TY - JOUR
T1 - Whiplash-Associated Dysphagia
T2 - Considerations of Potential Incidence and Mechanisms
AU - Stone, D.
AU - Bogaardt, H.
AU - Linnstaedt, S. D.
AU - Martin-Harris, B.
AU - Smith, A. C.
AU - Walton, D. M.
AU - Ward, E.
AU - Elliott, J. M.
N1 - Funding Information:
ACS and JME are supported by a National Institutes of Health award, National Institute of Child Health and Development—NIH R03HD094577.
Funding Information:
ACS and JME are supported by a National Institutes of Health award, National Institute of Child Health and Development?NIH R03HD094577.
Funding Information:
Funding was provided by Foundation for the National Institutes of Health (Grant Number R01 HD079076-01A1).
Publisher Copyright:
© 2019, Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Non-specific self-reports of dysphagia have been described in people with whiplash-associated disorders (WAD) following motor vehicle collision (MVC); however, incidence and mechanistic drivers remain poorly understood. Alterations in oropharyngeal dimensions on magnetic resonance imaging (MRI), along with heightened levels of stress, pain, and changes in stress-dependent microRNA expression (e.g., miR-320a) have been also associated with WAD, suggesting multi-factorial issues may underpin any potential swallowing changes. In this exploratory paper, we examine key biopsychosocial parameters in three patients with persistent WAD reporting swallowing change and three nominating full recovery after whiplash with no reported swallowing change. Parameters included (1) oropharyngeal volume with 3D MRI, (2) peritraumatic miR-320a expression, and (3) psychological distress. These factors were explored to highlight the complexity of patient presentation and propose future considerations in relation to a potential deglutition disorder following WAD. The three participants reporting changes in swallowing all had smaller oropharyngeal volumes at < 1 week and at 3 months post injury and lower levels of peritraumatic miR-320a. At 3 months post MVC, oropharyngeal volumes between groups indicated a large effect size (Hedge’s g = 0.96). Higher levels of distress were reported at both time points for those with persistent symptomatology, including self-reported dysphagia, however, this was not featured in those nominating recovery. This paper considers current evidence for dysphagia as a potentially under-recognized feature of WAD and highlights the need for future, larger-scaled, multidimensional investigation into the incidence and mechanisms of whiplash-associated dysphagia.
AB - Non-specific self-reports of dysphagia have been described in people with whiplash-associated disorders (WAD) following motor vehicle collision (MVC); however, incidence and mechanistic drivers remain poorly understood. Alterations in oropharyngeal dimensions on magnetic resonance imaging (MRI), along with heightened levels of stress, pain, and changes in stress-dependent microRNA expression (e.g., miR-320a) have been also associated with WAD, suggesting multi-factorial issues may underpin any potential swallowing changes. In this exploratory paper, we examine key biopsychosocial parameters in three patients with persistent WAD reporting swallowing change and three nominating full recovery after whiplash with no reported swallowing change. Parameters included (1) oropharyngeal volume with 3D MRI, (2) peritraumatic miR-320a expression, and (3) psychological distress. These factors were explored to highlight the complexity of patient presentation and propose future considerations in relation to a potential deglutition disorder following WAD. The three participants reporting changes in swallowing all had smaller oropharyngeal volumes at < 1 week and at 3 months post injury and lower levels of peritraumatic miR-320a. At 3 months post MVC, oropharyngeal volumes between groups indicated a large effect size (Hedge’s g = 0.96). Higher levels of distress were reported at both time points for those with persistent symptomatology, including self-reported dysphagia, however, this was not featured in those nominating recovery. This paper considers current evidence for dysphagia as a potentially under-recognized feature of WAD and highlights the need for future, larger-scaled, multidimensional investigation into the incidence and mechanisms of whiplash-associated dysphagia.
KW - Deglutition
KW - Deglutition disorders
KW - Dysphagia
KW - Muscle tension dysphagia
KW - Whiplash
KW - Whiplash-associated disorder
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UR - http://www.scopus.com/inward/citedby.url?scp=85084713257&partnerID=8YFLogxK
U2 - 10.1007/s00455-019-10039-4
DO - 10.1007/s00455-019-10039-4
M3 - Article
C2 - 31377863
AN - SCOPUS:85084713257
VL - 35
SP - 403
EP - 413
JO - Dysphagia
JF - Dysphagia
SN - 0179-051X
IS - 3
ER -