Delineating Swallowing Impairment and Decline in ALS

NCT ID: NCT02962050

Last Updated: 2023-02-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

109 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-05-31

Study Completion Date

2023-02-16

Brief Summary

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The purpose of this study is to 1) evaluate the discriminant ability of simple clinical markers to detect swallowing impairment in individuals with ALS, 2) develop and validate a minimally invasive clinical screening tool for use at multidisciplinary ALS clinics, and 3) determine the natural history of swallowing impairment and decline in ALS.

Detailed Description

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This research study is being performed to determine screening tools or tests that are able to identify and track swallowing problems associated with Amyotrophic Lateral Sclerosis (ALS) over time. Also, this study will provide insight into the natural progression of swallowing impairment in persons with ALS over time.

Participants enrolled in this study will complete an evaluation at the University of Florida Aerodigestive Research Core laboratory located at Shands Hospital, Gainesville every three months. Each evaluation will take approximately 90 minutes. During these evaluations, a videofluoroscopy (X-ray of swallowing) examination, cough tests and questionnaires will be completed.

Conditions

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Amyotrophic Lateral Sclerosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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ALS

Participants enrolled will complete the following tests: Videofluoroscopic Swallowing Study, Voluntary Peak Cough Flow Testing, lingual strength and endurance trials using the Iowa Oral Performance Instrument, reflexive cough testing, Pulmonary Function Testing; Eating Assessment Tool-10 (EAT-10), Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R), and the The Center for Neurologic Study Bulbar Function Scale (CNS-BFS).

Videofluoroscopic Swallowing Study (VFSS)

Intervention Type PROCEDURE

Videofluoroscopic swallowing study will be performed to measure oropharyngeal swallowing

Voluntary Peak Cough Flow Testing

Intervention Type DEVICE

Voluntary peak cough flow testing will be performed to determine the peak expiratory flow (PEF) and volume of air expelled (FEV1) during voluntary coughing.

Iowa Oral Performance Instrument

Intervention Type DEVICE

The Iowa Oral Performance Instrument (IOPI) is a device that measures the peak pressure performance of lingual strength and endurance via the action of a bulb placed on the hard palate.

Capsaicin Challenge

Intervention Type DRUG

A capsaicin challenge with three randomized blocks of 0, 50, 100, 200, and 500 μM capsaicin. The capsaicin will be dissolved in a vehicle solution consisting of 80% physiological saline, and 20% ethanol. Participants will be given the instruction "cough if you need to" prior to capsaicin delivery.The solution will be administered automatically upon detection of an inspired breath and there will be a minimum of one minute between each trial. This is to test the reflexive cough testing for upper airway sensitivity and motor thresholds.

Pulmonary Function Testing

Intervention Type DEVICE

Pulmonary Function testing will be performed using conventional methods and will include the following outcomes: forced vital capacity (FVC), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) expressed as a percentage of predicted values.

Eating Assessment Tool 10

Intervention Type OTHER

The Eating Assessment Tool-10 will be used for participant reporting of swallowing system severity.

The Center for Neurologic Study Bulbar Function Scale

Intervention Type OTHER

The Center for Neurologic Studies Bulbar Function Scale (CNS-BFS) will be used to report bulbar function in study participants.

Interventions

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Videofluoroscopic Swallowing Study (VFSS)

Videofluoroscopic swallowing study will be performed to measure oropharyngeal swallowing

Intervention Type PROCEDURE

Voluntary Peak Cough Flow Testing

Voluntary peak cough flow testing will be performed to determine the peak expiratory flow (PEF) and volume of air expelled (FEV1) during voluntary coughing.

Intervention Type DEVICE

Iowa Oral Performance Instrument

The Iowa Oral Performance Instrument (IOPI) is a device that measures the peak pressure performance of lingual strength and endurance via the action of a bulb placed on the hard palate.

Intervention Type DEVICE

Capsaicin Challenge

A capsaicin challenge with three randomized blocks of 0, 50, 100, 200, and 500 μM capsaicin. The capsaicin will be dissolved in a vehicle solution consisting of 80% physiological saline, and 20% ethanol. Participants will be given the instruction "cough if you need to" prior to capsaicin delivery.The solution will be administered automatically upon detection of an inspired breath and there will be a minimum of one minute between each trial. This is to test the reflexive cough testing for upper airway sensitivity and motor thresholds.

Intervention Type DRUG

Pulmonary Function Testing

Pulmonary Function testing will be performed using conventional methods and will include the following outcomes: forced vital capacity (FVC), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) expressed as a percentage of predicted values.

Intervention Type DEVICE

Eating Assessment Tool 10

The Eating Assessment Tool-10 will be used for participant reporting of swallowing system severity.

Intervention Type OTHER

The Center for Neurologic Study Bulbar Function Scale

The Center for Neurologic Studies Bulbar Function Scale (CNS-BFS) will be used to report bulbar function in study participants.

Intervention Type OTHER

Other Intervention Names

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VFSS X-Ray of Swallowing Modified Barium Swallow Study IOPI Reflexive Cough Testing EAT 10 CNS-BFS

Eligibility Criteria

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Inclusion Criteria

* diagnosis of probable or definite ALS

Exclusion Criteria

* allergies to barium or capsaicin
* History of stroke
* Head and Neck Cancer
* Other disorder that might contribute to swallowing impairment
* Not enrolled in other research investigations that might impact swallowing
* Not pregnant
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Neurological Disorders and Stroke (NINDS)

NIH

Sponsor Role collaborator

University of Florida

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Emily Plowman, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Florida

Locations

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University of Florida

Gainesville, Florida, United States

Site Status

University of South Florida

Tampa, Florida, United States

Site Status

Countries

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United States

Other Identifiers

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R01NS100859

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB201602098-N

Identifier Type: -

Identifier Source: org_study_id

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