{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:45:24Z","timestamp":1789541124405,"version":"build-2803163510"},"reference-count":58,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JND"],"published-print":{"date-parts":[[2023,3,7]]},"abstract":"<jats:p>Background: Novel Spinal Muscular Atrophy (SMA) treatments have demonstrated improvements on motor measures that are clearly distinct from the natural history of progressive decline. Comparable measures are needed to monitor bulbar function, which is affected in severe SMA. Objective: To assess bulbar function with patient-reported outcome measures (PROs) and determine their relationships with clinical characteristics. Methods: We recruited 47 non-ambulatory participants (mean (SD) age\u200a=\u200a29.8 (13.7) years, range\u200a=\u200a10.3\u201373.2) with SMA. PROs including Voice Handicap Index (VHI) and Eating Assessment Tool-10 (EAT-10) were collected alongside clinical characteristics and standardized motor assessments. Associations were assessed using Spearman correlation coefficients and group comparisons were performed using Wilcoxon rank sum tests. Results: A majority of the 47 participants were SMA type 2 (70.2%), non-sitters (78.7%), 3 copies of SMN2 (77.5%), and using respiratory support (66.0%). A majority (94%) reported voice issues primarily in 8\/30 VHI questions. Problems included: difficulty understanding me in a noisy room (87.2%); difficult for people to hear me (74.5%); and people ask me to repeat when speaking face-to-face (72.3%). A majority (85.1%) reported swallowing issues primarily in 3\/10 EAT-10 questions: swallowing pills (68.1%); food sticks to my throat (66.0%); and swallowing solids (61.7%). The two PROs were moderately associated (rs\u200a=\u200a0.66). Conclusions: Weaker individuals with SMA experience bulbar problems including difficulties with voice and swallowing. Further refinement and assessment of functional bulbar scales will help determine their relevance and responsiveness to changes in SMA. Additional study is needed to quantify bulbar changes caused by SMA and their response to disease-modifying treatments.<\/jats:p>","DOI":"10.3233\/jnd-221573","type":"journal-article","created":{"date-parts":[[2023,2,7]],"date-time":"2023-02-07T11:33:38Z","timestamp":1675769618000},"page":"199-209","source":"Crossref","is-referenced-by-count":19,"title":["Assessing Bulbar Function in Spinal Muscular Atrophy Using Patient-Reported Outcomes"],"prefix":"10.1177","volume":"10","author":[{"given":"Sally","family":"Dunaway Young","sequence":"first","affiliation":[{"name":"Department of Neurology and Clinical Neurosciences, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Department of Physical Therapy and Occupational Therapy, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurosciences, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katlyn E.","family":"McGrattan","sequence":"additional","affiliation":[{"name":"Department of Speech-Language-Hearing Sciences, University of Minnesota, Minneapolis, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Stranberg","sequence":"additional","affiliation":[{"name":"Outpatient Neurologic Rehabilitation Program, Stanford Health Care, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Maczek","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Department of Physical Therapy and Occupational Therapy, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"Dias","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Department of Physical Therapy and Occupational Therapy, Boston Children\u2019s Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Whitney","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurosciences, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurosciences, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa","family":"Rohan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Wolford","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Neurosciences, Stanford University, Palo Alto, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Rochester, Rochester, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael 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