Relationship Between Swallowing Performance and Swallowing-Related Quality of Life in Patients With Multiple Sclerosis

INTRODUCTION: Dysphagia is a common but often under-recognized problem in patients with multiple sclerosis (MS) and may adversely affect both swallowing function and swallowing-related quality of life. This study aimed to investigate the relationship between subjective swallowing complaints and objective swallowing performance in patients with MS and to determine how these parameters vary across MS subtypes.
METHODS: This retrospective study included 60 patients with confirmed MS. Subjective swallowing complaints were assessed using the Dysphagia in MS Questionnaire (DYMUS) and the Eating Assessment Tool-10 (EAT-10). Objective swallowing performance was evaluated using the Repetitive Saliva Swallowing Test (RSST), and swallowing-related quality of life was assessed using the SWAL-QOL questionnaire. Comparisons among relapsing–remitting MS (RRMS), primary progressive MS (PPMS), and secondary progressive MS (SPMS) were performed using non-parametric tests. Correlation analyses were conducted to examine associations among age, disease duration, swallowing measures, and quality-of-life scores. Spearman’s rank correlation coefficient (ρ) or Pearson’s correlation coefficient (r) was used.
RESULTS: Of the 60 patients, 38 (63.3%) had RRMS, 14 (23.3%) had PPMS, and 8 (13.4%) had SPMS. Disease duration differed significantly across MS subtypes (p<0.001). Significant differences were found among MS subtypes for EAT-10, DYMUS, RSST, and total SWAL-QOL scores (all p<0.001). The RRMS group showed the most favorable swallowing profile, whereas the SPMS group had the highest subjective dysphagia scores and the lowest objective swallowing performance and swallowing-related quality of life. RSST was strongly negatively correlated with DYMUS (ρ=−0.732, p<0.001) and EAT-10 (ρ=−0.706, p<0.001), and positively correlated with total SWAL-QOL (r=0.646, p<0.001). Disease duration was positively correlated with DYMUS (ρ=0.483, p < 0.001) and EAT-10 (ρ =0.435, p<0.001), and negatively correlated with RSST (ρ=−0.317, p=0.013) and total SWAL-QOL (r=−0.571, p<0.001).
DISCUSSION AND CONCLUSION: Subjective and objective swallowing measures were significantly associated in MS, and swallowing impairment appeared more pronounced in progressive subtypes, particularly SPMS.