التفاصيل البيبلوغرافية
| العنوان: |
Differences in swallow physiology in patients with left and right hemispheric strokes |
| المؤلفون: |
William G. Pearson, Leonardo Bonilha, Janet Horn, Heather Shaw Bonilha, Janina Wilmskoetter, Bonnie Martin-Harris, Jordan J. Elm |
| المصدر: |
Physiology & Behavior. 194:144-152 |
| بيانات النشر: |
Elsevier BV, 2018. |
| سنة النشر: |
2018 |
| مصطلحات موضوعية: |
Adult, Male, Modified Barium Swallow, Physiology, Experimental and Cognitive Psychology, Logistic regression, Article, Lateralization of brain function, Lesion, 030507 speech-language pathology & audiology, 03 medical and health sciences, Behavioral Neuroscience, 0302 clinical medicine, Swallowing, Modified Barium Swallow Impairment Profile, medicine, Humans, Dominance, Cerebral, Pharyngeal Residue, Stroke, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Brain, Middle Aged, medicine.disease, Cross-Sectional Studies, Diffusion Magnetic Resonance Imaging, Case-Control Studies, Pharynx, Female, Larynx, medicine.symptom, Deglutition Disorders, 0305 other medical science, business, 030217 neurology & neurosurgery |
| الوصف: |
Background We sought to determine the impact of lesion lateralization and lesion volume on swallow impairment on group-level by comparing patients with left and right hemisphere strokes and on patient-level by analyzing patients individually. Methods We performed a retrospective, observational, cross-sectional study of 46 patients with unilateral (22 left, 24 right), acute, first-ever, ischemic strokes who received a diffusion weighted MRI (DW-MRI) and modified barium swallow study (MBSS) during their acute hospital stay. We determined lesion side on the DW-MRI and measured swallow physiology using the Modified Barium Swallow Impairment Profile (MBSImP™©), Penetration-Aspiration Scale (PAS), swallow timing, distance, area, and speed measures. We performed Pearson's Chi-Square and Wilcoxon Rank-Sum tests to compare patients with left and right hemisphere strokes, and Pearson or Spearman correlation, simple logistic regression, linear, and logistic multivariable regression modeling to assess the relationship between variables. Results At the group-level, there were no differences in MBSImP oral swallow impairment scores between patients with left and right hemisphere stroke. In adjusted analyses, patients with right hemisphere strokes showed significantly worse MBSImP pharyngeal total scores (p = 0.02), worse MBSImP component specific scores for laryngeal vestibular closure (Bonferroni adjusted alpha p ≤ 0.0029), and worse PAS scores (p = 0.03). Patients with right hemisphere strokes showed worse timing, distance, area, and speed measures. Lesion volume was significantly associated with MBSImP pharyngeal residue (p = 0.03) and pharyngeal total scores (p = 0.04). At the patient-level, 24% of patients (4 left, 7 right) showed opposite patterns of MBSImP oral and pharyngeal swallow impairment than seen at group-level. Conclusion Our study showed differences in swallow physiology between patients with right and left unilateral strokes with patients with right hemisphere strokes showing worse pharyngeal impairment. Lesion lateralization seems to be a valuable marker for the severity of swallowing impairment at the group-level but less informative at the patient-level. |
| تدمد: |
0031-9384 |
| URL الوصول: |
https://explore.openaire.eu/search/publication?articleId=doi_dedup___::070c9615fefab8b4da8c3ec96a721432
https://doi.org/10.1016/j.physbeh.2018.05.010 |
| حقوق: |
OPEN |
| رقم الأكسشن: |
edsair.doi.dedup.....070c9615fefab8b4da8c3ec96a721432 |
| قاعدة البيانات: |
OpenAIRE |
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