Lesions Responsible for Delayed Oral Transit Time in Post-stroke Dysphagia

Area of Science:

• Neuroscience
• Clinical Neurology
• Swallowing Disorders

Background:

• Oral phase dysphagia, marked by prolonged oral transit time, is a common complication in stroke patients, significantly impairing oral feeding.
• Understanding the clinical characteristics and underlying brain lesions associated with delayed swallowing is crucial for effective patient management.

Purpose of the Study:

• To investigate the clinical features and specific brain lesions linked to delayed oral transit time in stroke survivors.
• To identify predictors of delayed oral phase swallowing and map lesion locations associated with this deficit.

Main Methods:

• Reviewed 90 stroke patients, assessing oral transit time for semisolid food.
• Analyzed demographic, lesion, and cognitive factors, using logistic regression and voxel-based lesion symptom mapping (VLSM).
• Measured lesion location and volume on MRI scans.

Main Results:

• Patients with delayed oral transit time exhibited significantly lower cognitive function, with low K-MMSE scores predicting delayed oral phase.
• VLSM analysis, adjusted for cognitive scores, indicated a trend for lesions in the left frontal lobe to be associated with delayed oral phase.
• While not statistically significant, the lesion pattern predominantly involved the left frontal lobe.

Conclusions:

• Delayed oral phase swallowing is a clinically relevant issue in post-stroke patients, influenced by cognitive impairments.
• A potential association exists between left frontal lobe lesions and delayed oral transit time, possibly related to praxis function.
• Further research is needed to confirm the specific lesion locations and their impact on swallowing.