Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-11T05:34:04.060Z Has data issue: false hasContentIssue false
  • English
  • Français

Dysphagia characteristics in Huntington’s disease patients: insights from the Fiberoptic Endoscopic Evaluation of Swallowing and the Swallowing Disturbances Questionnaire

Published online by Cambridge University Press:  10 September 2018

Yael Manor Open the ORCID record for Yael Manor [Opens in a new window] ,
Yael Oestreicher-Kedem ,
Alona Gad ,
Jennifer Zitser ,
Achinoam Faust-Socher ,
Dina Shpunt ,
Stav Naor ,
Noit Inbar ,
Meir Kestenbaum  and
Nir Giladi
...Show all authors
Yael Manor*
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Communication Sciences Disorders Department, School of Health Professions, Ono Academic College, Kiryat Ono, Israel
Yael Oestreicher-Kedem
Affiliation:
Voice and Swallowing Disorders Clinic, Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Alona Gad
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Jennifer Zitser
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Achinoam Faust-Socher
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Dina Shpunt
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Stav Naor
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Noit Inbar
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Meir Kestenbaum
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Nir Giladi
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Tanya Gurevich
Affiliation:
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
*
*Address for correspondence: Yael Manor, PhD, Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel Aviv 6423906, Israel. (Email: yaelm@tlvmc.gov.il)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Huntington’s disease (HD) is a neurodegenerative disease characterized by increasing dysphagia as the disease progresses. Specific characteristics of the HD dysphagia are not well defined.

Objective

To characterize the swallowing disturbances of HD patients, to evaluate the feasibility of Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in assessing dysphagia in HD patients, and to discern the relation between FEES findings and patients’ self-report on dysphagia symptoms and swallowing related quality of life (SWAL-QOL).

Method

A retrospective case series in a tertiary referral center. All recruited HD patients underwent Bed Side Swallowing Evaluation (BSE), FEES, the Unified Huntington’s Disease Rating Scale (UHDRS), and the Montreal Cognitive Assessment (MoCA). All completed the Swallowing Disturbances Questionnaire (SDQ) and the SWAL-QOL questionnaire.

Results

Fourteen HD patients were recruited. All were able to complete the FEES study. The FEES demonstrated delayed swallowing reflex, solid food residues, and pre/post swallowing spillage in most patients (50%, 53.5%, 83.3%, and 87.5%, respectively). The mean SDQ score was 13.2. Significant correlations were found between the SWAL-QOL fear of eating score; the SDQ oral, pharyngeal, and total scores; and the FEES parameters of pureed and solid food bolus flow time. Significant correlations were also found between the total UHDRS score, the volitional cough score, and the SWAL-QOL disease burden score.

Conclusion

HD patients exhibit prominent unique oropharyngeal dysphagia features that may serve as a marker of disease progression. The FEES and the SDQ are valuable tools for detecting these features in HD patients with swallowing disturbance.

Keywords

DysphagiaFiberoptic Endoscopic evaluation of Swallowing (FEES)Huntington’s diseasequality of life
Type
Original Research
Information
CNS Spectrums , Volume 24 , Issue 4 , August 2019 , pp. 413 - 418
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

†

This author contributed equally to this article.

