Association between Location of Brain Lesion and Clinical Factors and Findings of Videofluoroscopic Swallowing Study in Subacute Stroke Patients

Jeon, Woo Hyun; Park, Gun Woong; Lee, Jae Hyun; Jeong, Ho Joong; Sim, Young Joo

doi:10.12786/bn.2014.7.1.54

Cited by 16 publications

(18 citation statements)

References 18 publications

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“…Furthermore, people who could not obey single commands had more aspiration of liquids than those who could follow the instructions (OR = 1.566, 95% CI = 1.307‐1.876); this was also true for puree (OR = 1.484, 95% CI = 1.202‐1.831) . One research with patients with subacute stroke (at least 59 days post‐stroke) revealed that cognition did not correlate with dysphagia …”

Section: Discussionmentioning

confidence: 99%

The mediator effect of cognition on the relationship between brain lesion location and dysphagia in patients with stroke: Applying a structural equation model

Dehaghani

Yadegari

Asgari

et al. 2018

J of Oral Rehabilitation

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Summary Background Cognitive status is important for performing the assessment and treatment of dysphagia. Nonetheless, the cognitive neuropsychological profile of patients with stroke and dysphagia is not studied as deeply enough as it should be. On the one hand, focal and non‐focal brain lesions may lead to dysphagia and cognitive disorders, and on the other hand, the cognitive status possibly affects swallowing. In this study, cognition is supposed to be a mediator between brain lesion and swallowing disorder (dysphagia). The role of cognition and attention as mediators between brain lesion and dysphagia was evaluated via three causal models in which the causal mechanisms of swallowing were explained. Methods Eighty‐eight patients with their first stroke (34 women and 54 men) in the acute phase (mean: 3.5 days after stroke; SD: 2.7) participated in this research. The data of dysphagic and non‐dysphagic patients were entered into structural equation models. Two relationships were estimated: a direct relationship between brain lesion and dysphagia and an indirect association between brain lesion and dysphagia through cognition and attention. Results The goodness‐of‐fit indices confirmed the three models. Our first model proved a good fit [CFI = 1.00; TLI = 1.00]. The second model revealed an appropriate goodness of fit [CFI = 1.00; TLI = 1.00]. Our third model also showed a good fit [CFI = 1.00; TLI = 1.00]. Conclusion It is suggested that in the assessment and treatment of dysphagia, cognition is better to be considered as a mediator along with physical aspects of dysphagia.

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Section: Discussionmentioning

confidence: 99%

The mediator effect of cognition on the relationship between brain lesion location and dysphagia in patients with stroke: Applying a structural equation model

Dehaghani

Yadegari

Asgari

et al. 2018

J of Oral Rehabilitation

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“…infratentorial, supratentorial, cortical, subcortical, bulbar) (e.g. Cola et al, 2010; Jeon et al, 2014; Moon et al, 2012), limiting the precision and sensitivity of lesion location. Moreover, studies have focused primarily on the occurrence of (oral or pharyngeal) dysphagia in general, symptoms like aspiration or residue, and have mainly applied clinical bedside or fiberendoscopic assessments (Daniels et al, 2017; Flowers et al, 2017; Galovic et al, 2013, Galovic et al, 2016; Gonzalez-Fernandez et al, 2008; Schmahmann et al, 2004; Steinhagen et al, 2009; Suntrup-Krueger et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Mapping acute lesion locations to physiological swallow impairments after stroke

