Dysarthria as a predictor of dysphagia following stroke

Bahia, Mariana Mendes; Mourão, Lúcia Figueiredo; Chun, Regina Yu Shon

doi:10.3233/nre-161305

Cited by 24 publications

(18 citation statements)

References 38 publications

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“…With FBAS administration, valuable clinical information is further collected with regards to functional language comprehension associated with a patient's ability to follow a verbal command as well as dysarthria, with the latter proven to be a strong predictive factor for both dysphagia and aspiration risk. 3,[45][46][47] Our protocol includes a water swallow trial (WST) to aid in recognition of aspiration risk in acute stroke as do most valid swallowing screening tests 7,8,45 and acknowledges as failure criteria already established sensitive indicators for aspiration. 5,10,18,40,46 A recent meta-analysis 10 revealed that when administering single sips of small and large volumes, the WST offers the best evidence for accurately discriminating patients who are aspirating.…”

Section: Discussionmentioning

confidence: 99%

Predictive value of a novel pragmatic tool for post‐stroke aspiration risk: The Functional Bedside Aspiration Screen

Virvidaki

Giannopoulos

Nasios

et al. 2019

Neurogastroenterology Motil

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Background There is still a strong need for an optimal clinician‐friendly screening tool for the identification of aspiration risk in stroke patients. In this study, we present the development of a novel, context‐specific screening tool for the prediction of aspiration risk on recent stroke survivors, the Functional Bedside Aspiration Screen (FBAS), and examine its construct validity, reliability with the predictive values toward pragmatic patients' outcomes. Methods We conducted a prospective validation study of 104 acute ischemic stroke patients admitted to clinical wards in a tertiary university hospital. A group of experts developed and administered the FBAS 10‐point scale to all patients. Outcome measures were compared with those of the validated Yale Swallow Protocol (YSP, reference measure) and health indicators. Key Results A strong association was found between the FBAS cutoff criterion and the YSP (Pearson χ2 = 54.92, P < .001). A score of ≤8 on the FBAS presented with 93.3% sensitivity and 83.3% specificity in deeming patient with reduced safety for oral nutrition (AUC = 0.934, CI = 0.884‐0.985). An inverse relationship was found between performance on the FBAS and in‐hospital and long‐term outcome indicators. Patients who failed the FBAS were 1.82 times more likely to develop aspiration pneumonia (95% CI = 1.42‐2.35) and 1.35 times more likely to develop pneumonia within 3 months postonset (95% CI = 1.15‐1.59). Conclusions and Inferences The FBAS is a potentially useful tool for timely prediction of aspiration risk and health outcome in acute stroke.

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Section: Discussionmentioning

confidence: 99%

Predictive value of a novel pragmatic tool for post‐stroke aspiration risk: The Functional Bedside Aspiration Screen

Virvidaki

Giannopoulos

Nasios

et al. 2019

Neurogastroenterology Motil

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“…Common neurological impairments include facial paresis as well as tongue, mandibular, pharyngeal, and laryngeal dysfunction. In isolation, or in various combinations these symptoms can lead to dysphagia, dysarthria, malnutrition, dehydration, airway obstruction, and death (Bahia, Mourão, & Chun, 2016;Daniels, Brailey, Priestly, Weisberg, & Foundas, 1998;Daniels & Foundas, 1997;Galovic et al, 2013;Kumral, Celebisoy, Celebisoy, Canbaz, & Calli, 2007;Leder & Espinosa, 2002;Miller, 1999Miller, , 2008Nunes et al, 2012;Smithard et al, 1996;Urban, Hopf, Fleischer, Zorowka, & M€ uller-Forell, 1997;Urban, Wicht, Hopf, Fleischer, & Nickel, 1999). Underlying these severe and debilitating clinical consequences is the presumed disruption of descending axons destined for the brainstem reticular formation, and corticobulbar fibers directly innervating cranial nerve motor nuclei.…”

Section: Introductionmentioning

confidence: 99%

Localization of orofacial representation in the corona radiata, internal capsule and cerebral peduncle inMacaca mulatta

