@article{FrankRadtkeNienstedtetal.2021,
  author    = {Frank, Ulrike and Radtke, Julia and Nienstedt, Julie Cl{\"a}re and P{\"o}tter-Nerger, Monika and Sch{\"o}nwald, Beate and Buhmann, Carsten and Gerloff, Christian and Niessen, Almut and Fl{\"u}gel, Till and Koseki, Jana-Christiane and Pflug, Christina},
  title     = {Dysphagia screening in Parkinson's Disease},
  series = {Neurogastroenterology and motility},
  volume    = {33},
  journal   = {Neurogastroenterology and motility},
  number    = {5},
  publisher = {Wiley},
  address   = {Hoboken},
  issn      = {1350-1925},
  doi       = {10.1111/nmo.14034},
  pages     = {8},
  year      = {2021},
  abstract  = {Background Simple water-swallowing screening tools are not predictive of aspiration and dysphagia in patients with Parkinson's Disease (PD). We investigated the diagnostic accuracy of a multi-texture screening tool, the Gugging Swallowing Screen (GUSS) to identify aspiration and dysphagia/penetration in PD patients compared to flexible endoscopic evaluation of swallowing (FEES). Methods Swallowing function was evaluated in 51 PD participants in clinical 'on-medication' state with the GUSS and a FEES examination according to standardized protocols. Inter-rater reliability and convergent validity were determined and GUSS- and FEES-based diet recommendations were compared. Key Results Inter-rater reliability of GUSS ratings was high (r(s) = 0.8; p < 0.001). Aspiration was identified by the GUSS with a sensitivity of 50\%, and specificity of 51.35\% (PPV 28\%, NPV 73\%, LR+ 1.03, LR- 0.97), dysphagia/penetration was identified with 72.97\% sensitivity and 35.71\% specificity (PPV 75\%, NPV 33.33\%, LR+ 1.14, LR- 0.76). Agreement between GUSS- and FEES-based diet recommendations was low (r(s) = 0.12, p = 0.42) with consistent NPO (Nil per Os) allocation by GUSS and FEES in only one participant. Conclusions and Inferences The multi-texture screening tool GUSS in its current form, although applicable with good inter-rater reliability, does not detect aspiration in PD patients with acceptable accuracy. Modifications of the GUSS parameters "coughing," "voice change" and "delayed swallowing" might enhance validity. The GUSS' diet recommendations overestimate the need for oral intake restriction in PD patients and should be verified by instrumental swallowing examination.},
  language  = {en}
}
@article{VogelClausAhringetal.2022,
  author    = {Vogel, Annemarie and Claus, Inga and Ahring, Sigrid and Gruber, Doreen and Haghikia, Aiden and Frank, Ulrike and Dziewas, Rainer and Ebersbach, Georg and Gandor, Florin and Warnecke, Tobias},
  title     = {Endoscopic characteristics of dysphagia in multiple system atrophy},
  series = {Movement disorders : official journal of the Movement Disorder Society},
  volume    = {37},
  journal   = {Movement disorders : official journal of the Movement Disorder Society},
  number    = {3},
  publisher = {Wiley-Blackwell},
  address   = {Hoboken},
  issn      = {0885-3185},
  doi       = {10.1002/mds.28854},
  pages     = {535 -- 544},
  year      = {2022},
