Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy
ObjectiveTo evaluate the swallowing function in the advanced stages of progressive supranuclear palsy (PSP) and clarify the factors that lead to adjustment of food consistency and discontinuation of oral intake.MethodsA total of 56 patients with PSP were recruited. Based on medical records, informat...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-09-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1259327/full |
| _version_ | 1797687160498814976 |
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| author | Yuki Iwashita George Umemoto George Umemoto Shinsuke Fujioka Hajime Arahata Yuriko Dotsu Asami Oike Yoshio Tsuboi |
| author_facet | Yuki Iwashita George Umemoto George Umemoto Shinsuke Fujioka Hajime Arahata Yuriko Dotsu Asami Oike Yoshio Tsuboi |
| author_sort | Yuki Iwashita |
| collection | DOAJ |
| description | ObjectiveTo evaluate the swallowing function in the advanced stages of progressive supranuclear palsy (PSP) and clarify the factors that lead to adjustment of food consistency and discontinuation of oral intake.MethodsA total of 56 patients with PSP were recruited. Based on medical records, information about the basic attributes, clinical features (including axial rigidity and dementia), food intake, the results of a videofluoroscopic swallowing study (VFSS), and the timing of nasogastric tube transition and gastrostomy were extracted. From the VFSS images, the presence or absence of aspiration and retrocollis were assessed.ResultsThe average age at the onset, diagnosis, and the final follow-up examination were 67.6 ± 6.4 years, 71.6 ± 5.8 years, and 75.4 ± 5.6 years, respectively. The average duration of illness was 64.6 ± 42.8 months. Twenty-four individuals (42.9%) were continuing oral intake, while 32 were tube-fed, among whom 16 (50.0%) underwent gastrostomy tube placement. There were significant differences in the duration from the disease onset to tube feeding between the patients with and without cognitive decline at the time of the diagnosis (p < 0.01) and in the duration from the initial VFSS to tube feeding between the patients with and without aspiration on the initial VFSS (p < 0.01). There were significant differences in the duration from the diagnosis to tube feeding and from the initial VFSS to tube feeding between patients with and without axial rigidity at the time of the diagnosis (p < 0.05 and p < 0.05, respectively). Additionally, there was a significant association between axial rigidity and retrocollis (p < 0.01).ConclusionCognitive decline, axial rigidity and retrocollis, which are associated with the deterioration of dysphagia in PSP, are the highest risk factors for the discontinuation of oral intake. The early identification of these factors associated with the progression of dysphagia can contribute to the improvement of patient care and management. |
| first_indexed | 2024-03-12T01:14:17Z |
| format | Article |
| id | doaj.art-fd6e2c15139a40269d3d95cf7c28778d |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T01:14:17Z |
| publishDate | 2023-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-fd6e2c15139a40269d3d95cf7c28778d2023-09-13T19:44:14ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-09-011410.3389/fneur.2023.12593271259327Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsyYuki Iwashita0George Umemoto1George Umemoto2Shinsuke Fujioka3Hajime Arahata4Yuriko Dotsu5Asami Oike6Yoshio Tsuboi7Swallowing Disorders Center, Fukuoka University Hospital, Fukuoka, JapanSwallowing Disorders Center, Fukuoka University Hospital, Fukuoka, JapanDepartment of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, JapanDepartment of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanDepartment of Neurology, Neuro-Muscular Center, NHO Omuta National Hospital, Fukuoka, JapanSwallowing Disorders Center, Fukuoka University Hospital, Fukuoka, JapanSwallowing Disorders Center, Fukuoka University Hospital, Fukuoka, JapanDepartment of Neurology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanObjectiveTo evaluate the swallowing function in the advanced stages of progressive supranuclear palsy (PSP) and clarify the factors that lead to adjustment of food consistency and discontinuation of oral intake.MethodsA total of 56 patients with PSP were recruited. Based on medical records, information about the basic attributes, clinical features (including axial rigidity and dementia), food intake, the results of a videofluoroscopic swallowing study (VFSS), and the timing of nasogastric tube transition and gastrostomy were extracted. From the VFSS images, the presence or absence of aspiration and retrocollis were assessed.ResultsThe average age at the onset, diagnosis, and the final follow-up examination were 67.6 ± 6.4 years, 71.6 ± 5.8 years, and 75.4 ± 5.6 years, respectively. The average duration of illness was 64.6 ± 42.8 months. Twenty-four individuals (42.9%) were continuing oral intake, while 32 were tube-fed, among whom 16 (50.0%) underwent gastrostomy tube placement. There were significant differences in the duration from the disease onset to tube feeding between the patients with and without cognitive decline at the time of the diagnosis (p < 0.01) and in the duration from the initial VFSS to tube feeding between the patients with and without aspiration on the initial VFSS (p < 0.01). There were significant differences in the duration from the diagnosis to tube feeding and from the initial VFSS to tube feeding between patients with and without axial rigidity at the time of the diagnosis (p < 0.05 and p < 0.05, respectively). Additionally, there was a significant association between axial rigidity and retrocollis (p < 0.01).ConclusionCognitive decline, axial rigidity and retrocollis, which are associated with the deterioration of dysphagia in PSP, are the highest risk factors for the discontinuation of oral intake. The early identification of these factors associated with the progression of dysphagia can contribute to the improvement of patient care and management.https://www.frontiersin.org/articles/10.3389/fneur.2023.1259327/fullprogressive supranuclear palsydysphagiaaxial rigidityretrocolliscognitive decline |
| spellingShingle | Yuki Iwashita George Umemoto George Umemoto Shinsuke Fujioka Hajime Arahata Yuriko Dotsu Asami Oike Yoshio Tsuboi Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy Frontiers in Neurology progressive supranuclear palsy dysphagia axial rigidity retrocollis cognitive decline |
| title | Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy |
| title_full | Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy |
| title_fullStr | Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy |
| title_full_unstemmed | Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy |
| title_short | Factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy |
| title_sort | factors that impact dysphagia and discontinuance of oral intake in patients with progressive supranuclear palsy |
| topic | progressive supranuclear palsy dysphagia axial rigidity retrocollis cognitive decline |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1259327/full |
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