During the past year we have focused our ultrasound and videofluoroscopic studies on patients with progressive supranuclear palsy, post-pallidotomy Parkinson's disease, and corticobasal degeneration. Follow-up studies were performed on patients with inclusion body myositis and polymyositis in preparation for long-term descriptions of these conditions. Considerable effort has been spent to develop a computer program that digitizes and analyzes the videofluoroscopic images. This model allows us to examine the timing of specific swallowing events and the range of motion of specific structures in sequential and discrete swallows. Post-Pallidotomy Study Twelve patients who underwent bilateral pallidotomy and were evaluated at NIH received comprehensive oral motor and swallowing evaluations 1 month before and 2 months following the procedure. Intrasubject comparisons were made to determine whether swallowing severity and function swallowing changed after surgery. Findings revealed great variability across the evaluation parameters, with more patients who worsened on the pharyngeal and esophageal phases and no difference on the oral findings. In spite of changes in the instrumental swallowing studies, 10 out of 12 subjects did not evidence any category change in the severity and functional outcome rating scales. This study suggests that pallidotomy does not conclusively benefit subjects with respect to either oral motor or swallowing ability.

Agency
National Institute of Health (NIH)
Institute
Clinical Center (CLC)
Type
Intramural Research (Z01)
Project #
1Z01CL060042-10
Application #
6161574
Study Section
Special Emphasis Panel (RM)
Project Start
Project End
Budget Start
Budget End
Support Year
10
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Clinical Center
Department
Type
DUNS #
City
State
Country
United States
Zip Code
Sonies, B C (2000) Patterns of care for dysphagic patients with degenerative neurological diseases. Semin Speech Lang 21:333-44; quiz 334-5
Frattali, C M; Sonies, B C (2000) Speech and swallowing disturbances in corticobasal degeneration. Adv Neurol 82:153-60
Chi-Fishman, G; Sonies, B C (2000) Motor strategy in rapid sequential swallowing: new insights. J Speech Lang Hear Res 43:1481-92