Cognitive Profile in Patients Admitted to Intensive Rehabilitation after Stroke Is Associated with the Recovery of Dysphagia: Preliminary Results from the RIPS (Intensive Post-Stroke Rehabilitation) Study

Abstract

Dysphagia represents one of the most frequent symptoms in the post–acute stroke population. Swallowing impairment and cognitive deficits can often co-occur. This study aims to investigate the relationship between cognitive impairment and the recovery of dysphagia in patients attending specific rehabilitation. Patients admitted to intensive rehabilitation units were administered the Functional Oral Intake Scale (FOIS) and Montreal Cognitive Screening Test (MoCA); when screening positive for dysphagia, they entered a rehabilitation program. Their FOIS score at discharge was the primary outcome measure. In the multivariate analysis, younger age (B = − 0.077, p = 0.017), higher MoCA (B = 0.191, p = 0.002), and higher FOIS (B = 1.251, p = 0.032) at admission were associated with higher FOIS at discharge. When executive function (EF) replaced the MoCA total score in the model, younger age (B = − 0.134, p = 0.001), higher admission EF (B = 1.451, p < 0.001), and FOIS (B = 1.348, p = 0.035) were associated with higher FOIS at discharge. Our results confirm the hypothesis that a better cognitive profile upon admission is associated with a higher probability of dysphagia recovery at discharge. EF seems to have a crucial role in dysphagia recovery. These results highlight the importance of considering the cognitive profile when assessing and treating dysphagia after stroke and of using screening tests that include executive functions.

An exploratory study of longitudinal trajectory of language, swallowing and cognition post endovascular clot retrieval

“…The present study found TMT-A performance was correlated with swallowing function at initial assessment. This result may reflect the role of the frontal cortex in regulating voluntary phases of swallowing (Basagni et al, 2023). No significant correlation between swallowing function and other cognitive measures were observed which is in contrast to previous studies that report a strong correlation between dysphagia severity, attention (Ebrahimian Dehaghani et al, 2019;Jo et al, 2017), and visuospatial intelligence (Jo et al, 2017) in stroke patients not treated with ECR.…”

“…Spearman's rho was used to calculate the correlation between language, cognitive and swallowing performance, and the mTICI, 24 h NIHSS, and QoL. As recommended by Perneger (1998) and Armstrong (Basagni et al., 2023) to avoid a type II error in this exploratory study the Bonferroni correction was not completed. All tests were two‐tailed and p ‐values ≤ 0.05 were considered statistically significant.…”