{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T09:09:00Z","timestamp":1789549740113,"version":"build-2803163510"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100013238","name":"Faculty of Medicine Siriraj Hospital, Mahidol University","doi-asserted-by":"publisher","award":["[IO] R016631065"],"award-info":[{"award-number":["[IO] R016631065"]}],"id":[{"id":"10.13039\/501100013238","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Dysphagia"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Neuromuscular oropharyngeal dysphagia impairs the coordinated neurologic and muscular mechanisms of deglutition, predisposing patients to aspiration pneumonia, malnutrition, and diminished quality of life. Substance P participates in the swallow reflex; nicergoline, an ergot derivative, increases substance P concentrations, yet its therapeutic effect on dysphagia remains uncertain. We conducted a double-blind, randomized, placebo-controlled trial to determine whether nicergoline improves swallow function, quantified by the visual analog scale and flexible endoscopic evaluation of swallowing. Forty-four patients with neuromuscular oropharyngeal dysphagia were randomized to receive nicergoline 30\u00a0mg daily (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200921) or matched placebo (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200923) for 4 weeks. Baseline and week-4 visual analog scale scores, flexible endoscopic evaluation of swallowing scores, and penetration\u2013aspiration scale ratings were compared within and between groups. Thirty-eight participants completed the study (nicergoline\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200919; placebo\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200919). Changes in visual analog scale and flexible endoscopic evaluation scores did not differ significantly between groups. However, nicergoline produced a statistically significant reduction in penetration\u2013aspiration scale score, indicating enhanced airway protection during swallowing. These data suggest that nicergoline augments swallow safety in neuromuscular oropharyngeal dysphagia and may offer a therapeutic option for its management.\n                  <\/jats:p>","DOI":"10.1007\/s00455-026-11003-9","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T08:51:24Z","timestamp":1789548684000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Nicergoline for Neuromuscular Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled Randomized Trial"],"prefix":"10.1007","author":[{"given":"Pittayut","family":"Wongwarawanith","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phawin","family":"Keskool","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunun","family":"Ongard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasalaksamon","family":"Chanachai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jitima","family":"Jariyakhunphanya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"issue":"1","key":"11003_CR1","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s42466-021-00122-3","volume":"3","author":"R Dziewas","year":"2021","unstructured":"Dziewas R, Allescher HD, Aroyo I, Bartolome G, Beilenhoff U, Bohlender J, et al. Diagnosis and treatment of neurogenic dysphagia - S1 guideline of the German Society of Neurology. Neurol Res Pract. 2021;3(1):23.","journal-title":"Neurol Res Pract"},{"issue":"9","key":"11003_CR2","doi-asserted-by":"publisher","first-page":"1970","DOI":"10.1016\/j.cgh.2019.10.029","volume":"18","author":"C Adkins","year":"2020","unstructured":"Adkins C, Takakura W, Spiegel BMR, Lu M, Vera-Llonch M, Williams J, et al. Prevalence and Characteristics of Dysphagia Based on a Population-Based Survey. Clin Gastroenterol Hepatol. 2020;18(9):1970. 9.e2.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"11003_CR3","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.2147\/NDT.S371624","volume":"18","author":"I Cheng","year":"2022","unstructured":"Cheng I, Hamad A, Sasegbon A, Hamdy S. Advances in the Treatment of Dysphagia in Neurological Disorders: A Review of Current Evidence and Future Considerations. Neuropsychiatr Dis Treat. 