Early predictors of dysphagia in ischaemic stroke patients

Mattavelli, Daniele; Mele, Francesco; Cova, Ilaria; Rosa, Sílvia Aguiar; Bertora, Pierluigi; Pomati, Simone; Pizzorni, Nicole; Schindler, Antonio; Pantoni, Leonardo

doi:10.1111/ene.15846

Cited by 5 publications

(1 citation statement)

References 52 publications

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“…There are numerous autonomous predictors of PSD, including advanced age (12), higher National Institutes of Health Stroke Scale scores (13), greater modified Rankin Scale scores (14), lower Barthel Index scores (15), larger lesion volumes (16), cognitive impairment (17), and the presence of dysarthria (18), among others (19). The regions frequently implicated in dysphagia after a stroke encompass the subcortex, cortex, brainstem, corticobulbar tract, white matter, and other relevant areas.…”

Section: Introductionmentioning

confidence: 99%

Effect of acupuncture on post-stroke dysphagia: a randomized controlled trial

Bai,

Cheng,

et al. 2024

Front. Neurol.

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IntroductionPost-stroke dysphagia (PSD) is associated with various complications that increase morbidity and mortality rates. Acupuncture has been used extensively in China to treat these complications; however, its therapeutic efficacy remains uncertain. We therefore aimed to study the clinical effects of acupuncture on PSD.MethodsPatients (n = 101) were randomly divided into acupuncture (n = 50) and rehabilitation training control (n = 51) groups based on the treatment used. Both groups were treated once daily, 6 days a week, for a total of 4 weeks. Pulse oxygen saturation (SpO2) and standardized swallowing assessment (SSA) were performed before the intervention, 2 weeks into treatment, after the intervention (4 weeks post-intervention), and at a 6-month follow-up (28 weeks). The levels of hemoglobin (Hb) and albumin (ALB), and 5-hydroxytryptamine (5-HT) and dopamine (DA) were measured before the intervention, 2 weeks into treatment, and after the intervention (4 weeks), as nutrition and swallowing function indices, respectively.ResultsFollowing the intervention, significant differences were observed between the acupuncture and control groups. The acupuncture group exhibited considerably superior enhancements in SpO2 and SSA scores at 4 weeks (p < 0.001). Moreover, this group demonstrated significantly greater improvements in Hb, ALB, 5-HT, and DA values 4 weeks post-treatment (p < 0.001). However, sex-based differences were not observed (P > 0.005).ConclusionAcupuncture treatment can improve the swallowing function and nutritional status of patients with PSD, and increase the levels of 5-HT and DA. These findings strongly support the efficacy of acupuncture as a therapeutic intervention in patients with PSD.Clinicaltrial registration: identifier, ChiCTR2100052201. (https://www.chictr.org.cn/).

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Section: Introductionmentioning

confidence: 99%

Effect of acupuncture on post-stroke dysphagia: a randomized controlled trial

Bai,

Cheng,

et al. 2024

Front. Neurol.

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Cerebral small vessel disease is an independent determinant of dysphagia after acute stroke

Wilmskoetter,

Bonilha,

Wolf

et al. 2024

NeuroImage: Clinical

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The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial

Suh,

You,

Son

et al. 2024

International Journal of Rehabilitation Research

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Repetitive transcranial magnetic stimulation to the pharyngeal motor cortex has shown beneficial effects on poststroke dysphagia. Previous studies, however, using intermittent theta burst stimulation (iTBS) for dysphagia have targeted the suprahyoid motor cortex. This study aimed to investigate the effects of iTBS to the pharyngeal motor cortex in patients with poststroke dysphagia, using ultrasound and videofluoroscopic swallowing studies (VFSS). A randomized controlled trial was conducted on patients with dysphagia due to a first-time unilateral stroke. Patients who had signs and symptoms of dysphagia and showed aspiration or penetration on VFSS were included. Twenty-eight patients were randomly assigned to either real or sham iTBS groups, and each patient underwent five sessions of iTBS to the ipsilesional pharyngeal motor cortex. Each iTBS session was followed by conventional dysphagia treatment for 30 min. The hyoid–larynx approximation measured by ultrasound, penetration–aspiration scale (PAS) and functional dysphagia scale (FDS) assessed by VFSS were evaluated before and after completion of iTBS. There were no significant differences between the two groups in terms of demographic and clinical characteristics, including age and type of stroke. The hyoid–larynx approximation ratio increased in the real iTBS group and decreased in the sham iTBS group (median values of pre–post differences were 0.27 vs. −0.01, P < 0.001). The PAS and FDS showed greater improvements in the real iTBS group than in the sham iTBS group (median values of pre–post differences of the PAS were −2.50 vs. 0.00, P = 0.004; median values of pre–post differences of the FDS were −12.50 vs. −2.50, P < 0.001). No adverse effects were reported during or after iTBS sessions. Five-session iTBS to the pharyngeal motor cortex combined with conventional treatment led to a significant improvement in poststroke dysphagia in terms of hyoid–larynx approximation which is related to the suprahyoid muscle. Considering the short duration of one iTBS session, this can be an efficient and effective treatment tool for patients with this condition.

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Early predictors of dysphagia in ischaemic stroke patients

Cited by 5 publications

References 52 publications

Effect of acupuncture on post-stroke dysphagia: a randomized controlled trial

Effect of acupuncture on post-stroke dysphagia: a randomized controlled trial

Cerebral small vessel disease is an independent determinant of dysphagia after acute stroke

The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial

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