology, Second University of Naples, Naples, Italy

    Maria Rosaria Barillari

  6. II Department of Neurology, Second University of Naples, Piazza Miraglia 2, 80138, Naples, Italy

    Maria Rosaria Monsurrò

Authors
  1. Antonio Solazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Luigi Monaco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lucia Del Vecchio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alfonso Reginelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Francesca Iacobellis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Raffaella Capasso
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stefania Tamburrini
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Daniela Berritto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Maria Rosaria Barillari
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Maria Rosaria Monsurrò
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Natale Di Martino
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Roberto Grassi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Antonio Solazzo.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Solazzo, A., Monaco, L., Vecchio, L.D. et al. Earliest Videofluoromanometric Pharyngeal Signs of Dysphagia in ALS Patients. Dysphagia 29, 539–544 (2014). https://doi.org/10.1007/s00455-014-9542-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-014-9542-9

Keywords

Search

Navigation