Ann Rehabil Med.  2017 Apr;41(2):225-230. 10.5535/arm.2017.41.2.225.

Lesion Characteristics of Chronic Dysphagia in Patients With Supratentorial Stroke

• Jang S
• Yang HE
• Yang HS
• Kim DH

• KMID: 2389480
• DOI: http://doi.org/10.5535/arm.2017.41.2.225

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.

Keyword

Dysphagia; Video fluoroscopy; Stroke; Neuroimaging

MeSH Terms

Basal Ganglia
Brain
Deglutition
Deglutition Disorders*
Frontal Lobe
Humans
Neuroimaging
Putamen
Retrospective Studies
Stroke*

Figure

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  Fig. 1 Lesion overlapping maps.

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  Fig. 2 Voxel-based lesion symptom mapping results showing voxels in patients with dysphagia. (A) Correlation with delayed oral transit time. (B) Correlation with delayed pharyngeal transit time. (C) Correlation with the presence of aspiration.

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