Correlation between lesion location and dysphagia characteristics in post-stroke patients

Area of Science:

• Neuroscience
• Otolaryngology
• Speech-Language Pathology

Background:

• Post-stroke dysphagia (PSD) is a common complication affecting swallowing function.
• Lesion location is a critical factor influencing the severity and characteristics of PSD.
• Understanding these correlations aids in targeted rehabilitation strategies.

Purpose of the Study:

• To investigate the relationship between the anatomical location of brain lesions and specific swallowing function parameters in PSD patients.
• To compare swallowing characteristics across different stroke lesion locations (supratentorial, infratentorial, left/right hemisphere, cortical/subcortical, brainstem).
• To explore the impact of bolus volume on swallowing function based on lesion site.

Main Methods:

• 133 PSD patients were analyzed using videofluoroscopic swallowing studies (VFSS) with 3ml and 5ml barium liquid volumes.
• Patients were categorized into supratentorial, infratentorial, left/right hemispheric (cortical/subcortical), and brainstem stroke groups.
• VFSS parameters (e.g., HMD, PTD, LCD, UESO) and clinical scales (PAS, FOIS) were assessed and statistically analyzed.

Main Results:

• Significant differences in hyoid bone movement duration (HMD), pharyngeal transit duration (PTD), and laryngeal closure duration (LCD) were observed between supratentorial and brainstem lesions at 5ml bolus volume.
• Left cortical and subcortical lesions showed significant differences in HMD and LCD compared to brainstem lesions at 5ml.
• Pharyngeal transit duration (PTD) moderately correlated with Penetration Aspiration Scale (PAS) scores, while HMD and LCD showed weak correlations.

Conclusions:

• Brainstem lesions are associated with more severe pharyngeal phase dysfunction in PSD.
• The left hemisphere plays a role in both oral and pharyngeal swallowing phases.
• Lesions in cortical, subcortical, and brainstem regions may contribute to impaired sensory input during swallowing.