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Communication Sciences and Disorders


Taeok Park

Mentor Department

Communication Sciences and Disorders


Multiple System Atrophy (MSA) can be defined as a sporadic neurodegenerative disorder. Muscular weakness is a major clinical feature of myotonic dystrophy. Bradykinesia and rigidity affect the motor function of the tongue which can cause dysphagia. Oral-related symptoms such as drooling, sensory changes in the oral cavity, difficulty in chewing, and dry mouth are characteristics of MSA. Also, delayed pharyngeal swallow, penetration, and aspiration can also be symptoms of this disorder.

The purpose of this longitudinal study was to determine temporal characteristics changes of swallowing in a patient with MSA in order to better understand how the swallowing mechanism is directly affected from this neurogenic disease. The participant included a 60-year-old male who was diagnosed with MSA in 2009. Over the course of six evaluations, 1/21/2013-6/16/2014, a videofluoroscopic swallow examination (VFSE) procedure was performed for 5 different boluses. The types of bolus and volumes included 2mL thin liquid, 5mL thin liquid, thick liquid, puree, and pudding.

To measure temporal characteristics, each swallow was analyzed for the following points: onset of posterior movement of bolus, bolus head passing the ramus of mandible, initial opening of UES, tail of bolus passing the UES, initiation of maximal excursion of hyoid, first contact of arytenoid and epiglottis, and the final contact of arytenoids and epiglottis. The temporal measurements included Oral Transit Time (OTT), Pharyngeal Transit Time (PTT), Duration of UES Opening (DUESO), Stage Transition Duration (STD), Initiation of Laryngeal Closure (ILC), and Laryngeal Closure Duration (LCD). The average time in seconds per each kind of bolus were compared to normative data.

Overall the temporal characteristics of the swallow were different in comparison with the normative data. Evaluations showed prolonged bolus transition in the oral and pharyngeal stage across all consistencies due to rigid and stiff musculature of the oral and pharyngeal structures and also delayed initiation of laryngeal closure (ILC) which is related to risk of aspiration. Utilizing these measurements helped to determine how MSA was affecting the swallowing mechanisms individually. Since MSA is a progressive disease there must be follow-up evaluations to look at long-term proponents. Dysphagia management will help maintain function of swallow.

Temporal Characteristics of Oropharnygeal Swallowing in Multiple System Atrophy: A Longitudinal Study

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