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Nicergoline for Neuromuscular Oropharyngeal Dysphagia: A Double-Blind, Placebo-Controlled Randomized Trial

In brief

Nicergoline lowers aspiration scores, improving airway safety in dysphagia trial

In a 4-week double-blind trial of 44 patients with neuromuscular oropharyngeal dysphagia, nicergoline 30 mg daily reduced penetration-aspiration scale scores compared with placebo, indicating better airway protection during swallowing. Subjective and endoscopic swallow scores did not differ, so the benefit appears limited to reducing aspiration risk, warranting larger studies to confirm clinical impact.

Journal
Dysphagia (Q1)
Published
16 September 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Pittayut Wongwarawanith, Phawin Keskool, Sunun Ongard, Sasalaksamon Chanachai, Jitima Jariyakhunphanya
PMID
42747485
DOI
10.1007/s00455-026-11003-9

Why clinicians should know about it

  • Picked for Gastroenterology (top studies of the week, 20 September 2026): Ranked by evidence level and journal quartile
  • Picked for Otorhinolaryngology (top studies of the week, 20 September 2026): Nicergoline improves airway protection in neuromuscular oropharyngeal dysphagia

Abstract

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 mg daily (n = 21) or matched placebo (n = 23) for 4 weeks. Baseline and week-4 visual analog scale scores, flexible endoscopic evaluation of swallowing scores, and penetration-aspiration scale ratings were compared within and between groups. Thirty-eight participants completed the study (nicergoline n = 19; placebo n = 19). 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-aspiration 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.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.