Screening for dysphagia in patients with relapsing-remitting multiple sclerosis

Area of Science:

• Neurology
• Clinical Medicine
• Rehabilitation

Background:

• Dysphagia is a common, often underdiagnosed symptom in multiple sclerosis (MS).
• It significantly impacts quality of life and can lead to severe complications like malnutrition and aspiration pneumonia.
• Early detection of dysphagia is essential for timely intervention and risk mitigation.

Purpose of the Study:

• To compare the diagnostic performance of a simple swallowing question, the DYsphagia in MUltiple Sclerosis (DYMUS) questionnaire, and the Timed Water Swallowing Test (TWST).
• To evaluate the effectiveness of these screening methods in detecting dysphagia in people with relapsing-remitting MS (RRMS).

Main Methods:

• Patients with RRMS were screened using a simple swallowing question, the DYMUS questionnaire, and the TWST.
• Individuals with positive screening results were offered objective assessment via Fiberoptic Endoscopic Evaluation of Swallowing (FEES).
• Statistical analysis correlated screening results with demographic and MS-related parameters.

Main Results:

• 15.1% reported subjective swallowing difficulty; DYMUS was positive in 19.4%, and TWST in 16.8%.
• A combination of DYMUS and TWST identified more patients with dysphagia than a simple question.
• FEES confirmed dysphagia in 94.6% of positively screened patients, indicating high specificity.

Conclusions:

• The DYMUS questionnaire and TWST are more sensitive for detecting dysphagia in MS patients than a simple question.
• Combining DYMUS and TWST enhances sensitivity for identifying at-risk individuals.
• Age, female gender, and higher Expanded Disability Status Scale (EDSS) scores are potential risk factors for dysphagia in MS.