Response to Letter Regarding Article, “Association of Leukoaraiosis With Convalescent Rehabilitation Outcome in Patients With Ischemic Stroke”

Abstract

We thank Toscano et al 1 for their comments on our study. 2They were concerned about the influence of dysphagia in patients with ischemic stroke in the convalescent rehabilitation stage. We agree that dysphagia can be affected by white matter involvement. 3 However, unfortunately, we did not assess the accurate estimation of the degree of dysphagia by using videofluoroscopic and video endoscopic examinations. Moreover, as well known, dysphagia is basically characterized by ischemic stroke lesions and their portions. 4 In particular, for example, only medullary infarction causes a high rate of dysphagia, regardless of whether the size of the infarction is small, and leukoaraiosis and history of stroke are present or not.5,6 Therefore, we cannot define whether periventricular or deep white matter hyperintensities, and motor or cognitive circuits affect dysphagia at this stage. In addition, we should investigate the associations of lesion localization in ischemic stroke, leukoaraiosis, and poststroke dysphagia with the functional anatomy of the swallowing system in a future research. DisclosuresNone.