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.
方法:首先测试了Hyodo评分在对88例MSA患者进行FEES检查时预测误吸的能力。然后是临床特征,Hyodo评分,比较了同时接受FEES和DaTSPECT检查的显性帕金森病(MSA-P;n=11)或小脑共济失调(MSA-C;n=25)患者的SBR。
结果:Logistic回归表明,Hyodo评分是误吸的重要预测因素(p=0.003)。MSA-P组的Hyodo评分(p=0.026)和SBR(p=0.011)明显高于MSA-C组,而在FEES检查中,两组均未表现出疾病持续时间的显着差异。线性回归表明,在MSA-P(p=0.044;r=-0.616)和MSA-C(p=0.044;r=-0.406)组中,Hyodo评分与SBR之间呈负相关。当通过协方差分析去除SBR的影响时,两组间Hyodo评分无显著差异.
结论:我们的结果表明,黑质纹状体多巴胺能神经元的突触前变化与MSA吞咽困难严重程度之间存在关联,这在很大程度上导致了MSA-P和MSA-C之间吞咽困难严重程度的差异。