Voxel-based lesion symptom mapping analysis for dysphagia in stroke patients with isolated cerebellar lesions

Moon, Hyun Im; Jeong, Yoon Jeong; Suh, Jeung Keun

doi:10.1007/s00702-021-02438-5

Cited by 9 publications

(16 citation statements)

References 50 publications

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“…The median sample size was 95 (ranging from 20 to 342). Thirteen of the included studies were supratentorial strokes [ 11 , 12 , 13 , 17 , 25 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], one infratentorial stroke [ 36 ], and seven both the supratentorial and infratentorial strokes [ 16 , 37 , 38 , 39 , 40 , 41 , 42 ]. Besides, subjects of sixteen studies were in acute phase of stroke [ 11 , 12 , 13 , 14 , 16 , 17 , 25 , 29 , 34 , 35 , 38 , 39 , 41 , 42 , 43 , 44 ], one was in subacute phase of stroke [ 30 ], and one was in chronic phase of stroke [ 28 ], while the stroke phases of the remaining six studies were unclear ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The swallowing assessment tools included the Water Swallowing Test (WST) [ 11 , 43 ], Videofluoroscopic Swallowing Study (VFSS) (taking up 37.5% of included studies) [ 12 , 24 , 28 , 30 , 31 , 36 , 38 , 39 , 40 ], Volume-viscosity Swallow Test (V-VST) (4.2%) [ 43 ], Fiberoptic Endoscopic Evaluation of Swallowing (FEES) (12.5%) [ 29 , 42 , 44 ], MBS impairment tool (MBSImP) (4.2%) [ 13 ], Standardized Clinical Assessment Tool (4.2%) [ 25 ], and Bogenhausen Dysphagia Score Part 2 (BDS-2) (4.2%) [ 35 ]. A total of thirteen articles described the days to the evaluation of PSD (ranging from 24 h to 4 weeks; Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The MRI was used for the diagnosis of stroke in the 24 articles, in which four articles reported using DWI scans [ 13 , 34 , 35 , 43 ], two articles adopted DTI scans [ 30 , 43 ], three articles used flair scans [ 34 , 38 , 40 ], and the remaining twelve articles did not report the scanning sequence. Of all the articles, eight articles adopted VLSM in the assessment of stroke-related brain regions [ 11 , 13 , 17 , 28 , 35 , 36 , 37 , 43 ], and eight described the days to evaluation of lesion sites after stroke (ranging from 24 h to 14 days; Table 1 ) [ 14 , 16 , 17 , 24 , 34 , 38 , 43 , 44 ].…”

Section: Resultsmentioning

confidence: 99%

“… Study Number of Patients PSD vs. No PSD Male vs. Female Ischemic vs. Hemorrhagic Right vs. Left Infratentorial vs. Supratentorial Hess 2021 [ 11 ] n = 132 84/48 48/36 NA 36/48 10/74 Zhang 2021 [ 43 ] n = 275 113/162 75/38 NA 52/43 NA Galovic 2017 [ 17 ] n = 62 NA NA NA NA NA Moon 2018 [ 37 ] n = 90 90/0 57/33 64/26 50/35 16/74 Moon 2022 [ 36 ] n = 40 NA NA NA NA NA ...…”

Section: Resultsmentioning

confidence: 99%

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Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis

Qiao

Cheng

et al. 2022

Brain Sciences

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Objective: To investigate the relationship of lobar and deep brain regions with post-stroke dysphagia (PSD). Method: The databases of Medline, Embase, Web of Science, and Cochrane Library were searched from the establishment to May 2022. Studies that investigated the effects of lesions in lobar and deep brain regions on swallowing function after stroke were screened. The primary outcomes were PSD-related brain regions (including aspiration-related and oral transit time-related brain regions). The secondary outcomes were the incidence rate of PSD. The brain regions with the most overlap in the included studies were considered to be most relevant to PSD, and were presented as percentages. Data were compared utilizing the t-tests for continuous variables and χ2 for frequency-based variables. Result: A total of 24 studies and 2306 patients were included. The PSD-related lobar and deep brain regions included the insular cortex, frontal lobe, temporal gyrus, basal ganglia, postcentral, precentral, precuneus, corona radiate, etc. Among these brain regions, the insular cortex was most frequently reported (taking up 54.2%) in the included studies. Furthermore, the total incidence rate of PSD was around 40.4%, and the incidence of male was nearly 2.57 times as much as that of female (χ2 = 196.17, p < 0.001). Conclusions: In lobar and deep brain regions, the insular cortex may be most relevant to PSD and aspiration, which may be a potentially promising target in the treatment of PSD.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis

Qiao

Cheng

et al. 2022

Brain Sciences

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“…In addition, the findings of Suntrup et al (2015) and Jang et al (2017) showed that the degree of dysphagia lesions was more correlated with lesions in the right cerebral hemisphere. In terms of two ROI studies, Moon et al (2022) reported lesion localization analysis of dysphagia after isolated cerebellar stroke and found that the severity of dysphagia was associated with lesions in the left posterior lobe of the cerebellum and that the lesions were more extensive on the left side. Galovic et al (2013) reported 11 swallowing-related ROIs and found that insular cortex was significantly associated with the risk of post-stroke aspiration.…”

Section: Studies Not Included In the Structural Mri Ale Analysismentioning

confidence: 99%

Neural basis of dysphagia in stroke: A systematic review and meta-analysis

Yin

Tang

et al. 2023

Front. Hum. Neurosci.

