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Published on: December 1, 2023
Lingual pressure as a physiological indicator for dysphagia in amyotrophic lateral sclerosis and multiple system
Jin Magara1,2, Taku Suzuki2, Midori Yoshihara2
1Unit of Dysphagia Rehabilitation, Niigata University Medical & Dental Hospital, Niigata, Japan.
Background:
This study aimed to characterize lingual pressure (LP) and clarify its association with dysphagia in patients with amyotrophic lateral sclerosis (ALS) and multiple system atrophy (MSA).
Methods:
We examined 52 patients with ALS (Spinal-onset, 39; bulbar-onset, 13) and 36 patients with MSA (MSA-C, 26; MSA-P, 10). LP was measured using a balloon-type instrument during isometric contractions. Maximum LP (MLP) and 80% endurance of LP (ELP; duration above 80% of MLP during 7 seconds) were analyzed against videofluoroscopic findings of dysphagia.
Results:
Both parameters significantly correlated with food intake scales, especially in ALS. Liquid aspiration was predicted in ALS with 80.8% accuracy (AUC = 0.794, p < 0.001) using MLP cutoff of 20.5 kPa, and in MSA with 75.0% accuracy (AUC = 0.786, p < 0.01) using an ELP cutoff of 1.68 second. Predictive accuracy improved in spinal-onset ALS and MSA-C.
Conclusion:
LP thus may represent a physiological indicator for dysphagia detection and management.
