The Brain Lesion Affecting Dysphagia in Patient with Supratentorial Stroke

BackgroundDysphagia is a common sequela of stroke. However, specific swallowing impairments associated with brain lesions at different sites are not well characterized.ObjectiveThis study aimed to determine the relationship between the location of supratentorial brain lesions and the features of dysphagia.MethodsMedical records of patients with first-ever supratentorial stroke who underwent videofluoroscopic swallowing studies within 4 weeks of onset were retrospectively analyzed.ResultsA total of 158 patients (92 men and 66 women) were included. The lesions in internal capsule were associated with prolonged pharyngeal delay time (odds ratio [OR] 4.02, 95% confidence interval [CI] 1.13-14.28) and were inversely associated with post-swallowing vallecular residue (OR 0.55, 95% CI 0.32-0.95). The lesions in the insular cortex were associated with premature spillage and prolonged pharyngeal delay time (OR 2.27, 95% CI 1.08-4.76; OR 2.29, 95% CI 1.05-4.99, respectively). The lesions in the frontal lobe were associated with oral residue, vallecular residue, and pyriformis residue (OR 3.16, 95% CI 1.63-6.10; OR 3.06, 95% CI 1.55-6.02; OR 2.57, 95% CI 1.28-5.15, respectively).ConclusionsThis study revealed specific patterns of swallowing associated with specific brain lesions. Our findings may help elucidate the correlation between dysphagia patterns and the sites of brain lesions.