Differences in swallow physiology in patients with left and right hemispheric strokes

Area of Science:

• Neurology
• Swallowing Disorders
• Neuroscience

Background:

• Stroke-related swallowing impairment (dysphagia) affects patient recovery and quality of life.
• Understanding the impact of lesion location and size is crucial for targeted rehabilitation.

Purpose of the Study:

• To investigate the effect of lesion lateralization (left vs. right hemisphere) and volume on swallowing impairment in acute ischemic stroke patients.
• To compare swallowing function at both group and individual patient levels.

Main Methods:

• Retrospective, observational study of 46 acute ischemic stroke patients.
• Diffusion-weighted MRI for lesion localization and Modified Barium Swallow Impairment Profile (MBSImP) for swallow assessment.
• Statistical analyses included group comparisons and regression modeling to correlate lesion characteristics with swallowing outcomes.

Main Results:

• Patients with right hemisphere strokes exhibited significantly worse pharyngeal swallowing impairment (MBSImP scores, PAS scores) and altered swallow physiology compared to left hemisphere stroke patients.
• Lesion volume was associated with increased pharyngeal residue and overall pharyngeal impairment.
• A notable percentage of patients (24%) displayed swallowing impairment patterns inconsistent with group-level findings.

Conclusions:

• Right hemisphere strokes are associated with more severe pharyngeal swallowing deficits than left hemisphere strokes.
• Lesion lateralization is a useful group-level predictor of swallowing severity, though less predictive for individual patients.
• Swallowing impairment patterns can vary significantly at the individual patient level despite similar lesion laterality.