References

Ross, CA, Tabrizi, SJ. Huntington’s disease: from molecular pathogenesis to clinical treatment. Lancet Neurol. 2011; 10(1): 83–98.CrossRefGoogle ScholarPubMed
Heemskerk, A, Roos, RA. Dysphagia in Huntington’s disease: a review. Dysphagia. 2011; 26(1): 62–66.CrossRefGoogle ScholarPubMed
de Tommaso, M, Nuzzi, A, Dellomonaco, AR, et al. Dysphagia in Huntington’s disease: correlation with clinical features. Eur Neurol. 2015; 74(1–2): 49–53.CrossRefGoogle ScholarPubMed
McHorney, CA, Robbins, J, Lomax, K, et al. The SWAL-QOL and SWAL-CARE outcomes tool for oropharyngeal dysphagia in adults: III. Documentation of reliability and validity. Dysphagia. 2002; 17(2): 97–114.CrossRefGoogle ScholarPubMed
Manor, Y, Mootanah, R, Freud, D, Giladi, N, Cohen, JT. Video-assisted swallowing therapy for patients with Parkinson’s disease. Parkinsonism Relat Disord. 2013; 19(2): 207–211.CrossRefGoogle ScholarPubMed
Manor, Y, Giladi, N, Cohen, A, Fliss, DM, Cohen, JT. Validation of a swallowing disturbance questionnaire for detecting dysphagia in patients with Parkinson’s disease. Mov Disord. 2007; 22(13): 1917–1921.CrossRefGoogle ScholarPubMed
Fletcher, SG. Time-by-count measurement of diadochokinetic syllable rate. J Speech Hear Res. 1972; 15(4): 763–770.CrossRefGoogle ScholarPubMed
Kremer, HPH. Huntington Unified Huntington's Disease Rating Scale: reliability and consistency. Huntington Study Group Movement Disorders. 1996; 11(2): 136–142.Google Scholar
Nasreddine, Z. MoCA Version August 18, 2010. www.mocatest.org.Google Scholar
Icht, M, Ben-David, BM. Oral-diadochokinesis rates across languages: English and Hebrew norms. J Commun Disord. 2014; 48: 27–37.CrossRefGoogle ScholarPubMed
Wallerstein, SL. Scaling clinical pain and pain relief. In: Bromm B, ed. Pain Measurement in Man: Neurophysiological Correlates of Pain. New York: Elsevier; 1984.Google Scholar
Kagel, MC, Leopold, NA. Dysphagia in Huntington’s disease: a 16-year retrospective. Dysphagia. 1992; 7(2): 106–114.CrossRefGoogle ScholarPubMed
Lee, TH, Lee, JS, Kim, WJ. High resolution impedance manometric findings in dysphagia of Huntington’s disease. World J Gastroentrol. 2012; 18(14): 1695–1699.CrossRefGoogle ScholarPubMed
Atkinson, M, McHanwell, S. Basic Medical Science for Speech & Language Therapy Students. London: Whurr Publishers; 2002.Google Scholar
Van Lieshout, PH, Steele, CM, Lang, AE. Tongue control for swallowing in Parkinson’s disease: effects of age, rate, and stimulus consistency. Mov Disord. 2011; 26(9): 1725–1729.CrossRefGoogle ScholarPubMed
Alves, TC, Cola, PC, Santos, RR, Motonaga, SM, Silva, RG. Swallowing endoscopy findings in Huntington’s disease: a case report. CoDAS. 2016; 28(4): 486–488.CrossRefGoogle ScholarPubMed
Hamakawa, S, Koda, C, Umeno, H, et al. Oropharyngeal dysphagia in a case of Huntiongton’s disease. Auris Nasus Larynx. 2004; 31(2): 171–176.CrossRefGoogle Scholar
Langmore, S. Endoscopic Evaluation and Treatment of Swallowing Disorders. New York: Thieme; 2001.Google Scholar
Leder, SB, Cohn, SM, Moller, BA. Fiberoptic endoscopic documentation of the high incidence of aspiration following extubation in critically ill trauma patients. Dysphagia. 1998; 13(4): 208–212.CrossRefGoogle ScholarPubMed
Wu, C, Ko, J, Hsiao, T, Hsu, M. Dysphagia after radiotherapy: endoscopic examination of swallowing in patients with nasopharyngeal carcinoma. Ann Otol Rhinol Laryngol. 2000; 109(3): 320–325.CrossRefGoogle ScholarPubMed
Hartley, BE, Harnick, CJ, Miller, C, Willging, JP. Pediatric fiberoptic endoscopic evaluation of swallowing. Ann Otol Rhinol Laryngol. 2000; 109(11): 996–999.Google Scholar
Stringer, S. Managing dysphagia in palliative care. Prof Nurse. 1999; 14(7): 489–492.Google ScholarPubMed
Rosenblatt, A, Ranen, N, Nance, M, Paulsen, J. A Physician’s Guide to the Management of Huntington’s Disease. 2nd ed. New York: HDSA; 1999.Google Scholar
Aziz, NA, van der Marck, MA, Pijl, H, et al. Weight loss in neurodegenerative disorders. J Neurol. 2008; 255(12): 1872–1880.CrossRefGoogle ScholarPubMed
Van Liew, C, Gluhm, S, Goldstein, J, Cronan, TA, Corey-Bloom, J. The functional implications of motor, cognitive, psychiatric, and social problem-solving states in Huntington’s disease. Psychiatry. 2013; 76(4): 323–335.CrossRefGoogle ScholarPubMed
Saldert, C, Fors, A, Ströberg, S, Hartelius, L. Comprehension of complex discourse in different stages of Huntington’s disease. Int J Lang Commun Disord. 2010; 45(6): 656–669.CrossRefGoogle ScholarPubMed
Baker, M, Blumlein, D. Huntington’s disease part I: what is it? British Journal of Healthcare Assistants. 2009; 3(5): 223–227.CrossRefGoogle Scholar