Effects of stroke‐induced damage to swallow‐related areas in the brain on swallowing mechanics of elderly patients

Warabi, Tateo; Ito, Takuya; Κato, Masamichi; Takei, Hidetoshi; Kobayashi, Nozomu; Chiba, Susumu

doi:10.1111/j.1447-0594.2008.00473.x

Cited by 9 publications

(7 citation statements)

References 27 publications

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“…Patients with stroke have a reported frequency of dysphagia in recent studies, ranging from approximately 50–80% [7]. Mechanics of swallowing dysfunction included reduced hyoid excursion, reduced tongue base retraction, and reduced pharyngeal shortening [8–10]. Many studies have found that dysphagia is association with subtype and severity of stroke [11].…”

Section: Discussionmentioning

confidence: 99%

Risk scores for predicting dysphagia in critically ill patients after cardiac surgery

et al. 2019

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BackgroundThis study aimed at developing and validating a scoring model to stratify critically ill patients after cardiac surgery based on risk for dysphagia, a common but often neglected complication.MethodsData were prospectively collected and analyzed from January 2016 to June 2017 from 395 consecutive post cardiac surgery patients at the cardiac care unit (CCU) at a single center; 103 (26.1%) developed dysphagia. Univariate and multivariate logistic analyses were used to identify independent predictors for dysphagia. The survival nomogram was developed on the basis of a multivariable Cox model, which allowed us to obtain survival probability estimations. The predictive performance of the nomogram was verified for discrimination and calibration. Areas under receiver operating characteristic curve analysis were used to illustrate and evaluate the diagnostic performance of the novel model.ResultsThe final novel scoring model, named SSG-OD, consists of three independent factors: gastric intubation (OR = 1.024, 95% CI 1.015–1.033), sedative drug use duration (OR = 1.031, 95% CI 1.001–1.063) and stroke or not (OR = 6.182, 95% CI 3.028–12.617). SSG-OD identified patients at risk for dysphagia with sensitivity of 68.5% and specificity of 89.0% (OR = 0.833, 95% CI: 0.782–0.884). The positive and negative likelihood ratios were 6.22 and 0.35.ConclusionsThe novel SSG-OD scoring system to risk stratify CCU patients for dysphagia is an easy-to-use bedside prognostication aid with good predictive performance and the potential to reduce aspiration incidence and accelerate recovery.

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Section: Discussionmentioning

confidence: 99%

Risk scores for predicting dysphagia in critically ill patients after cardiac surgery

et al. 2019

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“…Current literature of the functional changes in stroke related dysphagia emphasizes delays in timing [6–8], aspiration risk associated with timing [9–11], and related sensorineural deficits [12–14] with mechanistic deficits receiving less attention. Reports suggest differences in hyoid and laryngeal displacement but are mixed (Table 1) [11, 15–18].…”

Section: Introductionmentioning

confidence: 99%

Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke

May

Pisegna

Marchina

et al. 2017

Journal of Stroke and Cerebrovascular Diseases

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Goals Computational Analysis of Swallowing Mechanics is a method that utilizes multivariate shape change analysis to uncover covariant elements of pharyngeal swallowing mechanics associated with impairment using videofluoroscopic swallowing studies. The goals of this preliminary study were to (1) characterize swallowing mechanics underlying stroke related dysphagia, (2) decipher the impact of left and right hemispheric stroke on pharyngeal swallowing mechanics, and (3) determine pharyngeal swallowing mechanics associated with penetration-aspiration status. Materials and Methods Videofluoroscopic swallowing studies of 18 dysphagic patients with hemispheric infarcts and age and gender matched controls were selected from well-controlled data sets. Patient data including laterality, and penetration-aspiration status was collected. Coordinates mapping muscle group action during swallowing were collected from videos. Multivariate morphometric analyses of coordinates associated with stroke, affected hemisphere, and penetration-aspiration status were performed. Findings Pharyngeal swallowing mechanics differed significantly in the following comparisons: stroke vs. controls (D=2.19, p<.0001); right hemispheric stroke vs. controls (D=3.64, p<.0001); left hemispheric stroke vs. controls (D=2.06, p<.0001); right hemispheric stroke vs. left hemispheric stroke (D=2.89, p<.0001); and penetration-aspiration vs. within normal limits (D=2.25, p<.0001). Differences in pharyngeal swallowing mechanics associated with each comparison were visualized using eigenvectors. Conclusion While current literature focuses on timing changes in stroke-related dysphagia, this data suggests that mechanical changes are also functionally important. Pharyngeal swallowing mechanics differed by affected hemisphere and penetration-aspiration status. Computational Analysis of Swallowing Mechanics can be used to identify patient specific swallowing impairment associated with stroke injury that could help guide rehabilitation strategies to improve swallowing outcomes.

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“…1994; Abraham and Yun 2002; Warabi et al. 2008; Terré and Mearin 2012). Pharyngeal swallow delay frequently results in aspiration of thin liquids and potentially pneumonia (Morton et al.…”

Section: Introductionmentioning

confidence: 99%

“…2007; Warabi et al. 2008). Stroke patients with dysphagia have been shown to demonstrate significant sensory deficits in the laryngopharynx that likely contribute to the development of aspiration (Aviv et al.…”

Section: Introductionmentioning

confidence: 99%

“…Pharyngeal swallow delay is one of the most common and significant oropharyngeal swallowing disorders, presenting in high frequency in patients with dysphagia resulting from neurologic disorders such as stroke and Parkinson's disease and those with treatment for head and neck cancers (Logemann and Bytell 1979;Veis and related to a sensory disorder in which the cortex and brainstem take longer to recognize sensory input regarding the need to swallow and to trigger the pharyngeal stage of swallow (Power et al 2007;Warabi et al 2008). Stroke patients with dysphagia have been shown to demonstrate significant sensory deficits in the laryngopharynx that likely contribute to the development of aspiration (Aviv et al 1996(Aviv et al , 1997Dziewas et al 2004).…”

Section: Introductionmentioning

confidence: 99%

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Orosensory contributions to dysphagia: a link between perception of sweet and sour taste and pharyngeal delay time

Pauloski

Nasir

2016

Physiol Rep

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Pharyngeal delay is a significant swallowing disorder often resulting in aspiration. It is suspected that pharyngeal delay originates from sensory impairment, but a direct demonstration of a link between oral sensation and pharyngeal delay is lacking. In this study involving six patients with complaints of dysphagia, taste sensation of the oral tongue was measured and subsequently related to swallowing kinematics. It was found that a response bias for sour taste was significantly correlated with pharyngeal delay time on paste, highlighting oral sensory contributions to swallow motor dysfunctions. Investigating the precise nature of such a link between oral sensation and dysphagia would constitute a basis for understanding the disorder. The results of this study highlight oral sensory contributions to pharyngeal swallow events and provide impetus to examine this link in larger samples of dysphagic patients.

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Effects of stroke‐induced damage to swallow‐related areas in the brain on swallowing mechanics of elderly patients

Cited by 9 publications

References 27 publications

Risk scores for predicting dysphagia in critically ill patients after cardiac surgery

Risk scores for predicting dysphagia in critically ill patients after cardiac surgery

Pharyngeal Swallowing Mechanics Secondary to Hemispheric Stroke

Orosensory contributions to dysphagia: a link between perception of sweet and sour taste and pharyngeal delay time

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