title: Earliest videofluoromanometric pharyngeal signs of dysphagia in ALS patients.
abstract: The aim of this study was to find whether there are manometric pharyngeal changes that may have diagnostic and prognostic relevance in the amyotrophic lateral sclerosis (ALS) patient who does not show changes in contrast-medium oropharyngeal transit in a videofluoroscopic swallowing study. Ten ALS patients, with an ALS Severity Scale Score of at least 7, no need to change dietary habit, no aspiration and/or penetration, and no other changes in contrast-medium oropharyngeal transit, were collected from our institution's database of videofluoromanometric swallowing studies. They were included in the study together with a group of 11 healthy volunteers. For each subject, 12 manometric items-7 for the pharyngeal phase and 5 for UES functionality-were evaluated. Statistically significant differences between the ALS patients and the healthy volunteers were found for pharyngeal contraction time of the upper region (median = 1,120, range = 880-1,420 vs. median = 970, range = 800-1,140), pharyngeal contraction time of the intermediate region (median = 1140, range = 960-1,360 vs. median = 770, range = 280-1,180), pharyngeal contraction time of the lower region (median = 1,320, range = 920-1,760 vs. median = 800, range = 620-1,780), and residual pressure after the relaxation of the UES (median = 2.2, range = -20.2 to 27.8 vs. median = -5.7, range = -2.9 to 8.4). A videofluoromanometric swallowing study may show an increase in the pharyngeal contraction time and in residual pressure after relaxation of the UES in ALS patients without videofluoroscopic changes in contrast-medium oropharyngeal transit.
authors.affiliation: Department of Radiology, Second University of Naples, Piazza Miraglia 2, 80138, Naples, Italy, antoniosolazzo@hotmail.it.
authors.forename: Antonio
authors.initials: A
authors.lastname: Solazzo
authors.forename: Luigi
authors.initials: L
authors.lastname: Monaco
authors.forename: Lucia Del
authors.initials: LD
authors.lastname: Vecchio
authors.forename: Alfonso
authors.initials: A
authors.lastname: Reginelli
authors.forename: Francesca
authors.initials: F
authors.lastname: Iacobellis
authors.forename: Raffaella
authors.initials: R
authors.lastname: Capasso
authors.forename: Stefania
authors.initials: S
authors.lastname: Tamburrini
authors.forename: Daniela
authors.initials: D
authors.lastname: Berritto
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Barillari
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Monsurrò
authors.forename: Natale
authors.initials: N
authors.lastname: Di Martino
authors.forename: Roberto
authors.initials: R
authors.lastname: Grassi
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001466:Barium Sulfate / Q000008:administration & dosage; D002933:Cineradiography / Q000379:methods; D003287:Contrast Media / Q000008:administration & dosage; D003679:Deglutition / Q000502:physiology; D003680:Deglutition Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004435:Eating / Q000502:physiology; D049631:Esophageal Sphincter, Upper / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008365:Manometry / Q000295:instrumentation / Q000379:methods; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D010609:Pharyngeal Muscles / Q000000981:diagnostic imaging / Q000503:physiopathology; D010614:Pharynx / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013997:Time Factors; D014160:Transducers, Pressure
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate