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Article History

Received: 9 December 2025

Accepted: 15 February 2026

First Online: 18 March 2026

Declarations

:

: The study design was approved by the Ethics Committee of the University Hospital Düsseldorf (2022–2121).

: Not applicable.

: GM: has received travel grants from the German Neurological Society (DGN) and AbbVie, and honoraria for lectures from Medtronic and bsh medical communications GmbH. LM: has received honoraria for lecturing, consulting, and travel expenses for attending meetings from Biogen, Merck, Sanofi, ArgenX, Roche, Alexion, and Novartis, His research is funded by the German Multiple Sclerosis Foundation (DMSG) and the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—493659010. RD: is a former advisory board member of Phagenesis Ltd, and he serves as president for the European Society for Swallowing Disorders (ESSD) and chairman of the German Dysphagia Society (DGD) (unpaid). MP: received honoraria for lecturing and travel expenses for attending meetings from Alexion, ArgenX, Bayer Health Care, Biogen, Hexal, Merck Serono, Novartis, Roche, Sanofi-Aventis, Takeda and Teva. His research is funded by ArgenX, Biogen, Demecan, Hexal, Horizon Merck Serono, Novartis, Roche, Viatris, Takeda and Teva, all outside the scope of this work. His research is funded by the by the German Multiple Sclerosis Foundation (DMSG), the B.Braun Foundation and the German Alzheimer Society. JH: has received a scholarship from the German National Academic Foundation. SL: has received honoraria and travel grants for lectures and conferences from the German Society for Clinical Neurophysiology and Functional Imaging (DGKN), Phagenesis Ltd, the United European Gastroenterology (UEG), the German Stroke Society (DSG), argenx, AbbVie, and Merck, and serves as a consultant for Phagenesis Ltd. AJ: has received a travel grant for a conference from the German Society for Dysphagia (DGD) and honoraria for lectures from the German Society for Clinical Neurophysiology and Functional Imaging (DGKN) and Phagenesis Ltd. PM: has received honoraria for lectures from Nestle Health Science, Phagenesis Ltd and Alexion Pharma. SSK: is supported with an endowed professorship from the Else Kröner-Fresenius Foundation, has received honoraria from Phagenesis Ltd and served as congress president 2024 of the European Society of Swallowing Disorders (ESSD) (unpaid). TW: has received support for scientific projects from AbbVie, EVER Pharma, Clexio Bioscience Ltd, has received consulting fees from Desitin, BIAL, Stadapharm, Phagenesis, Merz, has received honoraria for lectures from BIAL, AbbVie, Desitin, Zambon. Pfizer, Britannia, Esteve and Merz. SGM: has received funding for research-projects from the German Ministry for Education and Research (BMBF), German Federal Institute for Risk Assessment (BfR), German Research Foundation (DFG), Else Kröner-Fresenius Foundation, Gemeinsamer Bundesausschuss (G-BA), German Academic Exchange Service, Hertie Foundation, Interdisciplinary Center for Clinical Studies (IZKF) Muenster, German Foundation Neurology, Ministry of Culture and Science of the State of North Rhine-Westphalia, the Daimler and Benz Foundation, Multiple Sclerosis Society North Rhine-Westphalia Regional Association (dmsg), Peek & Cloppenburg Düsseldorf Foundation, Hempel Foundation for Science, Art and Welfare, German Alzheimer Society e.V. Dementia self-help and Alexion, Almirall, Amicus Therapeutics Germany, Argenx, Bayer Vital GmbH, BGP Products Operations (Viatris Company), Biogen, BMS, Demecan, Diamed, DGM e.v., Fresenius Medical Care, Genzyme, Gesellschaft von Freunden und Förderern der Heinrich-Heine-Universität Düsseldorf e.V., HERZ Burgdorf, Hexal, Janssen, Merck Serono, Novartis, Novo Nordisk Pharma, ONO Pharma, Roche and Teva, has received honoraria for lecturing, travel expenses and for attending meetings from Academy 2, Argenx, Alexion, Almirall, Amicus Therapeutics Germany, AstraZeneca, Bayer Health Care, Biogen, BioNtech, BMS, Celgene, Datamed, Demecan, Desitin, Diamed, Diaplan, DIU Dresden, DPmed, Gen Medicine and Healthcare products, Genzyme, Hexal AG, IGES, Impulze GmbH, Janssen Cilag, KW Medipoint, MedDay Pharmaceuticals, Medmile, Merck Serono, MICE, Mylan, Neuraxpharm, Neuropoint, Novartis, Novo Nordisk, ONO Pharma, Oxford PharmaGenesis, QuintilesIMS, Roche, Sanofi, Springer Medizin Verlag, STADA, Chugai Pharma, Teva, UCB, Viatris, Wings for Life international and Xcenda. BL: has received research funding from the German Research Foundation (DFG), Clexio Bioscience Ltd, the Medical Faculty of the University of Münster, the Gesellschaft von Freunden und Förderern der Heinrich-Heine-Universität Düsseldorf e.V (GFFU), has received scientific prizes from the German Geriatric Society (DGG) in conjunction with the Rolf and Hubertine Schiffbauer Foundation and the German Neurological Society (DGN), has received honoraria and/or travel grants for lectures and conferences from the German Society for Clinical Neurophysiology and Functional Imaging (DGKN), the European Stroke Organization (ESO), the Society for Clinical Nutrition and Metabolism (ESPEN), Phagenesis Ltd, the German Society for Neurology (DGN), the European Society for Swallowing Disorders (ESSD), the United European Gastroenterology (UEG), the University of Strasbourg, the German Society for Muscular Dystrophy (DGM), the German Society for Nutritional Medicine (DGEM), the German Society for Internal Medicine (DGIM), the German Stroke Society (DSG), the University of Zurich, the Confederation of European Otorhinolaryngology - Head and Neck Surgery (CEORL-HNS), CONGRES ORPHEO, the Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Novartis, and Danone.