Can Voice Parameters Provide Cutoff Values to Predict Dysphagia in Individuals with Multiple Sclerosis?
Merve Sapmaz Atalar, Gençer Genç, Elif Ezgi Işık and 3 others
PMID 38872058WHAT IT FOUND
Shimmer values above 1.69 before swallowing and 1.57 after predict dysphagia risk in multiple sclerosis, with moderate accuracy.
These acoustic measures offer a low-cost screening aid, but cannot replace instrumental assessment for confirming aspiration.
Key findings
01Post-swallowing shimmer (local) showed moderate discriminative ability for dysphagia/penetration risk, with an area under the curve of 78.6% and a cutoff value of 1.57.
02Individuals with multiple sclerosis had significantly higher post-swallowing shimmer (local) and lower harmonic-to-noise ratio values compared to healthy individuals.
03No significant differences were found in any pre- or post-swallowing acoustic voice parameters between individuals with multiple sclerosis classified as having dysphagia risk by the DYMUS scale and those without.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not use instrumental imaging (such as videofluoroscopy or endoscopy) to confirm the presence of aspiration or penetration, relying instead on bedside screening and questionnaires. The sample size was relatively small, particularly the subgroup of individuals with multiple sclerosis identified as having dysphagia risk by the symptom questionnaire (11 participants). The study excluded individuals with significant cognitive impairment (MMSE < 24) or severe disability, so findings may not apply to all people with multiple sclerosis. The authors state the study is theoretical and descriptive, with no direct clinical implications established.
Declared interests
The study was funded by the University of Health Sciences. No other conflicts of interest were reported.
The easy way to misread this
Do not use these shimmer cutoff values to diagnose aspiration or penetration. The study did not confirm swallowing safety with instrumental imaging, so a high shimmer score indicates risk on a bedside screen, not necessarily actual airway invasion.