Morecraft

Binneboese

Stilwell-Morecraft

et al. 2017

J of Comparative Neurology

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Subcortical white matter injury is often accompanied by orofacial motor dysfunction, but little is known about the structural substrates accounting for these common neurological deficits. We studied the trajectory of the corticobulbar projection from the orofacial region of the primary (M1), ventrolateral (LPMCv), supplementary (M2), rostral cingulate (M3) and caudal cingulate (M4) motor regions through the corona radiata (CR), internal capsule (IC) and crus cerebri of the cerebral peduncle (ccCP). In the CR each pathway was segregated. Medial motor area fibers (M2/M3/M4) arched over the caudate and lateral motor area fibers (M1/LPMCv) curved over the putamen. At superior IC levels, the pathways were widespread, involving the anterior limb, genu and posterior limb with the M3 projection located anteriorly, followed posteriorly by projections from M2, LPMCv, M4 and M1, respectively. Inferiorly, all pathways maintained this orientation but shifted posteriorly, with adjacent fiber bundles overlapping minimally. In the ccCP, M3 fibers were located medially and M1 fibers centromedially, with M2, LPMCv, and M4 pathways overlapping in between. Finally, at inferior ccCP levels, all pathways overlapped. Following CR and superior IC lesions, the dispersed pathway distribution may correlate with acute orofacial dysfunction with spared pathways contributing to orofacial motor recovery. In contrast, the gradually commixed nature of pathway representation inferiorly may enhance fiber vulnerability and correlate with severe, prolonged deficits following lower subcortical and midbrain injury. Additionally, in humans these findings may assist in interpreting orofacial movements evoked during deep brain stimulation, and neuroimaging tractography efforts to localize descending orofacial motor pathways.

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“…It is one of the consequences of ECA, when articulation, breathing, voice, rhythm and fluency (30) can be impaired. In TBI, dysarthrias are present in approximately 45% of cases (31) . In SCP, hyperreflexia and exaggerated increase in muscle tone occur, with reduction of voluntary movements (13) .…”

Section: Discussionmentioning

confidence: 99%

Biofeedback eletromiográfico no tratamento das disfunções orofaciais neurogênicas: revisão sistemática de literatura

Freitas

Mituuti

Furkim

et al. 2016

Audiol., Commun. Res.

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Purpose:To determine whether the use of electromyographic biofeedback in the therapy of orofacial functions (facial expression, chewing, swallowing, phonation and speech) will result in beneficial effects for individuals with neurological diseases. Research strategy: A keyword search was conducted in the MEDLINE, LILACS and SciELO databases, using the terms "electromyographic biofeedback", "swallowing", "speech", "chewing", "phonation", and "facial expression". The database search and the selection of papers were conducted independently by two researchers. In case of any disagreement, there was a discussion based on the inclusion and exclusion criteria, so that they could reach a common ground. Selection criteria: This work has included experimental studies in humans, in English and Portuguese, which described and discussed the use of electromyographic biofeedback in the treatment of orofacial function diseases resulting from neurological illness. Results: A total of 175 papers were found, wherein only 10 fitted the inclusion criteria. Most works were case studies, followed by case series, case control, and only one randomized controlled trial. Most of studies addressed the therapy with electromyographic biofeedback in the swallowing function, followed by speech function, and only one study addressed the use of electromyographic biofeedback in therapy to improve facial expression. No studies addressing speech therapy using electromyographic biofeedback in patients with neurological diseases in the functions of phonation and chewing were found. Conclusion: The use of electromyographic biofeedback in the therapy for orofacial functions can result in beneficial effects for individuals with neurological diseases in the swallowing, speech, and facial expression functions.Keywords: Electromyography; Deglutition; Speech; Mastication; Phonation; Facial expression RESUMO Objetivo: Investigar se o uso do biofeedback eletromiográfico na terapia voltada às funções orofaciais (expressão facial, mastigação, deglutição, fonação e fala) produz efeitos benéficos para os indivíduos com doenças neurológicas. Estratégia de pesquisa: Foi realizada busca nas bases de dados MEDLINE, LILACS e SciELO, por meio dos descritores "electromyographic biofeedback", "swallowing", "speech" "chewing", "phonation", e "facial expression". A busca nas bases de dados e a seleção dos artigos foram realizadas independentemente, por duas pesquisadoras e, nos casos de não concordância, houve discussão fundamentada nos critérios de inclusão e exclusão para que chegassem a um consenso. Critérios de seleção: Foram incluídos estudos experimentais em seres humanos, em inglês e português, que descreveram e discutiram a utilização do biofeedback eletromiográfico no tratamento das alterações das funções orofaciais provenientes de doenças neurológicas. Resultados: Foram encontrados 175 artigos, sendo que somente 10 se adequaram aos critérios de inclusão. A maioria dos trabalhos relacionou-se a estudo de caso, seguido por estudos de série de casos, caso c...

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Dysarthria as a predictor of dysphagia following stroke

Cited by 24 publications

References 38 publications

Predictive value of a novel pragmatic tool for post‐stroke aspiration risk: The Functional Bedside Aspiration Screen

Predictive value of a novel pragmatic tool for post‐stroke aspiration risk: The Functional Bedside Aspiration Screen

Localization of orofacial representation in the corona radiata, internal capsule and cerebral peduncle inMacaca mulatta

Biofeedback eletromiográfico no tratamento das disfunções orofaciais neurogênicas: revisão sistemática de literatura

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