UMSARS Versus Laryngoscopy‐Based Assessment of Dysphagia

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.

Swallowing Characteristics in Patients with Multiple System Atrophy Analyzed Using FEES Examination

“…The GD-UMSARS Item 2 of Part 1 has not been used as it focuses on swallowing impairment, while the FOIS focuses on functional oral intake. In addition, according to the results of El Fassi et al [ 26 ] the UMSARS-based assessment of dysphagia alone seems not to completely capture the key aspects of pharyngo-laryngeal dysfunction reflecting swallowing efficiency.…”