Diagnostic value of masseter muscle thickness fraction measured by ultrasound for dysphagia in patients with Parkinson's disease

doi:10.11958/20250931

Abstract

Abstract:

Objective To investigate the diagnostic value of masseter muscle thickness fraction (MMTF) measured by ultrasound for the occurrence of dysphagia in patients with Parkinson's disease (PD). Methods A total of 100 patients were selected as the study group, and another 50 healthy individuals who received medical checkups with matched age, gender and body mass index (BMI) in our hospital during the same period were selected as the control group. The demographic data and disease characteristics of PD patients were recorded, and patients were divided into the dysphagia group (n=34) and the non-dysphagia group (n=66) according to the occurrence of dysphagia. The demographic data, and disease characteristics such as Hoehn-Yahr (H&Y) stage, Unified Parkinson's Disease Rating Scale (UPDRS) Ⅲ score, levodopa equivalent daily dose (LEDD) and MMT-related parameters measured by ultrasound were compared between the two groups. The indicators with P<0.05 in univariate analysis were used as independent variables, and the influencing factors of dysphagia in patients with PD were investigated by binary Logistic regression analysis. The diagnostic efficacy of each index for dysphagia in patients with PD was evaluated by constructing receiver operating characteristic (ROC) curves, and the area under the curve (AUC) was calculated. Results The MMT during forceful biting and MMTF were lower in the study group than those in the control group (all P<0.05). Compared with the non-dysphagia group, the dysphagia group was older and had higher H&Y stage and UPDRS III scores (all P<0.05). The MMT during forceful biting and MMTF in the dysphagia group were lower than those in the non-dysphagia group (all P<0.05). Multivariate Logistic regression analysis showed that increased UPDRS Ⅲ score was the risk factor for dysphagia in patients with PD, and increased MMT during forceful biting and MMTF were protective factors. The ROC curve analysis indicated that the AUC (95%CI) of UPDRS Ⅲ score, MMT during forceful biting and MMTF for diagnosing dysphagia in patients with PD were 0.714 (0.615-0.800), 0.744 (0.647-0.826) and 0.888 (0.809-0.942), respectively. The AUC of MMTF for diagnosing dysphagia in patients with PD was higher than those of UPDRS Ⅲ scores and MMT during forceful biting (Z values were 2.611 and 2.208, respectively, P<0.05). Conclusion MMTF is an independent influencing factor for dysphagia in patients with PD and can be used as a screening indicator for dysphagic patients.

Key words: Parkinson disease, deglutition disorders, masseter muscle, ultrasonography, masseter muscle thickness fraction

CLC Number:

R742.5

Figures/Tables 6

References 25

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组别	n	放松时MMT/mm	强咬时MMT/mm	MMTF/%
对照组	50	9.17±0.99	11.95±1.28	30.86±11.56
研究组	100	9.12±0.99	11.35±1.08	24.93±10.29
t		0.257	3.039^＊＊	3.193^＊＊

组别	n	放松时MMT/mm	强咬时MMT/mm	MMTF/%
对照组	50	9.17±0.99	11.95±1.28	30.86±11.56
研究组	100	9.12±0.99	11.35±1.08	24.93±10.29
t		0.257	3.039^＊＊	3.193^＊＊

组别	n	性别（男/女）	年龄/ 岁	BMI/（kg/m²）		受教育程度			高血压	糖尿病		冠心病		抑郁
组别	n	性别（男/女）	年龄/ 岁	BMI/（kg/m²）		小学及以下	初、高中	大专及以上	高血压	糖尿病		冠心病		抑郁
非吞咽困难组	66	35/31	66.94±6.49	22.94±3.64		15（22.73）	28（42.42）	23（34.85）	18（27.27）	15（22.73）		12（18.18）		10（15.15）
吞咽困难组	34	19/15	70.18±9.31	22.61±2.39		11（32.35）	13（38.24）	10（29.41）	14（41.18）	13（38.24）		10（29.41）		7（20.59）
t、χ²或Z		0.073	2.029^＊	0.469		1.097			1.994	2.677		1.649		0.470
组别	焦虑		MCI	牙齿缺损		病程/年		H&Y分期		UPDRS Ⅲ 评分/分		LEDD/（mg/d）
组别	焦虑		MCI	<6颗	≥6颗	病程/年		1—2期	3—5期			LEDD/（mg/d）
非吞咽困难组	15（22.73）		17（25.76）	49（74.24）	17（25.76）	3.75（2.00，6.00）		46（69.70）	20（30.30）	UPDRS Ⅲ 评分/分	36.21±12.73		181.00（122.00，358.38）
吞咽困难组	12（35.29）		10（29.41）	23（67.65）	11（32.35）	5.25（2.75，6.25）		16（47.06）	18（52.94）	44.74±11.49		305.25（158.50，375.25）
t、χ²或Z	1.798		0.152	0.484		1.570		4.881^＊		3.276^＊＊		1.364

组别	n	性别（男/女）	年龄/ 岁	BMI/（kg/m²）		受教育程度			高血压	糖尿病		冠心病		抑郁
组别	n	性别（男/女）	年龄/ 岁	BMI/（kg/m²）		小学及以下	初、高中	大专及以上	高血压	糖尿病		冠心病		抑郁
非吞咽困难组	66	35/31	66.94±6.49	22.94±3.64		15（22.73）	28（42.42）	23（34.85）	18（27.27）	15（22.73）		12（18.18）		10（15.15）
吞咽困难组	34	19/15	70.18±9.31	22.61±2.39		11（32.35）	13（38.24）	10（29.41）	14（41.18）	13（38.24）		10（29.41）		7（20.59）
t、χ²或Z		0.073	2.029^＊	0.469		1.097			1.994	2.677		1.649		0.470
组别	焦虑		MCI	牙齿缺损		病程/年		H&Y分期		UPDRS Ⅲ 评分/分		LEDD/（mg/d）
组别	焦虑		MCI	<6颗	≥6颗	病程/年		1—2期	3—5期			LEDD/（mg/d）
非吞咽困难组	15（22.73）		17（25.76）	49（74.24）	17（25.76）	3.75（2.00，6.00）		46（69.70）	20（30.30）	UPDRS Ⅲ 评分/分	36.21±12.73		181.00（122.00，358.38）
吞咽困难组	12（35.29）		10（29.41）	23（67.65）	11（32.35）	5.25（2.75，6.25）		16（47.06）	18（52.94）	44.74±11.49		305.25（158.50，375.25）
t、χ²或Z	1.798		0.152	0.484		1.570		4.881^＊		3.276^＊＊		1.364

组别	n	放松时MMT/mm	强咬时MMT/mm	MMTF/%
非吞咽困难组	66	9.07±0.95	11.68±0.95	29.50±8.75
吞咽困难组	34	9.23±0.99	10.70±1.03	16.06±6.63
t		0.764	4.786^＊＊	7.865^＊＊