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ObjectivesDysphagia is a major cause of stroke infection and death, and identification of structural and functional brain area changes associated with post-stroke dysphagia (PSD) can help in early screening and clinical intervention. Studies on PSD have reported numerous structural lesions and functional abnormalities in brain regions, and a systematic review is lacking. We aimed to integrate several neuroimaging studies to summarize the empirical evidence of neurological changes leading to PSD.MethodsWe conducted a systematic review of studies that used structural neuroimaging and functional neuroimaging approaches to explore structural and functional brain regions associated with swallowing after stroke, with additional evidence using a live activation likelihood estimation (ALE) approach.ResultsA total of 35 studies were included, including 20 studies with structural neuroimaging analysis, 14 studies with functional neuroimaging analysis and one study reporting results for both. The overall results suggest that structural lesions and functional abnormalities in the sensorimotor cortex, insula, cerebellum, cingulate gyrus, thalamus, basal ganglia, and associated white matter connections in individuals with stroke may contribute to dysphagia, and the ALE analysis provides additional evidence for structural lesions in the right lentiform nucleus and right thalamus and functional abnormalities in the left thalamus.ConclusionOur findings suggest that PSD is associated with neurological changes in brain regions such as sensorimotor cortex, insula, cerebellum, cingulate gyrus, thalamus, basal ganglia, and associated white matter connections. Adequate understanding of the mechanisms of neural changes in the post-stroke swallowing network may assist in clinical diagnosis and provide ideas for the development of new interventions in clinical practice.

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Clinical Features and Voxel-Based-Symptom-Lesion Mapping of Silent Aspiration in Acute Infratentorial Stroke

et al. 2023

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Post-stroke dysphagia (PSD) is a severe and common complication after ischemic stroke. The role of silent aspiration as an important contributing factor in the development of a dysphagia-associated complications, in particular aspiration-associated pneumonia has been insufficiently understood. The aim of this study was to investigate the characteristics and risk factors of silent aspiration in patients with acute infratentorial stroke by FEES and to identify culprit lesions in stroke patient with a high risk of silent aspiration via voxel-based-symptom-lesion mapping (VBS/ML). This study is a retrospective observational study based on a prospectively collected FEES and stroke database. Consecutive patient cases with acute ischemic infratentorial stroke and FEES examination between 2017 and 2022 were identified. Group allocation was performed based on PAS scores. Imaging analysis was performed by manual assignment and by VBS/ML. Group comparisons were performed to assess silent aspiration characteristics. Binary logistic regression analysis was performed to determine if baseline clinical, demographic, and imaging parameters were helpful in predicting silent aspiration in patients. In this study 84 patient cases with acute infratentorial stroke who underwent FEES examination were included. Patients were moderately affected at admission (mean NIH-SS score at admission 5.7 SD ± 4.7). Most lesions were found pontine. Overall 40.5% of patients suffered from silent aspiration, most frequently in case of bilateral lesions. Patients with silent aspiration had higher NIH-SS scores at admission (p < 0.05), had a more severe swallowing disorder (p < 0.05) and were 4.7 times more likely to develop post-stroke pneumonia. Patients who underwent FEES examination later than 72 h after symptom onset were significantly more likely to suffer from silent aspiration and to develop pneumonia compared to patients who underwent FEES examination within the first 72 h (p < 0.05). A binary logistic regression model identified NIH-SS at admission as a weak predictor of silent aspiration. Neither in manual assignment of the lesions to brain regions nor in voxel-wise statistic regression any specific region was useful in prediction of silent aspiration. Silent aspiration is common in patients with infratentorial stroke and contributes to the risk for pneumonia. Patients with silent aspiration are more severely affected by stroke, but cannot reliably be identified by NIH-SS at admission or lesion location. Patients suffering from acute infratentorial stroke should been screened and examined for PSD and silent aspiration.

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Voxel-based lesion symptom mapping analysis for dysphagia in stroke patients with isolated cerebellar lesions

Cited by 9 publications

References 50 publications

Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis

Effects of Insular Cortex on Post-Stroke Dysphagia: A Systematic Review and Meta Analysis

Neural basis of dysphagia in stroke: A systematic review and meta-analysis

Clinical Features and Voxel-Based-Symptom-Lesion Mapping of Silent Aspiration in Acute Infratentorial Stroke

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