Association of dysphagia severity in multiple system atrophy with the specific binding ratio on dopamine transporter SPECT.

Autor: Wada T; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan. Electronic address: Takahide_wada@outlook.jp., Sugaya K; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Asano Y; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Nakata Y; Department of Neuroradiology, TMNH, Tokyo, Japan., Naito R; Department of Neuro-otology, TMNH, Tokyo, Japan., Kawazoe T; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Saitoh Y; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Bokuda K; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Tobisawa S; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Shimizu T; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan., Takahashi K; Department of Neurology, Tokyo Metropolitan Neurological Hospital (TMNH), Tokyo, Japan.
Jazyk: angličtina
Zdroj: Journal of the neurological sciences [J Neurol Sci] 2024 Aug 15; Vol. 463, pp. 123116. Date of Electronic Publication: 2024 Jun 27.
DOI: 10.1016/j.jns.2024.123116
Abstrakt: Objective: Dysphagia in multiple system atrophy (MSA) is life-threatening and is caused by parkinsonism with cerebellar ataxia as a contributing factor. The present study investigated the relationship between dysphagia severity in MSA and the specific binding ratio (SBR) on dopamine transporter (DaT) SPECT using the Hyodo score, a qualitative scale for use with fiberoptic endoscopic evaluation of swallowing (FEES).
Methods: Hyodo score's ability to predict aspiration during a FEES examination of 88 patients with MSA was first tested. Then the clinical characteristics, Hyodo score, and SBR of patients with either predominant parkinsonism (MSA-P; n = 11) or cerebellar ataxia (MSA-C; n = 25) who underwent FEES and DaT SPECT simultaneously were compared.
Results: Logistic regression demonstrated that the Hyodo score was a significant predictive factor of aspiration (p = 0.003). The MSA-P group had a significantly higher Hyodo score (p = 0.026) and lower SBR (p = 0.011) than the MSA-C group while neither group demonstrated any significant difference in disease duration at the FEES examination. Linear regression demonstrated a significant, inverse correlation between the Hyodo score and SBR in the MSA-P (p = 0.044; r = -0.616) and MSA-C (p = 0.044; r = -0.406) groups. When the effect of SBR was removed by analysis of covariance, no significant difference in the Hyodo score remained between the groups.
Conclusions: Our results suggested an association between presynaptic changes in nigrostriatal dopaminergic neurons and dysphagia severity in MSA which largely contributes to the difference in dysphagia severity between MSA-P and MSA-C.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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