{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:06:56Z","timestamp":1786115216790,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aspiration pneumonia is the leading cause of morbidity and mortality in oculopharyngeal muscular dystrophy (OPMD), yet non\u2010muscular contributors to aspiration risk are poorly defined. Thick saliva is frequently reported but has never been quantitatively characterised.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The primary objective was to compare salivary kinematic viscosity in genetically confirmed patients vs. household controls. Secondary hypothesis\u2010generating exploratory objectives were to examine associations between viscosity, dysphagia severity, and aspiration risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this observational, cross\u2010sectional study, we compared genetically confirmed OPMD patients with matched household controls. Salivary kinematic viscosity was the primary outcome. Exploratory assessments examined associations between viscosity and validated dysphagia measures (Swallowing Disturbance Questionnaire, Penetration\u2013Aspiration Scale, Functional Oral Intake Scale) and oral health (number of decayed, missing, and filled teeth).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 57 participants (30 OPMD, 27 controls), salivary viscosity was higher in patients (difference 0.85 cSt; 95% CI 0.27\u20131.44;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007) and remained independently associated with the disease status after adjustment for age, oral health, and \u201cxerogenic\u201d medications. Higher viscosity was independently associated with higher aspiration risk (adjusted OR 2.5 per 1 cSt; 95% CI 1.1\u20136.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040), and discriminated patients with high risk for aspiration (Area Under the Curve of 0.76 and a positive likelihood ratio of 10.0). Salivary flow rates were preserved, indicating a compositional rather than hyposecretory rheological shift.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Oculopharyngeal muscular dystrophy is associated with a flow\u2010independent shift in salivary rheology quantitatively linked to dysphagia severity and aspiration risk. These cross\u2010sectional findings nominate salivary viscosity as a non\u2010invasive candidate biomarker warranting prospective validation for clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joor.70285","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T01:15:29Z","timestamp":1785978929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Salivary Viscosity as a Non\u2010Invasive Candidate Biomarker Associated With Aspiration Risk in Oculopharyngeal Muscular Dystrophy"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1271-8618","authenticated-orcid":false,"given":"Alex","family":"Zvulunov","sequence":"first","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"},{"name":"Rekanati School of Medicine, Reichman University  Herzliya Israel"},{"name":"The Non\u2010Profit Organization for Promotion of Health and Cure of OPMD  Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rawan","family":"Saif","sequence":"additional","affiliation":[{"name":"Oral Medicine Unit The Sheba Medical Center  Tel\u2010Hashomer Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liraz","family":"Olmer","sequence":"additional","affiliation":[{"name":"Biostatistics&amp; Biomathematics Unit, Data &amp; Analytics Division Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merav","family":"Ben\u2010David","sequence":"additional","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"},{"name":"Gray Faculty of Medicine &amp; Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limor","family":"Benyamini","sequence":"additional","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Otolaryngology, Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Dori","sequence":"additional","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Department of Neurology Sheba Medical Center  Tel Hashomer Israel"},{"name":"Gray Faculty of Medicine &amp; Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9771-7857","authenticated-orcid":false,"given":"Noam","family":"Yarom","sequence":"additional","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Oral Medicine Unit The Sheba Medical Center  Tel\u2010Hashomer Ramat Gan Israel"},{"name":"The Goldschleger School of Dental Medicine Gray Faculty of Medical and Health Sciences, Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6176-0941","authenticated-orcid":false,"given":"Lior","family":"Greenbaum","sequence":"additional","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Gray Faculty of Medicine &amp; Health Sciences, Tel Aviv University  Tel Aviv Israel"},{"name":"The Danek Gertner Institute of Human Genetics Sheba Medical Center  Tel Hashomer Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ephraim","family":"Tzur","sequence":"additional","affiliation":[{"name":"The Non\u2010Profit Organization for Promotion of Health and Cure of OPMD  Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvina","family":"Friedlander\u2010Barenboim","sequence":"additional","affiliation":[{"name":"The National Specialized Multidisciplinary Service for OPMD Patients Sheba Medical Center  Tel Hashomer Israel"},{"name":"Oral Medicine Unit The Sheba Medical Center  Tel\u2010Hashomer Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26888"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2023.09.010"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/febs.12294"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6255-y"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND-200507"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-026-04313-6"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-79875-x"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-022-05620-1"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40268-016-0153-9"},{"key":"e_1_2_11_11_1","first-page":"2988","article-title":"Kinematic Viscosity of Unstimulated Whole Saliva in Healthy Young Adults","volume":"18","author":"Foglio\u2010Bonda A.","year":"2014","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034518816961"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345970760111001"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0722.2001.00016.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21839"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00417897"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2004.11.049"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-021-10292-6"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.2527\/1998.763847x"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2015.03.004"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2024.105282"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11102280"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910708600316"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.colsurfb.2009.06.010"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21625"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/159476"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2015.07.021"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345211004842"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0135792"},{"key":"e_1_2_11_30_1","first-page":"19","article-title":"Rheology of Saliva in Health and Disease","volume":"59","author":"Rereddy S. 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