Swallowing difficulties, known as dysphagia, are common in stroke survivors, occurring in more than 50 percent of stroke patients and affecting the oral and/or pharyngeal phase of swallowing.
Stroke survivors are at risk of silent aspiration. Some people with dysphagia may have problems swallowing certain foods or liquids while others can’t swallow at all.
Although it improves within two weeks for most, some acute stroke survivors face longstanding swallowing problems that place them at risk for pneumonia, malnutrition, dehydration, and significantly affect quality of life.
The team at St. Mary’s Hospital in Seoul, South Korea conducted a prospective study to find out the relationship between the cortical medulla tract, the severity of dysphagia, and the possibility of recovery in stroke patients within two weeks of onset.
They obtained diffusion tensor imaging with cranial nerve fibers within two weeks of the onset of stroke patients who visited Bucheon St. Mary’s Hospital from March 2017 to February 2018, and quantitatively evaluated the swallowing function through a swallow test.
The patients were divided into three groups – people with dysphagia after stroke, people without dysphagia after stroke and a control group.
The findings showed that the group with dysphagia had more damage to the affected cortex than the group without the condition.
The researchers also found that the microstructure integrity of the unaffected cortical medulla oblongata in the dysphagia group was a biomarker that could predict up to 63.1 percent of the recovery of swallowing function after three months of onset.
“Although it is difficult to confirm the cortical tract in general magnetic resonance imaging, it has clinical significance in that it presented a method to visualise and quantitatively measure the degree of damage through 3D reconstruction,” Professor Kim Young-goook, who led the study, said.
“In the future, it may be used to determine the effectiveness of various treatment techniques for dysphagia.”
