Ann Rehabil Med.  2019 Apr;43(2):142-148. 10.5535/arm.2019.43.2.142.

Association Between Duration of Dysphagia Recovery and Lesion Location on Magnetic Resonance Imaging in Patients With Middle Cerebral Artery Infarction

• Kim JH
• Oh SH
• Jeong HJ
• Sim YJ
• Kim DG
• Kim GC

• KMID: 2448996
• DOI: http://doi.org/10.5535/arm.2019.43.2.142

Abstract

OBJECTIVE
To investigate association between lesion location on magnetic resonance imaging (MRI) performed after an infarction and the duration of dysphagia in middle cerebral artery (MCA) infarction.
METHODS
A videofluoroscopic swallowing study was performed for 59 patients with dysphagia who were diagnosed as cerebral infarction of the MCA territory confirmed by brain MRI. Lesions were divided into 11 regions of interest: primary somatosensory cortex, primary motor cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule (PLIC), thalamus, basal ganglia (caudate nucleus), and basal ganglia (putamen). Recovery time was defined as the period from the first day of L-tube feeding to the day that rice porridge with thickening agent was prescribed. Recovery time and brain lesion patterns were compared and analyzed.
RESULTS
The mean recovery time of all patients was 26.71±16.39 days. The mean recovery time was 36.65±15.83 days in patients with PLIC lesions and 32.6±17.27 days in patients with caudate nucleus lesions. Only these two groups showed longer recovery time than the average recovery time for all patients. One-way analysis of variance for recovery time showed significant differences between patients with and without lesions in PLIC and caudate (p<0.001).
CONCLUSION
Injury to both PLIC and caudate nucleus is associated with longer recovery time from dysphagia.

Keyword

Dysphagia; Middle cerebral artery; Infarction

MeSH Terms

Basal Ganglia
Brain
Caudate Nucleus
Cerebral Cortex
Cerebral Infarction
Deglutition
Deglutition Disorders*
Extremities
Gyrus Cinguli
Humans
Infarction
Infarction, Middle Cerebral Artery*
Internal Capsule
Magnetic Resonance Imaging*
Middle Cerebral Artery*
Motor Cortex
Prefrontal Cortex
Somatosensory Cortex
Thalamus

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