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Esophageal dysphagia in neuromuscular disorder patients with validity and reliability study of the brief esophageal dysphagia questionnaire

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Abstract

Esophageal dysphagia (ED) is often underestimated in neuromuscular disorders (NMD) and it is important to evaluate the esophageal phase of swallowing with an easy and rapid screening test. We aimed both to assess the prevalence of ED in NMD and to perform validity and reliability study of the brief easophageal dysphagia questionnaire (BEDQ) screening test in NMD patients. This prospective cross-sectional clinical study was performed on NMD patients. Demographic features and disease characteristics were recorded. Endoscopic evaluation for oropharyngeal dysphagia (OD) and high-resolution esophageal manometry for ED were performed. In addition, the BEDQ and the 10-item eating assessment tool (EAT-10) were used to all subjects. Cronbach’s α and principle components factor analysis (PFCA) with varimax rotation were used for reliability. The Chicago Classification version 3 (CCv3) level (high-resolution esophageal manometry) and EAT-10 was used for validity. A total of 50 patients were included in the study. Thirty-four (68%) patients were diagnosed with myasthenia gravis and 16 (32%) patients were diagnosed with myopathy. Esophageal dysphagia according to the CCv3 was found in 33 (66%) of patients. While the Cronbach’s α was excellent as 0.937 for test overall the T-BEDQ scale. The PCFA included all scale items and resulted in a single factor (eigenvalue = 5.72, 71.5%). The all BEDQ scores were demonstrated good correlation with EAT-10 score and very good correlation with CCv3 level. Evaluation of swallowing in patients with NMD should include not only the oropharyngeal phase of swallowing, but also esophageal phase. For this purpose, the BEDQ can be used as a rapid, valid, and reliable test for the evaluation of ED.

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Abbreviations

ALS:

Amyotrophic lateral sclerosis

BEDQ:

Brief easophageal dysphagia questionnaire

CCv3:

Chicago Classification version 3. Classification tool of esophageal function disorders by high-resolution esophageal manometry

DSQ:

Dysphagia symptom questionnaire

EAT-10:

10-item eating assessment tool. Oropharyngoesophageal dysphagia risk evaluation scale

ED:

Esophageal dysphagia. Disorder of the bolus moves towards the stomach by lack or ineffective peristaltism

EESAI:

Eosinophilic esophagitis symptom activity index

ESQ:

Esophageal symptoms questionnaire

FEES:

Fiberoptic endoscopic evaluation of swallowing. Oropharyngeal dysphagia evaluation method

GER:

Gastroesophageal reflux

KMO:

Kaiser–Meyer–Olkin

MDQ:

Mayo dysphagia questionnaire

MG:

Myasthenia gravis

NMD:

Neuromuscular disorders

OD:

Oropharyngeal dysphagia: dysphagia due to disturbances in the oral and pharyngeal phases of swallowing

PCFA:

Principle components factor analysis

SD:

Standard deviation

SDI:

Straumann dysphagia instrument

T-BEDQ:

Turkish-brief esophageal dysphagia questionnaire

UES:

Upper esophageal sphincter

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Funding

There is no funding source in this study.

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Authors and Affiliations

  1. Physical Medicine and Rehabilitation Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, 06170, Altindag, Ankara, Turkey

    Ebru Umay, Ibrahim Gundogdu & Erhan Arif Ozturk

  2. Department of Gastroenterology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey

    Yusuf Serdar Sakin

  3. Neurology Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey

    Mehlika Panpallı Ates

  4. Otolaryngology and Head and Neck Surgery Clinic, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, University of Health Sciences, Ankara, Turkey

    Sibel Alicura

  5. Department of Neurology, Gulhane School of Medicine, University of Health Sciences, Ankara, Turkey

    Guray Koc

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  1. Ebru Umay
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  3. Mehlika Panpallı Ates
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Correspondence to Ebru Umay.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (IRC:2020/342) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Subjects were informed about the study and their written informed consents were obtained at the beginning of the study.

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Umay, E., Sakin, Y.S., Ates, M.P. et al. Esophageal dysphagia in neuromuscular disorder patients with validity and reliability study of the brief esophageal dysphagia questionnaire. Acta Neurol Belg 122, 315–324 (2022). https://doi.org/10.1007/s13760-020-01563-4

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  • DOI: https://doi.org/10.1007/s13760-020-01563-4

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