Hyun Im Moon1, Seo Yeon Yoon2, Tae Im Yi2, Yoon Jeong Jeong2, Tae Hwan Cho2. 1. Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seoungnam-si, 13590, Gyeonggi-do, Republic of Korea. feellove99@gmail.com. 2. Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, 20, Seohyeon-ro 180 beon-gil, Bundang-gu, Seoungnam-si, 13590, Gyeonggi-do, Republic of Korea.
Abstract
INTRODUCTION: Some stroke patients show oral phase dysphagia, characterized by a markedly prolonged oral transit time that hinders oral feeding. The aim of this study was to clarify the clinical characteristics and lesions responsible for delayed swallowing. METHODS: We reviewed 90 patients with stroke. The oral processing time plus the postfaucial aggregation time required to swallow semisolid food was assessed. The patients were divided into two groups according to oral transit time, and we analyzed the differences in characteristics such as demographic factors, lesion factors, and cognitive function. Logistic regression analyses were performed to examine the predictors of delayed oral transit time. Lesion location and volume were measured on brain magnetic resonance images. We generated statistic maps of lesions related to delayed oral phase in swallowing using voxel-based lesion symptom mapping (VLSM). RESULTS: The group of patients who showed delayed oral transit time had significantly low cognitive function. Also, in a regression model, delayed oral phase was predicted with low K-MMSE (Korean version of the Mini Mental Status Exam). Using VLSM, we found the lesion location to be associated with delayed oral phase after adjusting for K-MMSE score. Although these results did not reach statistical significance, they showed the lesion pattern with predominant distribution in the left frontal lobe. CONCLUSION: Delayed oral phase in post-stroke patients was not negligible clinically. Patients' cognitive impairments affect the oral transit time. When adjusting it, we found a trend that the lesion responsible for delayed oral phase was located in the left frontal lobe, though the association did not reach significance. The delay might be related to praxis function.
INTRODUCTION: Some strokepatients show oral phase dysphagia, characterized by a markedly prolonged oral transit time that hinders oral feeding. The aim of this study was to clarify the clinical characteristics and lesions responsible for delayed swallowing. METHODS: We reviewed 90 patients with stroke. The oral processing time plus the postfaucial aggregation time required to swallow semisolid food was assessed. The patients were divided into two groups according to oral transit time, and we analyzed the differences in characteristics such as demographic factors, lesion factors, and cognitive function. Logistic regression analyses were performed to examine the predictors of delayed oral transit time. Lesion location and volume were measured on brain magnetic resonance images. We generated statistic maps of lesions related to delayed oral phase in swallowing using voxel-based lesion symptom mapping (VLSM). RESULTS: The group of patients who showed delayed oral transit time had significantly low cognitive function. Also, in a regression model, delayed oral phase was predicted with low K-MMSE (Korean version of the Mini Mental Status Exam). Using VLSM, we found the lesion location to be associated with delayed oral phase after adjusting for K-MMSE score. Although these results did not reach statistical significance, they showed the lesion pattern with predominant distribution in the left frontal lobe. CONCLUSION: Delayed oral phase in post-strokepatients was not negligible clinically. Patients' cognitive impairments affect the oral transit time. When adjusting it, we found a trend that the lesion responsible for delayed oral phase was located in the left frontal lobe, though the association did not reach significance. The delay might be related to praxis function.
Authors: Elizabeth Bates; Stephen M Wilson; Ayse Pinar Saygin; Frederic Dick; Martin I Sereno; Robert T Knight; Nina F Dronkers Journal: Nat Neurosci Date: 2003-05 Impact factor: 24.884
Authors: Jonathan W Sturm; Helen M Dewey; Geoffrey A Donnan; Richard A L Macdonell; John J McNeil; Amanda G Thrift Journal: Stroke Date: 2002-03 Impact factor: 7.914
Authors: Jonathan Graff-Radford; David T Jones; Edythe A Strand; Alejandro A Rabinstein; Joseph R Duffy; Keith A Josephs Journal: Brain Lang Date: 2014-02-18 Impact factor: 2.381
Authors: Antonio Muscari; Roberta Falcone; Enrico Pirazzoli; Luca Faccioli; Silvia Muscari; Marco Pastore Trossello; Giovanni M Puddu; Loredana Rignanese; Luca Spinardi; Marco Zoli Journal: Dysphagia Date: 2022-06-09 Impact factor: 3.438