  abstract  = {Background Dysphagia is a major clinical concern in multiple system atrophy (MSA). A detailed evaluation of its major endoscopic features compared with Parkinson's disease (PD) is lacking. Objective This study systematically assessed dysphagia in MSA compared with PD and correlated subjective dysphagia to objective endoscopic findings. Methods Fifty-seven patients with MSA (median, 64 [interquartile range (IQR): 59-71] years; 35 women) underwent flexible endoscopic evaluation of swallowing using a specific MSA-flexible endoscopic evaluation of swallowing task protocol. Findings were compared with an age-matched cohort of 57 patients with PD (median, 67 [interquartile range: 60-73] years; 28 women). In a subcohort, subjective dysphagia was assessed using the Swallowing Disturbance Questionnaire and correlated to endoscopy findings. Results Patients with MSA predominantly showed symptoms suggestive of oral-phase disturbance (premature spillage, 75.4\%, piecemeal deglutition, 75.4\%). Pharyngeal-phase symptoms occurred less often (pharyngeal residues, 50.9\%; penetration/aspiration, 28.1\%). In contrast, pharyngeal symptoms were the most common finding in PD (pharyngeal residues, 47.4\%). Oral symptoms occurred less frequently in PD (premature spillage, 15.8\%, P < 0.001; piecemeal deglutition, 1.8\%, P < 0.01). Patients with MSA had a greater risk for oral-phase disturbances with increased disease severity (P < 0.05; odds ratio, 3.15). Patients with MSA showed a significantly higher intraindividual interswallow variability compared with PD. When correlating Swallowing Disturbance Questionnaire scores with endoscopy results, its cutoff, validated for PD, was not sensitive enough to identify patients with MSA with dysphagia. We developed a subscore for identifying dysphagia in MSA and calculated a new cutoff (sensitivity 85\%, specificity 100\%). Conclusions In contrast with patients with PD, patients with dysphagic MSA more frequently present with oral-phase symptoms and a significantly higher intraindividual interswallow variability. A novel Swallowing Disturbance Questionnaire MSA subscore may be a valuable tool to identify patients with MSA with early oropharyngeal dysphagia.},
  language  = {en}
}
@article{MuellerBeerFrank2022,
  author    = {M{\"u}ller, Nina and Beer, Carola de and Frank, Ulrike},
  title     = {Ist die therapeutische Mundpflege bei Dysphagiepatient*innen verschwendete Zeit?},
  series = {Sprache, Stimme, Geh{\"o}r : Zeitschrift f{\"u}r Kommunikationsst{\"o}rungen},
  volume    = {46},
  journal   = {Sprache, Stimme, Geh{\"o}r : Zeitschrift f{\"u}r Kommunikationsst{\"o}rungen},
  number    = {03},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0342-0477},
  doi       = {10.1055/a-1714-1587},
  pages     = {150 -- 155},
  year      = {2022},
  abstract  = {Aspirationspneumonien sind eine h{\"a}ufige Todesursache bei Dysphagiepatient*innen. In diesem Beitrag wird durch die Evaluation relevanter Studien die Frage untersucht, ob die therapeutische Mundpflege bei Dysphagiepatient*innen zur Verringerung des Pneumonierisikos beitragen kann. Zudem wird auf dieser Grundlage eine Handlungsempfehlung f{\"u}r die Umsetzung der Mundpflege entwickelt. Die ausgew{\"a}hlten Studien zeigen, dass die Mundpflege einen positiven Effekt auf das Pneumonie-Risiko von Dysphagiepatient*innen hat. Sie sollte auf den Grunds{\"a}tzen Einfachheit, Sicherheit, Arbeitskr{\"a}fteentlastung, Wirksamkeit, Universalit{\"a}t, Wirtschaftlichkeit und vollst{\"a}ndige Mundpflege aller Teile der Mundh{\"o}hle beruhen und nimmt weniger als f{\"u}nf Minuten t{\"a}glich ein. Sie bereitet durch die taktile Stimulation auf die anschließende Dysphagie-Therapie vor und ist somit sinnvoll investierte Therapiezeit.},
  language  = {de}
}
@article{FrankCzepluchSticheretal.2013,
  author    = {Frank, Ulrike and Czepluch, C. and Sticher, H. and Maetzener, F. and Schlaegel, W. and M{\"a}der, M.},
  title     = {Modifiziertes Trachealkan{\"u}lenmanagement - Platzhaltereinsatz als Option bei erschwerten Dekan{\"u}lierungen (Pilotprojekt REHAB Basel)},
  series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation},
