Evidence map›Paper›PMID 39973456›Full record

ArticleJournal of neuromuscular diseases

Characterization of swallowing biomechanics and function in untreated infants with spinal muscular atrophy: A natural history dataset.

Katlyn Elizabeth McGrattan, Robert J Graham, Alicia Hofelich Mohr, Anna Miles, Jacqui Allen, Juliet Ochura, Kayla Hernandez, Katie Walsh, Vamshi Rao, Melanie Stevens and 19 more

Abstract read
In one paragraph

Article in Journal of neuromuscular diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. 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

29 authors.

Katlyn Elizabeth McGrattanDepartment of Speech Language and Hearing Science, University of Minnesota, Minneapolis, USA.ORCID 0000-0002-7853-1624
Robert J GrahamDepartment of Critical Care Medicine, Boston Children's Hospital, Boston, USA.
Alicia Hofelich MohrUniversity of Minnesota, Liberal Arts Technologies and Innovation Services, Minneapolis, USA.
Anna MilesDepartment of Speech Science, Psychology, The University of Auckland, Auckland, New Zealand.
Jacqui AllenDepartment of Medical and Health Sciences, Surgery, The University of Auckland, Auckland, New Zealand.
Juliet OchuraDepartment of Otolaryngology and Communication Enhancement, Boston's Children's Hospital, Boston, USA.
Kayla HernandezDepartment of Otolaryngology and Communication Enhancement, Boston's Children's Hospital, Boston, USA.
Katie WalshDepartment of Speech Language Pathology, Lurie Children's Hospital, Chicago, USA.
Vamshi RaoDepartment of Neurology, Lurie Children's Hospital, Chicago, USA.
Melanie StevensNationwide Children's Hospital, Pediatric Aerodigestive Team, Columbus, USA.
Lindsay AlfanoNationwide Children's Hospital, Center for Gene Therapy, Columbus, USA.
Mackenzi CokerDepartment of Neurology, University of Florida, Gainesville, USA.
Carmen Leon-AstudilloDepartment of Pediatrics, University of Florida College of Medicine, Gainesville, USA.
Leann Schow SmithDepartment of Speech Language Pathology, Primary Children's Hospital, Salt Lake City, USA.
John BrandsemaDepartment of Neurology, Children's Hospital of Philadelphia, Philadelphia, USA.
Hiba FarahDepartment Clinical Research, Children's Hospital of Philadelphia, Philadelphia, USA.
Julia WelcDepartment of Speech Language Pathology, Children's Hospital of Philadelphia, Philadelphia, USA.
Deborah Salle LevyDepartment of Health and Human Communication, Universidade Federal do Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
Miranda ClementsStanford Children's Hospital, Neuromuscular Diseases Care Team, Stanford, USA.
Whitney J TangDepartment of Neurology, Lucile Packard Children's Hospital, Stanford, USA.
Tina DuongDepartment of Neurology, Lucile Packard Children's Hospital, Stanford, USA.
Carolina Tesi RochaDepartment of Neurology, Lucile Packard Children's Hospital, Stanford, USA.
Graham SchenckDepartment of Craniofacial and Plastic Surgery, Gillette Children's Hospital, Minneapolis, USA.
Heather McGheeDepartment of Speech Language Pathology, Medical University of South Carolina, Charleston, USA.
Keeley NicholsDepartment of Rehabilitation Sciences, Medical University of South Carolina, Charleston, USA.
Ashley BrownDepartment of Speech Language Pathology, Children's Health System of Texas, Dallas, USA.
Allison BrownDepartment of Speech Language Pathology, Children's Health System of Texas, Dallas, USA.
Diana CastroDepartment of Neurology, Neurology and Neuromuscular Care Center Texas, Dallas, USA.
Basil T DarrasDepartment of Neurology, Boston Children's Hospital, Harvard Medical School, Boson, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSpinal Muscular Atrophy (SMA) is a progressive neuromuscular disorder that in its most severe form, causes profound swallowing deficits. There remains a paucity of research systematically elucidating the biomechanical and functional correlates. This void limits the ability to evaluate the effects of disease-modifying treatments on swallowing.

objectiveElucidate characteristics of swallowing biomechanics and function among untreated patients with SMA.

methodsInfants with SMA who had not received disease modifying therapy when they underwent a videofluoroscopic swallow study (VFSS) were retrospectively identified from 13 international children's hospitals. Infants were eligible if they exhibited symptoms by six months old, or in cases where they detected prior to symptom onset, if they had two copies of SMN2. Eligible infants underwent medical record review to gather oral intake status and need for suctioning for secretion management. Digital files of VFSS' were extracted and analyzed using BabyVFSSImP™. Non-parametric t-tests were used to compare swallowing biomechanics based on viscosity and the presence of dysphagia symptoms.

results62 infants were included in this investigation with average age at initial VFSS 4.4 ± 3.11 months. A high proportion of infants exhibited profound deficits in swallowing biomechanics that impeded extraction of the bolus from the nipple, clearance of the bolus from the pharynx, and prevention of the bolus from entering the airway. Deficits were significantly more prevalent in infants referred for VFSS due to dysphagia symptoms than asymptomatic infants referred as part of high-risk referral (t ≤ 2.5, p ≤ 0.03). A high proportion of infants relied on suctioning for secretion management (34%; N = 21) and alternative nutrition (39%; N = 24), with those relying on these supports exhibiting significantly worse swallowing biomechanics than those who did not (t ≤ 2.8, p ≤ 0.01).

conclusionsProfound deficits in swallowing biomechanics and function are common in infants with SMA. Though clinical symptoms may aid in identifying infants with the most profound swallowing deficits, their absence in cases of more mild deficits inhibits the ability to use these clinical markers as a valid metric of swallowing integrity.

Indexed as

DeglutitionDeglutition DisordersMuscular Atrophy, SpinalBiomechanical PhenomenaFemaleFluoroscopyHumansInfantMaleRetrospective StudiesbulbardysphagianutritionSMAswallowing

Identifiers

PMID39973456
PMCPMC11951134

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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.