Influences of motor speech impairments on the presentation of dysphagia in progressive supranuclear palsy.
Diana Petroi-Bock, Heather M Clark, Julie A G Stierwalt and 4 others
PMID 37334902WHAT IT FOUND
In 73 people with progressive supranuclear palsy, worse motor speech severity and the presence of apraxia of speech predicted more severe pharyngeal swallowing impairment.
Oral phase scores and diet safety did not relate to speech type. Swallowing function was largely preserved in this mild cohort.
Key findings
01Greater motor speech disorder severity and the presence of apraxia of speech were significantly associated with worse pharyngeal swallowing scores, even after adjusting for age and disease severity.
02Participants with spastic dysarthria had significantly worse pharyngeal swallowing scores than those with hypokinetic dysarthria.
03There were no significant relationships between motor speech features and oral swallowing scores, penetration/aspiration scores, or functional oral intake levels.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study was cross-sectional, capturing only a single time point, so it cannot determine if speech decline precedes swallowing decline over time. Participants had mild impairments overall, with very little variability in penetration/aspiration or diet safety scores, which limited the ability to detect relationships with these specific outcomes. Only three participants had ataxic dysarthria, so they were excluded from group comparisons, leaving that subtype unexamined. There was some overlap in participants with a previous study by the same group, which may introduce bias. The analysis used worst-case scores for swallowing measures, which the authors acknowledge could overidentify impairments.
Declared interests
The study was funded by the National Institutes of Health. No specific commercial conflicts of interest were reported in the provided text.
The easy way to misread this
Do not assume that normal penetration/aspiration scores or a regular diet mean swallowing is stable. While this cohort had safe oral intake, the study shows that pharyngeal impairment worsens as speech severity declines and when apraxia of speech is present. A patient with PSP and severe spastic dysarthria or apraxia of speech is at higher risk for pharyngeal dysfunction even if they are not currently aspirating.