Swallowing Outcomes In Patients With Subcortical Stroke Associated With Lesions Of The Caudate Nucleus And Insula

Keywords

age; caudate nucleus; insula; pharyngeal transit duration; Subcortical stroke; videofluoroscopic swallowing study

Abstract

Objective: The present study was performed to investigate the relationships between swallowing outcomes and lesion location, bolus characteristics, and age in patients with subcortical stroke. Patients: Patients with subcortical and insular stroke (mean age, 57.38 ± 12.71 years) were investigated. All patients (n = 21) completed both brain magnetic resonance imaging studies and videofluoroscopic swallowing studies. Main Outcome Measures: The oral transit duration, pharyngeal transit duration (PTD), laryngeal response duration, and Penetration-Aspiration Scale (PAS) score were applied to examine the efficiency of propulsion and airway protection in three swallowing tasks. Path analyses were performed to assess the relationships between swallowing outcomes and lesion location, age, bolus viscosity, and bolus volume. Results: Caudate nucleus (CN) lesions were associated with higher PAS scores. Insular lesions were associated with a longer PTD. Advanced age was associated with a longer PTD. Bolus viscosity significantly moderated the association between CN lesions and higher PAS scores. Conclusions: In the present cohort, CN lesions impacted airway protection and insular lesions impacted pharyngeal transit. An increased bolus viscosity reduced the aspiration severity. These results suggest that lesion location is an important indicator to predict subsequent dysphagia in patients with subcortical stroke.

Publication Date

9-1-2018

Publication Title

Journal of International Medical Research

Volume

46

Issue

9

Number of Pages

3552-3562

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1177/0300060518775290

Socpus ID

85053690245 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85053690245

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