{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T10:23:20Z","timestamp":1781605400962,"version":"3.54.5"},"reference-count":58,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dysphagia remains a major clinical concern in multiple system atrophy (MSA), and so far, lacks relevant treatment options.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically assess levodopa\u2010responsiveness of dysphagia in MSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>19 MSA\u2010patients underwent endoscopic swallowing evaluation in Off\u2010 and On\u2010state, following an adapted FEES\u2010levodopa\u2010test\u2010protocol. Findings were compared between states and correlated to disease\u2010specific and demographic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 19 MSA\u2010patients 70 [66\u201372] years, 15\/4 MSA\u2010P\/ C, 10 women exhibited dysphagia. Levodopa\u2010responsiveness of motor\u2010impairment was poor (UPDRS\u20103 Off 46 [34\u201352] vs On 43 [40\u201348],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.31). Dysphagia severity varied greatly. Sum\u2010scores ranged between 9\u201321 in Off and 6\u201320 in On. MSA\u2010P\u2010patients were more likely to have higher sum\u2010scores (rpb 0.41,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01). Sum\u2010scores otherwise were independent of disease\u2010specific and demographic factors. 3\/19 MSA\u2010patients showed marked score\u2010improvement by \u226530% through reduced leaking and aspiration but remained unchanged for the majority. Scores worsened in 2\/19 patients. In the group analysis, the median dysphagia\u2010score remained unchanged (2 [1, 2],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.28). The occurrence of leaking, pharyngeal residue, penetration, and aspiration was not changed (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.13\u20130.19). Severity of leaking was reduced (3 [2\u20134] vs. 0[0.5\u20131],\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), while severity of pharyngeal residue, penetration, and aspiration remained unchanged (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.29\u20130.53). Liquids were more often associated with leaking (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) and aspiration (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.005). All patients exhibited laryngeal movement disorders, with irregular arytenoid cartilage movements (iACM) being observed in all patients, regardless of levodopa\u2010state.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The levodopa\u2010response in MSA\u2010related dysphagia varies greatly. Some patients might improve markedly, necessitating individual assessments to tailor patient\u2010specific therapies. Non\u2010pharmacological measures should be investigated to address dysphagia in MSA. IACM again proved to be highly prevalent in MSA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70355","type":"journal-article","created":{"date-parts":[[2025,9,13]],"date-time":"2025-09-13T03:03:31Z","timestamp":1757732611000},"page":"683-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Is Dysphagia in Multiple System Atrophy Responsive to Levodopa? Results from a Retrospective Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2874-9817","authenticated-orcid":false,"given":"Florin","family":"Gandor","sequence":"first","affiliation":[{"name":"Macquarie University Hospital, Department of Neurology Macquarie University, Faculty of Medicine, Health and Human Sciences  Sydney New South Wales Australia"},{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"},{"name":"Department of Neurology Otto\u2010von\u2010Guericke\u2010University  Magdeburg Germany"},{"name":"Department of Neurology St. Vincent's Hospital Sydney  Victoria Street 390 Darlinghurst 2010 New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luise","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"},{"name":"Department of Neurology Otto\u2010von\u2010Guericke\u2010University  Magdeburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"J\u00e4ger","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Demmin","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Gruber","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"},{"name":"Department of Neurology Otto\u2010von\u2010Guericke\u2010University  Magdeburg Germany"},{"name":"Medical Faculty Health and Medical University Potsdam  Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Schimming","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulina","family":"Thimm","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 Beelitz 14547 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-6987","authenticated-orcid":false,"given":"Georg","family":"Ebersbach","sequence":"additional","affiliation":[{"name":"Department of Neurology Movement Disorders Hospital, Kliniken Beelitz GmbH  Strasse nach Fichtenwalde 16 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