Lesion Characteristics of Chronic Dysphagia in Patients With Supratentorial Stroke

Overview

Journal Ann Rehabil Med

Specialty Rehabilitation Medicine

Date 2017 May 16

PMID 28503455

Citations 12

Authors

Sol Jang

Hea Eun Yang

Hee Seung Yang

Dae Hyun Kim

Affiliations

Soon will be listed here.

Abstract

Objective: To analyze the relationship between brain lesion location and type of chronic dysphagia in patients with supratentorial stroke.

Methods: Data from 82 chronic stroke patients who underwent videofluoroscopic swallowing studies at >6 months after an initial stroke event were retrospectively analyzed. Delayed oral transit time, delayed pharyngeal transit time, and the presence of aspiration were extracted. A voxel-based lesion symptom mapping (VLSM) analysis was used to correlate types of dysphagia with specific brain lesions.

Results: VLSM identified several clusters of voxels that significantly correlated with type of dysphagia. Delayed oral transit time mainly correlated with lesions in the left inferior frontal lobe and precentral gyrus; delayed pharyngeal time mainly correlated with lesions in the right basal ganglia and corona radiate; and aspiration was mainly correlated with lesions in the putamen.

Conclusion: Understanding the association between lesion location and dysphagia in chronic stroke patients is an important first step towards predicting permanent dysphagia after stroke. Improved understanding of the neural correlates of dysphagia will inform the utility of interventions for its treatment and prevention after stroke.

Citing Articles

Post-stroke dysphagia: identifying the evidence missing.

Wang Z, Shi R, Moreira P Front Med (Lausanne). 2025; 12:1494645.

PMID: 40078394 PMC: 11897572. DOI: 10.3389/fmed.2025.1494645.

The neurorehabilitation of post-stroke dysphagia: Physiology and pathophysiology.

Sasegbon A, Cheng I, Hamdy S J Physiol. 2024; 603(3):617-634.

PMID: 38517302 PMC: 11782911. DOI: 10.1113/JP285564.

Prognostic Value of Dysphagia for Activities of Daily Living Performance and Cognitive Level after Stroke.

Hamada T, Yoshimura Y, Nagano F, Matsumoto A, Shimazu S, Shiraishi A Prog Rehabil Med. 2024; 9:20240005.

PMID: 38327737 PMC: 10844015. DOI: 10.2490/prm.20240005.

The Cortical and Subcortical Neural Control of Swallowing: A Narrative Review.

Wei K, Wang T, Hsiao M Dysphagia. 2023; 39(2):177-197.

PMID: 37603047 DOI: 10.1007/s00455-023-10613-x.

Risk factors independently associated with the maintenance of severe restriction of oral intake and alternative feeding method indication at hospital outcome in patients after acute ischemic stroke.

Kussik de Almeida Leite K, Sassi F, Perissinotti I, Comerlatti L, de Andrade C Clinics (Sao Paulo). 2023; 78:100275.

PMID: 37572389 PMC: 10428027. DOI: 10.1016/j.clinsp.2023.100275.

References

Teismann I, Dziewas R, Steinstraeter O, Pantev C . Time-dependent hemispheric shift of the cortical control of volitional swallowing. Hum Brain Mapp. 2007; 30(1):92-100. PMC: 6870608. DOI: 10.1002/hbm.20488. View

Hamdy S, Aziz Q, Rothwell J, Singh K, Barlow J, Hughes D . The cortical topography of human swallowing musculature in health and disease. Nat Med. 1996; 2(11):1217-24. DOI: 10.1038/nm1196-1217. View

Daniels S, Corey D, Fraychinaud A, DePolo A, Foundas A . Swallowing lateralization: the effects of modified dual-task interference. Dysphagia. 2006; 21(1):21-7. DOI: 10.1007/s00455-005-9007-2. View

Picelli A, Tamburin S, Gajofatto F, Zanette G, Praitano M, Saltuari L . Association between severe upper limb spasticity and brain lesion location in stroke patients. Biomed Res Int. 2014; 2014:162754. PMC: 4055577. DOI: 10.1155/2014/162754. View

Daniels S, Foundas A, Iglesia G, Sullivan M . Lesion site in unilateral stroke patients with dysphagia. J Stroke Cerebrovasc Dis. 1996; 6(1):30-4. DOI: 10.1016/s1052-3057(96)80023-1. View

Daniels S, Brailey K, Foundas A . Lingual discoordination and dysphagia following acute stroke: analyses of lesion localization. Dysphagia. 1999; 14(2):85-92. DOI: 10.1007/PL00009592. View

Mann G, Hankey G, Cameron D . Swallowing disorders following acute stroke: prevalence and diagnostic accuracy. Cerebrovasc Dis. 2000; 10(5):380-6. DOI: 10.1159/000016094. View

Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R . Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005; 36(12):2756-63. DOI: 10.1161/01.STR.0000190056.76543.eb. View

Robbins J, Levine R, Maser A, Rosenbek J, Kempster G . Swallowing after unilateral stroke of the cerebral cortex. Arch Phys Med Rehabil. 1993; 74(12):1295-300. DOI: 10.1016/0003-9993(93)90082-l. View

10.

Rorden C, Karnath H, Bonilha L . Improving lesion-symptom mapping. J Cogn Neurosci. 2007; 19(7):1081-8. DOI: 10.1162/jocn.2007.19.7.1081. View

11.

Kwon M, Lee J, Kim J . Dysphagia in unilateral medullary infarction: lateral vs medial lesions. Neurology. 2005; 65(5):714-8. DOI: 10.1212/01.wnl.0000174441.39903.d8. View

12.

Cola M, Daniels S, Corey D, Lemen L, Romero M, Foundas A . Relevance of subcortical stroke in dysphagia. Stroke. 2010; 41(3):482-6. DOI: 10.1161/STROKEAHA.109.566133. View

13.

Smithard D, ONeill P, Parks C, Morris J . Complications and outcome after acute stroke. Does dysphagia matter?. Stroke. 1996; 27(7):1200-4. DOI: 10.1161/01.str.27.7.1200. View

14.

Horner J, Massey E, Brazer S . Aspiration in bilateral stroke patients. Neurology. 1990; 40(11):1686-8. DOI: 10.1212/wnl.40.11.1686. View

15.

Martin R, Sessle B . The role of the cerebral cortex in swallowing. Dysphagia. 1993; 8(3):195-202. DOI: 10.1007/BF01354538. View

16.

Dziewas R, Soros P, Ishii R, Chau W, Henningsen H, Ringelstein E . Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing. Neuroimage. 2003; 20(1):135-44. DOI: 10.1016/s1053-8119(03)00285-4. View

17.

Smithard D, ONeill P, Martin D, England R . Aspiration following stroke: is it related to the side of the stroke?. Clin Rehabil. 1997; 11(1):73-6. DOI: 10.1177/026921559701100111. View

18.

Ertekin C . Voluntary versus spontaneous swallowing in man. Dysphagia. 2010; 26(2):183-92. DOI: 10.1007/s00455-010-9319-8. View

19.

Watanabe Y, Abe S, Ishikawa T, Yamada Y, Yamane G . Cortical regulation during the early stage of initiation of voluntary swallowing in humans. Dysphagia. 2004; 19(2):100-8. DOI: 10.1007/s00455-003-0509-5. View

20.

Steinhagen V, Grossmann A, Benecke R, Walter U . Swallowing disturbance pattern relates to brain lesion location in acute stroke patients. Stroke. 2009; 40(5):1903-6. DOI: 10.1161/STROKEAHA.108.535468. View