UMSARS Versus Laryngoscopy-Based Assessment of Dysphagia

Nadia El Fassi; Anne Pavy le Traon; Emmanuelle Mouchon; Olivier Rascol; Wassilios G Meissner; Alexandra Foubert-Saumier; Yohan Gallois; Samuel Tessier; Fabienne Ory-Magne; Virginie A Woisard; Margherita Fabbri

doi:10.1002/mdc3.13734

UMSARS Versus Laryngoscopy-Based Assessment of Dysphagia

Mov Disord Clin Pract. 2023 Apr 12;10(6):974-979. doi: 10.1002/mdc3.13734. eCollection 2023 Jun.

Authors

Affiliations

¹ Department of ENT Hospital of Larrey Toulouse France.
² French Reference Center for Multiple System Atrophy, Neurology Department Toulouse university hospital and Institute of Metabolic and Cardiovascular Diseases INSERM UMR 1297 Toulouse France.
³ Clinical Investigation Center CIC1436, Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Centre and NeuroToul Center of Excellence in Neurodegeneration (COEN) of Toulouse INSERM, University of Toulouse 3, CHU of Toulouse Toulouse France.
⁴ CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc Bordeaux France.
⁵ Univ. Bordeaux, CNRS, IMN, UMR 5293 Bordeaux France.
⁶ Dept. Medicine University of Otago, Christchurch, and New Zealand Brain Research Institute Christchurch New Zealand.
⁷ Service de Pharmacologie Médicale et Clinique, Centre de Pharmacovigilance, Faculté de Médecine, de Pharmacoépidémiologie et d'Informations Sur Le Médicament CIC INSERM 1436, Centre Hospitalier Universitaire Toulouse France.
⁸ Department of Neurology University Hospital of Toulouse Toulouse France.

Abstract

Background: Multiple System Atrophy (MSA) dysphagia is routinely assessed by the Unified Multiple System Atrophy Rating Scale (UMSARS) part I-item 2.

Objective: To compare the UMSARS part I-item 2 with an ear/nose/throat (ENT) expert physician assessment.

Methods: We retrospectively analyzed the data of MSA patients who underwent an ENT assessment (nasofibroscopic and radioscopic exam) and an annual UMSARS assessment. Deglutition Handicap Index (DHI) and pulmonary/nutrition complications were collected.

Results: Seventy-five MSA patients were included. The ENT assessment revealed more severe dysphagia compared to the UMSARS part I-item 2 score (P = 0.003). A higher proportion of patients with impaired protective mechanisms showed severe UMSARS-based dysphagia (P = 0.005). Patients with choking and oral/pharyngeal transit defects and nutritional complications were equally distributed across UMSARS part I-item 2 scores. Worse UMSARS part I-item 2 scores had worse DHI scores.

Conclusions: The UMSARS-based assessment of dysphagia does not capture key aspects of pharyngo-laryngeal dysfunction reflecting swallowing efficiency.

Keywords: UMSARS; dysphagia; ear nose and throat assessment; multiple system atrophy.