Clinical measures associated with aspiration risk in multiple system atrophy: a cross-sectional study

Area of Science:

• Neurology
• Swallowing Disorders
• Clinical Diagnostics

Background:

• Aspiration risk is a critical concern in Multiple System Atrophy (MSA) management.
• Identifying reliable clinical markers for aspiration is essential for timely intervention.

Purpose of the Study:

• To investigate the association between basic clinical measures (Barthel Index, UMSARS, DaT imaging) and aspiration risk in MSA patients.
• To evaluate the discriminative ability of these measures in identifying aspiration.

Main Methods:

• Cross-sectional study of 105 MSA patients undergoing videofluoroscopic swallowing examination (VF) and DaT imaging.
• Clinical measures (BI, UMSARS) assessed within 3 months of VF.
• Multivariable modified Poisson regression and ROC analyses used to assess associations and discriminative ability.

Main Results:

• 26.7% of MSA patients exhibited aspiration on VF.
• Lower BI and higher UMSARS scores were significantly associated with aspiration.
• BI demonstrated moderate discriminative ability for aspiration (AUC 0.77), particularly in the parkinsonian MSA subtype.

Conclusions:

• The Barthel Index (BI) shows potential as a clinical marker for aspiration risk in MSA.
• BI may aid in guiding swallowing assessments, especially for the parkinsonian MSA subtype, even with subtle dysphagia.
• These findings can inform clinical decision-making for MSA patient care.