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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
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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)
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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 

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Footnotes

†

This author contributed equally to this article.

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