Evidence map›Paper›PMID 39012305›Full record

ArticleEuropean journal of neurology2024

Dysphagia in primary progressive aphasia: Clinical predictors and neuroanatomical basis.

Salvatore Mazzeo, Eoin Mulroy, Jessica Jiang, Michael Lassi, Jeremy C S Johnson, Chris J D Hardy, Jonathan D Rohrer, Jason D Warren, Anna Volkmer

Abstract read
In one paragraph

Article in European journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Salvatore MazzeoDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
Eoin MulroyDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
Jessica JiangDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
Michael LassiBioRobotics Institute and Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy.
Jeremy C S JohnsonDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
Chris J D HardyDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.ORCID 0000-0002-4900-6492
Jonathan D RohrerDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
Jason D WarrenDementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
Anna VolkmerDepartment of Psychology & Language Sciences, University College London, London, UK.

Funding

Alzheimer's Research UKAlzheimer's SocietyAssociation of British Neurologists Clinical Research Training FellowshipInvention for Innovation NIHR204280Medical Research Council Clinician Scientist Fellowship MR/M008525/1Miriam Marks Brain Research UK Senior FellowshipNational Brain AppealNational Institute for Health Research Rare Disease Translational Research Collaboration BRC149/NS/MHThe National Brain Appeal Royal National Institute for Deaf People (Discovery Grant G105_WARREN)National Institute for Health Research University College London Hospitals Biomedical Research Centre NIHR Advanced Fellowship NIHR302240 UKRI and Wellcome Trust 204841/Z/16/ZUK Dementia Research InstituteWellcome Institutional Strategic Support Fund Award 204841/Z/16/ZWellcome Trust
6 · The paper itself

Abstract

background and purposeDysphagia is an important feature of neurodegenerative diseases and potentially life-threatening in primary progressive aphasia (PPA) but remains poorly characterized in these syndromes. We hypothesized that dysphagia would be more prevalent in nonfluent/agrammatic variant (nfv)PPA than other PPA syndromes, predicted by accompanying motor features, and associated with atrophy affecting regions implicated in swallowing control.

methodsIn a retrospective case-control study at our tertiary referral centre, we recruited 56 patients with PPA (21 nfvPPA, 22 semantic variant [sv]PPA, 13 logopenic variant [lv]PPA). Using a pro forma based on caregiver surveys and clinical records, we documented dysphagia (present/absent) and associated, potentially predictive clinical, cognitive, and behavioural features. These were used to train a machine learning model. Patients' brain magnetic resonance imaging scans were assessed using voxel-based morphometry and region-of-interest analyses comparing differential atrophy profiles associated with dysphagia presence/absence.

resultsDysphagia was significantly more prevalent in nfvPPA (43% vs. 5% svPPA and no lvPPA). The machine learning model revealed a hierarchy of features predicting dysphagia in the nfvPPA group, with excellent classification accuracy (90.5%, 95% confidence interval = 77.9-100); the strongest predictor was orofacial apraxia, followed by older age, parkinsonism, more severe behavioural disturbance, and more severe cognitive impairment. Significant grey matter atrophy correlates of dysphagia in nfvPPA were identified in left middle frontal, right superior frontal, and right supramarginal gyri and right caudate.

conclusionsDysphagia is a common feature of nfvPPA, linked to underlying corticosubcortical network dysfunction. Clinicians should anticipate this symptom particularly in the context of other motor features and more severe disease.

Indexed as

Aphasia, Primary ProgressiveDeglutition DisordersMagnetic Resonance ImagingAgedAtrophyCase-Control StudiesFemaleHumansMaleMiddle AgedRetrospective StudiesAlzheimer dementiadysphagiaprimary progressive aphasiasemantic dementiaswallowing

Identifiers

PMID39012305
PMCPMC11295169

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.