2022;18:2251\u201363.","journal-title":"Neuropsychiatr Dis Treat"},{"issue":"1","key":"11003_CR4","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/PL00009543","volume":"13","author":"I Perez","year":"1998","unstructured":"Perez I, Smithard DG, Davies H, Kalra L. Pharmacological treatment of dysphagia in stroke. Dysphagia. 1998;13(1):12\u20136.","journal-title":"Dysphagia"},{"key":"11003_CR5","doi-asserted-by":"publisher","first-page":"172601","DOI":"10.1016\/j.ejphar.2019.172601","volume":"861","author":"T Moriya","year":"2019","unstructured":"Moriya T, Nakayama K, Nakamura S, Mochizuki A, Ofuji T, Shirota T, et al. Enhancement of swallowing motor activity by the ACE inhibitor imidapril in an arterially perfused rat preparation. Eur J Pharmacol. 2019;861:172601.","journal-title":"Eur J Pharmacol"},{"issue":"02","key":"11003_CR6","doi-asserted-by":"publisher","first-page":"86","DOI":"10.4236\/ijcm.2013.42016","volume":"4","author":"Y Kishida","year":"2013","unstructured":"Kishida Y, Maeda N, Murawaki Y. Relationship between dysphagia and serum substance P level in chronic central nervous disease. Int J Clin Med. 2013;4(02):86\u201390.","journal-title":"Int J Clin Med"},{"key":"11003_CR7","unstructured":"Suthisisang C, Nicergoline M. University; 2020 [Available from: https:\/\/www.mims.com\/thailand\/news-updates\/topic\/update-pharmacology-of-nicergoline-th"},{"issue":"4","key":"11003_CR8","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1097\/MD.0b013e318224413b","volume":"90","author":"T Nakashima","year":"2011","unstructured":"Nakashima T, Hattori N, Okimoto M, Yanagida J, Kohno N. Nicergoline improves dysphagia by upregulating substance P in the elderly. Med (Baltim). 2011;90(4):279\u201383.","journal-title":"Med (Baltim)"},{"issue":"7","key":"11003_CR9","doi-asserted-by":"publisher","first-page":"e005090","DOI":"10.1136\/bmjopen-2014-005090","volume":"4","author":"M Fioravanti","year":"2014","unstructured":"Fioravanti M, Nakashima T, Xu J, Garg A. A systematic review and meta-analysis assessing adverse event profile and tolerability of nicergoline. BMJ Open. 2014;4(7):e005090.","journal-title":"BMJ Open"},{"key":"11003_CR10","doi-asserted-by":"publisher","first-page":"610103","DOI":"10.1155\/2014\/610103","volume":"2014","author":"B Saletu","year":"2014","unstructured":"Saletu B, Garg A, Shoeb A. Safety of nicergoline as an agent for management of cognitive function disorders. Biomed Res Int. 2014;2014:610103.","journal-title":"Biomed Res Int"},{"issue":"4","key":"11003_CR11","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.31557\/APJCP.2024.25.4.1451","volume":"25","author":"C Wasuthalainun","year":"2024","unstructured":"Wasuthalainun C, Keskool P, Petsuksiri J, Ongard S, Sureepong P. Sparing Swallowing-Related Structures Reduces Post-Radiotherapy Dysphagia in Oropharyngeal Cancer. Asian Pac J Cancer Prev. 2024;25(4):1451\u20136.","journal-title":"Asian Pac J Cancer Prev"},{"key":"11003_CR12","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1007\/s00455-022-10427-3","volume":"37","author":"LF Giraldo-Cadavid","year":"2022","unstructured":"Giraldo-Cadavid LF, Bastidas AR, Maldonado-Lancheros J, Gasca-Zuluaga DA, Aguilar-Farias MJ, Bohorquez-Tibavisco L. Pneumonia, Mortality, and Oher Outcomes Associatein Patientd with Unsafe Swallowing Detected via Fiberoptic Endoscopic Evaluation of Swallowing (FEES) in Patients with Functional Oropharyngeal Dysphagia: A Systematic Review and Meta-analysis. Dysphagia. 2022;37:1662\u201372.","journal-title":"Dysphagia"},{"issue":"3","key":"11003_CR13","doi-asserted-by":"publisher","first-page":"276","DOI":"10.4266\/acc.2021.01375","volume":"37","author":"MSA Elsyaad","year":"2022","unstructured":"Elsyaad MSA, Fayed AM, Megahed M, Hamouda NH, Elmenshawy AM. Early assessment of aspiration risk in acute stroke by fiberoptic endoscopy in critically ill patients. 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