Neurological Severity Versus Biomarker Dynamics in Post-Stroke Dysphagia: A Dual-Pathway Model for Functional...

Area of Science:

• Neurology
• Nutrition Science
• Inflammation Research

Background:

• Post-stroke dysphagia is a common complication leading to aspiration, malnutrition, and prolonged enteral feeding.
• Systemic inflammation and poor nutritional status can negatively impact neuromuscular recovery in stroke survivors.
• The specific impact of inflammation and nutrition on swallowing recovery and feeding transition post-stroke requires further clarification.

Purpose of the Study:

• To investigate the independent associations of inflammatory and nutritional markers with swallowing function recovery.
• To assess the relationship between these markers and the transition from enteral to oral feeding in post-stroke dysphagia patients.

Main Methods:

• Retrospective observational study of ischemic stroke patients with dysphagia.
• Calculation of inflammatory indices (NLR, PLR, SII, SIRI, PIV) and prognostic nutritional index (PNI) at baseline (T0) and post-rehabilitation (T1).
• Analysis of changes in indices (Δ) against changes in swallowing function (ΔFOIS, ΔPAS).

Main Results:

• Improved prognostic nutritional index (ΔPNI) correlated with better oral intake (ΔFOIS) and reduced aspiration severity (ΔPAS).
• Increased inflammatory markers (ΔSIRI, ΔSII, ΔPLR, ΔPIV) were linked to poorer swallowing outcomes.
• Baseline stroke severity (NIHSS) was the sole independent predictor for transitioning from enteral to oral feeding (OR=0.72, p=0.002).

Conclusions:

• Changes in nutritional status (ΔPNI) are the most consistent biomarker for functional swallowing recovery and reduced aspiration in post-stroke dysphagia.
• Inflammatory burden impacts swallowing physiology, but neurological severity primarily drives the enteral-to-oral feeding transition.
• Monitoring nutritional status alongside inflammatory markers is valuable for dysphagia rehabilitation.