Dysphagia in multiple sclerosis: pathophysiology, assessment, and management-an overview

Area of Science:

• Neurology
• Gastroenterology
• Speech-Language Pathology

Background:

• Dysphagia is a common and severe complication in multiple sclerosis (MS), affecting patients across all disease stages.
• Prevalence increases with age, disease duration, and progressive MS phenotypes.
• Pathophysiology involves damage to corticobulbar tracts, cerebellum, and brainstem.

Purpose of the Study:

• To provide an overview of the pathophysiology, assessment, and management of dysphagia in MS.
• To examine the potential role of novel therapeutic strategies, including neuromodulation.
• To highlight the challenges in treating MS-related swallowing disorders.

Main Methods:

• Review of existing literature on MS dysphagia.
• Discussion of diagnostic techniques, including imaging and neurophysiological methods.
• Exploration of current and emerging therapeutic approaches.

Main Results:

• Dysphagia significantly impacts quality of life and can lead to severe complications in MS.
• Rehabilitation is the primary treatment for MS dysphagia.
• Innovative neuromodulation techniques like PES, rTMS, and tDCS show promise but require further investigation for MS.

Conclusions:

• Accurate diagnosis and timely management of dysphagia are essential for improving outcomes in MS patients.
• While rehabilitation is key, novel strategies like neuromodulation may offer supplementary benefits.
• Further research is needed to establish the efficacy of neuromodulation for MS dysphagia.