Ultrasound and Videofluoroscopy for Diagnosing Swallowing Disorders

NCT00001220 | Completed

• 2 other identifiers: 87016087-CC-0160
• Study Type: observational
• Target: 750
• Locations: 1 country
• Sites: 1

Brief Summary

This study will identify clinical signs and symptoms critical for diagnosing swallowing disorders and will characterize swallowing problems in various patient populations, such as patients with Parkinson's disease, stroke, post-polio syndrome, multiple sclerosis and other conditions that cause swallowing abnormalities. Patients with swallowing difficulties who are enrolled in NIH neurology or speech pathology protocols may be eligible for this study. Participants will undergo the following procedures:

1. 1.Oral examination-A neurologist and speech pathologist examine the patient's swallowing function. The patient is interviewed about difficulties with food intake, chewing and swallowing during meals.
2. 2.Ultrasound examination-Ultrasound creates image of areas inside the body using sound waves. With the patient in a sitting position, a 3/4-inch transducer (device for transmitting and receiving sound waves) is placed under the chin to visualize tongue movements during swallowing.
3. 3.Modified barium swallow-While standing or sitting, the patient swallows 1/2 teaspoon of flavored barium (a radioactive substance) six times (a total of 3 teaspoons), while the tongue and pharynx (tube leading from the mouth to the esophagus) are scanned and videotaped. The barium is given in three consistencies-thin, medium and thick (pudding-like).
4. 4.Electromyography-A small plastic strip with wires attached is placed under the patient's chin. The patient then swallows 1/2 ounce of barium three times in a row, and the movement of the chin muscles during swallowing is displayed. Patients may also be asked to swallow 5/8 cup of barium twice; once with the head tilted upward and once with the head untilted.

Conditions

Deglutition Disorder; Motor Neuron Disease

Keywords

Swallowing Disorders; Neuromotor Dysfunction; Aspiration; Imaging

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Any Clinical Center inpatients and outpatients with known or suspected dysphagia on any other NIH institute protocol can be included for study as well as patients who are admitted specifically for this protocol.
• Those patients at risk for oropharyngeal dysfunction will be screened initially by completing a self-assessment swallowing questionnaire, and by an interview with staff and/or family members. Patients who demonstrate appropriate signs and symptoms of dysphagia and oral motor impairment on the screening assessment will be considered for the protocol:
• Difficulty swallowing food or pills.
• Changed swallowing ability.
• Coughing or choking when eating.
• Shortness of breath during swallowing.
• Food backing up into the mouth or nasal passage.
• Fever or voice changes after swallowing.
• Pain when swallowing.
• Unexplained loss of weight.

You may not qualify if:

• Patients who are severely demented or severely compromised will be excluded if they do not have sufficient cognitive ability to follow directions.
• Patients who are non-ambulatory will be excluded if they can not be braced or supported within the fluoroscopy unit.
• Highly agitated individuals will also be excluded if they are unable to remain confined in the equipment.
• Infants and children under age 3 will be excluded due to radiation risk on the developing visual system.

Sponsors & Collaborators

• National Institutes of Health Clinical Center (CC): lead

Study Sites (1)

National Institutes of Health Clinical Center (CC)

Bethesda, Maryland, 20892, United States

Location

Related Publications (3)

• Sonies BC, Parent LJ, Morrish K, Baum BJ. Durational aspects of the oral-pharyngeal phase of swallow in normal adults. Dysphagia. 1988;3(1):1-10. doi: 10.1007/BF02406274. No abstract available.

  PMID: 3073915 BACKGROUND

• Litvan I, Sastry N, Sonies BC. Characterizing swallowing abnormalities in progressive supranuclear palsy. Neurology. 1997 Jun;48(6):1654-62. doi: 10.1212/wnl.48.6.1654.

  PMID: 9191782 BACKGROUND

• Donner MW. Swallowing mechanism and neuromuscular disorders. Semin Roentgenol. 1974 Oct;9(4):273-82. doi: 10.1016/0037-198x(74)90045-5. No abstract available.

  PMID: 4421910 BACKGROUND

MeSH Terms

Conditions

Deglutition Disorders; Motor Neuron Disease

Condition Hierarchy (Ancestors)

Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Pharyngeal Diseases; Otorhinolaryngologic Diseases; Neurodegenerative Diseases; Nervous System Diseases; Neuromuscular Diseases

Study Design

• Study Type: observational
• Sponsor Type: NIH

Study Record Dates

• First Submitted: November 3, 1999
• First Posted: November 4, 1999
• Study Start: October 1, 1987
• Study Completion: November 1, 2005
• Last Updated: March 4, 2008

Record last verified: 2005-11

Locations

US (1)