The Relationship Between Lesion Localization and Dysphagia in Acute Stroke

AbstractFactors that can facilitate early identification of individuals at risk of dysphagia such as stroke location are potentially of great benefit. The aim of this study was to examine the role of hemisphere and lesion location in assessing dysphagia pattern and airway invasion as identified through the use of validated, standardized interpretation measures for the videofluoroscopic swallowing study. Consecutive patients (N = 80) presenting with stroke symptoms who had a first-time acute ischemic stroke confirmed on diffusion-weighted magnetic resonance imaging (DW-MRI) scan participated. Three swallowing outcome variables were assessed using regression models: modified barium swallow impairment profile (MBSImP) ora l impairment (OI) and pharyngeal impairment (PI) scores and penetration aspiration scale (PAS) score. Subjects were primarily male and demonstrated mild stroke and mild to moderate dysphagia. There was a significantly higher likelihood of abnormal PAS scores for infratentorial lesions compared to ri ght hemisphere location (Odds ratio: 3.1, SE: 1.8,p = 0.046) and for Whites compared to African Americans (Odds ratio: 5.5, SE: 2.6,p = <0.001). However, OI scores were higher (worse) in African Americans compared to Whites (Beta  = −1.2; SE: 0.56;p = 0.037). PI scores had no significant association with race or lesion location. Using DW-MRI to identify infratentorial stroke can help identify individuals at risk of airway invasion; however, imaging in...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research