{Reference Type}: Journal Article
{Title}: Association of dysphagia severity in multiple system atrophy with the specific binding ratio on dopamine transporter SPECT.
{Author}: Wada T;Sugaya K;Asano Y;Nakata Y;Naito R;Kawazoe T;Saitoh Y;Bokuda K;Tobisawa S;Shimizu T;Takahashi K;
{Journal}: J Neurol Sci
{Volume}: 463
{Issue}: 0
{Year}: 2024 Jun 27
{Factor}: 4.553
{DOI}: 10.1016/j.jns.2024.123116
{Abstract}: <B>OBJECTIVE: </B>Dysphagia in multiple system atrophy (MSA) is life-threatening and is caused by parkinsonism with cerebellar ataxia as a contributing factor. The present study investigated the relationship between dysphagia severity in MSA and the specific binding ratio (SBR) on dopamine transporter (DaT) SPECT using the Hyodo score, a qualitative scale for use with fiberoptic endoscopic evaluation of swallowing (FEES).<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.