Laryngopharyngeal dysmotility in multiple sclerosis

Area of Science:

• Neurology
• Gastroenterology
• Speech-Language Pathology

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Dysphagia (difficulty swallowing) is a common and often underdiagnosed symptom in MS patients.
• Impaired swallowing in MS can lead to malnutrition, dehydration, and aspiration pneumonia.

Purpose of the Study:

• To investigate the swallowing physiology in patients with multiple sclerosis (MS).
• To identify the specific patterns and severity of dysphagia in MS patients.
• To explore the relationship between swallowing dysfunction and neurological impairment in MS.

Main Methods:

• Videofluoroscopic swallowing studies (VFSS) were conducted on 13 MS patients with self-reported swallowing difficulties.
• Liquid and paste bolus swallows were analyzed for kinematic and temporal parameters.
• Swallowing data were compared with published normative values.

Main Results:

• All 13 MS patients exhibited disordered swallowing physiology, ranging from mild to severe.
• Pharyngeal dysphagia was primary in 11 patients, laryngeal in 1, and oral in 1.
• Laryngeal dysmotility and pharyngeal constrictor dysmotility were prevalent, with significant correlations between swallowing impairment severity and posterior pharyngeal dysfunction.
• Supraglottic penetration occurred in 9 patients, with 1 aspirating, linked to brainstem dysfunction.

Conclusions:

• Swallowing dysfunction is a significant issue in MS, characterized by laryngeal and pharyngeal motor impairments.
• Neuromotor sequencing deficits and progressive pharyngeal muscle weakening contribute to dysphagia in MS.
• While dysphagia is common, its severity did not correlate with overall neurological disability scores (EDSS or FS) in this cohort.