Wilmskoetter

Bonilha

Martin‐Harris

et al. 2019

NeuroImage: Clinical

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Dysphagia is a common deficit after a stroke, and it is frequently associated with pneumonia, malnutrition, dehydration, and poor quality of life. It is not yet fully clear which brain regions are directly related to swallowing, and how lesions affect swallow physiology. This study aimed to assess the statistical relationship between acute stroke lesion locations and impairment of specific aspects of swallow physiology. We performed lesion symptom mapping with 68 retrospectively recruited, acute, first-ever ischemic stroke patients. Lesions were determined on diffusion weighted MRI scans. Post-stroke swallow physiology was determined using the Modified Barium Swallow Study Impairment Profile (MBSImP©™). The relationship between brain lesion location and 17 physiological aspects of swallowing were tested using voxel-based and region-based statistical associations corrected for multiple comparisons using permutation thresholding. We found that laryngeal elevation, anterior hyoid excursion, laryngeal vestibular closure, and pharyngeal residue were associated with lesioned voxels or regions of interests. All components showed distinct and overlapping lesion locations, mostly in the right hemisphere, and including cortical regions (inferior frontal gyrus, pre- and postcentral gyrus, supramarginal gyrus, angular gyrus, superior temporal gyrus, insula), subcortical regions (thalamus, amygdala) and white matter tracts (superior longitudinal fasciculus, corona radiata, internal capsule, external capsule, ansa lenticularis, lenticular fasciculus). Our findings indicate that different aspects of post-stroke swallow physiology are associated with distinct lesion locations, primarily in the right hemisphere, and primarily including sensory-motor integration areas and their corresponding white matter tracts. Future studies are needed to expand on our findings and thus, support the development of a neuroanatomical model of post-stroke swallow physiology and treatment approaches targeting the neurophysiological underpinnings of swallowing post stroke.

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“…Besides, there have been limitations in the study presented here, since the groups have not been analyzed regarding the topography of the brain lesion but only regarding its laterality. Moreover, some studies that related the topography of the brain lesion with the prevalence of dysphagia have found some correlation between the laterality of the brain lesion and the findings found in the different stages of swallowing (28,29) .…”

Section: Discussionmentioning

confidence: 99%

Tempo de trânsito oral e lateralidade da lesão cerebral no acidente vascular encefálico

Alves

Santos

Cola

et al. 2017

Audiol., Commun. Res.

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Introduction:The oropharyngeal transit time changes according to several variables. Purpose: To compare the total oral transit time (TOTT) and laterality of brain lesion in the individual after stroke with oropharyngeal dysphagia. Methods: Analyzed 61 videofluoroscopic swallowing studies of individuals after unilateral cortical ischemic stroke. Participants were divided into two groups. Group 1 (G1) consisted of 30 individuals with right-side cortical lesion and group 2 (G2) of 31 individuals with left-side cortical lesion. Quantitative analysis of the TOTT was performed by two judges trained in the procedure by means of specific software and an analysis of the reliability between judges was performed. The Mann-Whitney test was used for the data analysis. Results: It was found TTOT longer than 2000 ms in 50% of the G1 and in 94% of the individuals of G2 with a significant statistical difference between the groups (p<0.01). In the comparison between G1 and G2 regarding TOTT, it was verified that there was significant statistical difference (p=0.001). However, there was no significant statistical difference in the comparison between G1 and G2 for both TOTT shorter than 2000 ms (p=1.000) and TOTT longer than 2000 ms (p=0.603). However, it was found that in G2 the TOTT average is longer than 2000 ms and was greater than in G1. Conclusion: There were TOTT shorter and longer than 2000 ms in both hemispheric cortical lesion. The frequency of individuals with TTOT are longer than 2000 ms and the average are greater in the left-side cortical lesion in stroke.

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Association between Location of Brain Lesion and Clinical Factors and Findings of Videofluoroscopic Swallowing Study in Subacute Stroke Patients

Cited by 16 publications

References 18 publications

The mediator effect of cognition on the relationship between brain lesion location and dysphagia in patients with stroke: Applying a structural equation model

The mediator effect of cognition on the relationship between brain lesion location and dysphagia in patients with stroke: Applying a structural equation model

Mapping acute lesion locations to physiological swallow impairments after stroke

Tempo de trânsito oral e lateralidade da lesão cerebral no acidente vascular encefálico

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