Translation of Clinical Dysphagia Scales for Use in Translational Studies

Abstract

Videofluoroscopy is the gold standard for clinical measurement of swallow disorders (dysphagia). Patients are presented with foods and liquids of varying consistencies in order to evaluate the risk of aspiration. The Modified Barium Swallow Impairment Profile (MBSImP) was developed in 2008 and has since become the primary tool to define the degree of dysphagia impairment. In order to determine the utility of the MBSImP in animals with cervical spinal cord injury, animals were presented with tuna water and pate cat food laced with 40% barium sulfate by volume. Data was collected using a miniature c‐arm collecting at 30 frames per second, and exams were performed pre and post cervical spinal cord injury. Out of the 17 components scored on the MBSImP, only 10 components are usable for animals. Additional components/variables are needed due to their anatomical and physiological differences. More specifically, the pharyngeal phase of the swallow in cats shows a threshold in the pharyngeal distention before a full swallow is completed as well as numerous “rocking” motions to transport the bolus posteriorly from the oral cavity. Another difference shows that component 9 (Anterior Hyoid Excursion) is harder to detect due to the slight displacement of the hyoid. However, we did determine that penetration and aspiration could be reliably detected post‐injury using the 30‐frames per second recording. These results support the use of clinical techniques; however, the addition of continuous variables would assist in the measurement of small changes across time.Support or Funding InformationThis work was supported by NIH grant NS110169 and the Craig H. Neilsen Foundation Pilot Research Grant 546714.