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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Neuromuscular Disorders and Peripheral Neuropathies
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1509917

Assessment of upper GI motor activity and GI symptoms in patients with Amyotrophic Lateral Sclerosis: an observational study

Provisionally accepted
Emanuela Ribichini Emanuela Ribichini 1*Nadia Pallotta Nadia Pallotta 1Danilo Badiali Danilo Badiali 1Maria Carlucci Maria Carlucci 1Marco Ceccanti Marco Ceccanti 2Chiara Cambieri Chiara Cambieri 2Laura Libonati Laura Libonati 2Enrico Stefano Corazziari Enrico Stefano Corazziari 3Giovanni Ruoppolo Giovanni Ruoppolo 4Maurizio Inghilleri Maurizio Inghilleri 2,5
  • 1 Department of Translational and Precision Medicine, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
  • 2 Department of Human Neurosciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
  • 3 Department of Gastroenterology, Istituto Clinico Humanitas, Rozzano, Italy., Rozzano (MI), Italy
  • 4 Department of Sense Organs, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Lazio, Italy
  • 5 IRCCS Neuromed, Pozzilli, IS, Italy., Pozzilli (IS), Italy

The final, formatted version of the article will be published soon.

    Oro-pharyngeal dysfunction has been reported in Amyotrophic Lateral Sclerosis (ALS). We aimed to assess ALS patients upper gastrointestinal (GI) motor activity and GI symptoms according to bulbar and spinal onset and severity of ALS.bulbar (B) and spinal (S) patients with ALS Functional Rating Scale (ALSFRS-r) ≥35, bulbar sub-score ≥10, Forced Vital Capacity (FVC) > 50%, underwent to: Fiberoptic Endoscopic Evaluation of Swallowing (FEES); esophageal manometry; gastric emptying; Rome symptom questionnaire. Medical Research Council Scale for Muscle Strength (MRC) was performed for the upper and lower limbs. Mann-Whitney's U, Fisher's ranks test, Pearson's test was used.Thirteen ALS patients were included (6 F; mean age 61.2±13.7 years, range: 37-87), 5 with B and 8 with S onset (ALSFRS-R score 39.5± 4.9, MRC score 128.6±23.3, disease duration 22.8±17.9 months). FEES detected a high dysphagia score in 5 patients with no difference between S and B phenotype. Lower esophageal sphincter pressure was normal in all patients. Esophageal dysmotility was observed in three S and two B onset patients. Upper esophageal sphincter (UES) pressure was higher in all ALS patients. UES spasms and delayed gastric emptying were detected in two B and one S and in two B and four S patients, respectively. There was no correlation between esophagogastric motor abnormalities and clinical characteristics of ALS, nor GI symptoms.Conclusions. The presence of UES spasm and the delayed gastric emptying in a subgroup of ALS patients may suggest the role of ANS dysfunction in ALS.

    Keywords: Amyotrophic Lateral Sclerosis, Gastric Emptying, ESOPHAGEAL MANOMETRY, Esophageal motility, upper esophageal sphincter, Autonomic Nervous System, Vagus Nerve

    Received: 11 Oct 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Ribichini, Pallotta, Badiali, Carlucci, Ceccanti, Cambieri, Libonati, Corazziari, Ruoppolo and Inghilleri. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Emanuela Ribichini, Department of Translational and Precision Medicine, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy

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