title: Scintigraphic Evaluation of Mild to Moderate Dysphagia in Motor Neuron Disease.
abstract: OBJECTIVE
  Approximately 30% of patients with motor neuron disease (MND) present swallowing difficulties even in early disease stages. The aim of this study was to examine the usefulness of esophageal scintigraphy in detecting early stage of dysphagia in MND.
  
  
  METHODS
  Esophageal scintigraphy (ES) including mean transit time (MTT) estimation was performed in 121 MND patients presenting various levels of upper (UMN) and lower motor neuron (LMN) degeneration.
  
  
  RESULTS
  ES detected dysphagia in more than 80% of MND patients who had referenced swallowing difficulties. In MND patients with ES-confirmed dysphagia, the MTT was increased approximately 2-fold without significant differences between the clinical phenotypes. The MTT was significantly longer in patients with bulbar-pseudobulbar syndrome in comparison to patients with isolated pseudobulbar syndrome, which indicates a higher involvement of the LMN deficiency in developing dysphagia in MND. The esophageal passage in MND was not dependent on age, sex, disease duration, or diagnosis delay. Interestingly, ES was also able to detect dysphagia in almost 70% of MND individuals who had no swallowing complaints (subclinical dysphagia). A more benign disease course and a higher percentage of male patients characterized this group.
  
  
  CONCLUSIONS
  Esophageal scintigraphy is a helpful screening tool in determining early swallowing impairment in a high percent of patients with MND of various clinical phenotypes.
authors.affiliation: From the Departments of *Neurology, and †Nuclear Medicine, Medical University of Warsaw; and ‡Neurodegenerative Diseases Research Group, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Szacka
authors.forename: Anna
authors.initials: A
authors.lastname: Potulska-Chromik
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Fronczewska-Wieniawska
authors.forename: Andrzej
authors.initials: A
authors.lastname: Spychała
authors.forename: Leszek
authors.initials: L
authors.lastname: Kròlicki
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kuźma-Kozakiewicz
mesh_terms: D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m