  volume    = {52},
  journal   = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation},
  number    = {1},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0034-3536},
  doi       = {10.1055/s-0032-1306290},
  pages     = {20 -- 26},
  year      = {2013},
  abstract  = {Tracheotomierte Patienten, die sowohl eine Dysphagie als auch respiratorische Defizite aufweisen, haben nach der Dekan{\"u}lierung h{\"a}ufig Probleme, sich an die translaryngeale Atmung anzupassen. Wir entwickelten ein Dekan{\"u}lierungsprotokoll f{\"u}r diese Patientengruppe, das optional in unser bestehendes Trachealkan{\"u}lenmanagement integriert werden kann. Erf{\"u}llt ein Patient die hierf{\"u}r definierten Kriterien, so erfolgt unter laryngoskopischer Kontrolle die Einlage eines Platzhalters, der bis zu 3 Tage in situ verbleibt. W{\"a}hrend dieser Probedekan{\"u}lierungsphase werden die respiratorischen Funktionen und das Speichelmanagement engmaschig {\"u}berwacht. Auf der Grundlage dieser Evaluation wird dann die Entscheidung f{\"u}r oder gegen eine endg{\"u}ltige Dekan{\"u}lierung getroffen. Wir stellen den Ablauf, die Kriterienkataloge und die Evaluationsparameter f{\"u}r diese Probedekan{\"u}lierungsphase vor und illustrieren den Ablauf anhand von 2 Fallbeispielen.},
  language  = {de}
}
@article{SchlickeweiNienstedtFranketal.2021,
  author    = {Schlickewei, Ole and Nienstedt, Julie Cl{\"a}re and Frank, Ulrike and Fr{\"u}ndt, Odette and P{\"o}tter-Nerger, Monika and Gerloff, Christian and Buhmann, Carsten and M{\"u}ller, Frank and Lezius, Susanne and Koseki, Jana-Christiane and Pflug, Christina},
  title     = {The ability of the eating assessment tool‑10 to detect penetration and aspiration in Parkinson's disease},
  series = {European archives of oto-rhino-laryngology and head \& neck},
  volume    = {278},
  journal   = {European archives of oto-rhino-laryngology and head \& neck},
  number    = {5},
  publisher = {Springer},
  address   = {Berlin},
  issn      = {0937-4477},
  doi       = {10.1007/s00405-020-06377-x},
  pages     = {1661 -- 1668},
  year      = {2021},
  abstract  = {Purpose: Dysphagia is common in patients with Parkinson's disease (PD) and often leads to pneumonia, malnutrition, and reduced quality of life. This study investigates the ability of the Eating Assessment Tool-10 (EAT-10), an established, easy self-administered screening tool, to detect aspiration in PD patients. This study aims to validate the ability of the EAT-10 to detect FEES-proven aspiration in patients with PD. Methods: In a controlled prospective cross-sectional study, a total of 50 PD patients completed the EAT-10 and, subsequently, were examined by Flexible Endoscopic Evaluation of Swallowing (FEES) to determine the swallowing status. The results were rated through the Penetration-Aspiration Scale (PAS) and data were analyzed retrospectively. Results: PAS and EAT-10 did not correlate significantly. Selected items of the EAT-10 could not predict aspiration or residues. 19 (38\%) out of 50 patients with either penetration or aspiration were not detected by the EAT-10. The diagnostic accuracy was established at only a sufficient level (AUC 0.65). An optimal cut-off value of >= 6 presented a sensitivity of 58\% and specificity of 82\%. Conclusions: The EAT-10 is not suited for the detection of penetration and aspiration in PD patients. Therefore, it cannot be used as a screening method in this patient population. There is still a need for a valid, simple, and efficient screening tool to assist physicians in their daily diagnostics and to avoid clinical complications.},
  language  = {en}
}