Is the Location of White Matter Lesions Important in the Swallowing Function of Older Patients with Mild Stroke?

被引:20
作者
Moon, Hyun Im [1 ]
Kim, Gyu Seong [1 ]
Lee, Eunchae [1 ]
机构
[1] Bundang Jesaeng Gen Hosp, Dept Rehabil Med, 20,Seohyeon Ro 180 Beon Gil, Seoungnam Si 13590, Gyeonggi Do, South Korea
关键词
Deglutition; Stroke; White matter; Periventricular leukomalacia; Prognosis; Corticobulbar tract; CORTICOBULBAR TRACT; ISCHEMIC-STROKE; HYPERINTENSITIES; RECOVERY;
D O I
10.1007/s00455-018-9955-y
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 [耳鼻咽喉科学];
摘要
Older patients with stroke have poor functional prognosis compared to younger patients. Patients with stroke who have severe white matter (WM) lesions have been reported to have swallowing problems. The aim of this study was to determine whether the location of WM lesions affects swallowing function in older patients with mild stroke. We conducted a retrospective analysis of 88 patients aged>65years who had a National Institutes of Health Stroke Scale score of 5 and who underwent videofluoroscopic swallowing examination after their first stroke. Participants were divided into three groups according to the involvement of corticobulbar tract (CBT) as follows: group I, no involvement of CBT; group II, involvement of CBT in one hemisphere; and group III, involvement of CBT in both hemispheres. Linear regression analysis showed that pharyngeal transit time tended to increase according to the involvement of CBT in WM lesion (p=0.043). In addition, inadequate laryngeal elevation was related to the involvement of CBT (p=0.016). Early spillage, inadequate laryngeal elevation, and penetration could also be predicted by Fazekas grade. Accordingly, the location of WM lesions can be regarded as a potential predictive factor for dysphagia. Moreover, in patients with WM lesions involving CBT, detailed evaluation of dysphagia is required.
引用
收藏
页码:407 / 414
页数:8
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