Relationship Between EAT-10 Scores, Pharyngeal Residue Severity, and Penetration-Aspiration in Individuals With Idiopathic Parkinson's Disease: A FEES-Based Correlation and Discriminative Performance Study.
İbrahim Erensoy, Fatma Esen Aydınlı, Özlem Yaşar and 3 others
PMID 42720198WHAT IT FOUND
Across FEES trials, more pharyngeal residue was linked to higher penetration-aspiration scores.
The EAT-10 tracked these findings and may help decide who needs instrumental assessment, but it does not measure swallowing physiology directly.
Key findings
01Across swallowing conditions, higher Penetration-Aspiration Scale scores were strongly correlated with more severe vallecular residue (ρ = 0.80 to 0.88) and pyriform sinus residue (ρ = 0.85 to 0.91).
02EAT-10 scores were moderately correlated with PAS scores (ρ = 0.56 to 0.64) and showed area-under-curve values from 0.752 to 0.856 for vallecular residue, 0.778 to 0.872 for pyriform sinus residue, 0.720 to 0.852 for penetration, and 0.810 to 0.908 for aspiration.
03Higher Hoehn-Yahr stage and longer disease duration were associated with higher EAT-10 scores, greater maximum vallecular and pyriform sinus residue, higher maximum PAS scores, and lower FOIS scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 84 of 97 participants had complete data for repeated-measures comparisons; 13 did not finish all trials, mainly for safety concerns or refusal. IDDSI levels 3, 5, and 6 and pill swallowing were not tested, so results do not cover those consistencies or medication swallowing. Participants with cognitive impairment were excluded, so EAT-10 findings may not apply to Parkinson's disease patients with impaired awareness or unreliable self-report. FEES was done at one time point, so the study cannot show how residue or aspiration change over disease progression. Reliability was based on 30 smartphone recordings, and agreement between live FEES and screen-recorded scoring was not formally tested. Pyriform sinus residue agreement was only moderate for thin liquid 5 mL, so small rapidly clearing residue in that site is hard to rate consistently. EAT-10 thresholds were outcome-specific and high for aspiration; they should not be generalized to broad dysphagia screening.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not use the EAT-10 as a stand-alone test for aspiration or residue. The paper found it only helped identify FEES findings in adults with Parkinson's disease who could understand instructions, and the aspiration score threshold of 19 or higher should not be generalized to broader screening.