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Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia

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Názov: Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia
Autori: Sriramya Lapa, Christian Foerch, Oliver C. Singer, Elke Hattingen, Sebastian Luger
Zdroj: Dysphagia
Informácie o vydavateľovi: Springer Science and Business Media LLC, 2020.
Rok vydania: 2020
Predmety: 2. Zero hunger, ddc:610, Deglutition Disorders/diagnostic imaging [MeSH], Risk Assessment [MeSH], Humans [MeSH], Swallowing, Infarction, Middle Cerebral Artery [MeSH], Stroke/complications [MeSH], Dysphagia, Original Article, Stroke, Magnetic Resonance Imaging [MeSH], Stroke/diagnostic imaging [MeSH], Pneumonia, ASPECTS, Deglutition Disorders/etiology [MeSH], 4. Education, Infarction, Middle Cerebral Artery, Magnetic Resonance Imaging, Risk Assessment, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, Humans, Deglutition Disorders
Popis: Dysphagia is common in patients with middle cerebral artery (MCA) infarctions and associated with malnutrition, pneumonia, and mortality. Besides bedside screening tools, brain imaging findings may help to timely identify patients with swallowing disorders. We investigated whether the Alberta stroke program early CT score (ASPECTS) allows for the correlation of distinct ischemic lesion patterns with dysphagia. We prospectively examined 113 consecutive patients with acute MCA infarctions. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed within 24 h after admission for validation of dysphagia. Brain imaging (CT or MRI) was rated for ischemic changes according to the ASPECT score. 62 patients (54.9%) had FEES-proven dysphagia. In left hemispheric strokes, the strongest associations between the ASPECTS sectors and dysphagia were found for the lentiform nucleus (odds ratio 0.113 [CI 0.028–0.433; p = 0.001), the insula (0.275 [0.102–0.742]; p = 0.011), and the frontal operculum (0.280 [CI 0.094–0.834]; p = 0.022). A combination of two or even all three of these sectors together increased relative dysphagia frequency up to 100%. For right hemispheric strokes, only non-significant associations were found which were strongest for the insula region. The distribution of early ischemic changes in the MCA territory according to ASPECTS may be used as risk indicator of neurogenic dysphagia in MCA infarction, particularly when the left hemisphere is affected. However, due to the exploratory nature of this research, external validation studies of these findings are warranted in future.
Druh dokumentu: Article
Other literature type
Popis súboru: application/octet-stream
Jazyk: English
ISSN: 1432-0460
0179-051X
DOI: 10.1007/s00455-020-10204-0
Prístupová URL adresa: https://link.springer.com/content/pdf/10.1007/s00455-020-10204-0.pdf
https://pubmed.ncbi.nlm.nih.gov/33159258
https://link.springer.com/article/10.1007/s00455-020-10204-0
https://pubmed.ncbi.nlm.nih.gov/33159258/
https://link.springer.com/content/pdf/10.1007/s00455-020-10204-0.pdf
https://www.scilit.net/article/e716c137d4abb0c2c09519451fe2bcef
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464570
https://europepmc.org/article/MED/33159258
https://repository.publisso.de/resource/frl:6469492
http://publikationen.ub.uni-frankfurt.de/files/63623/container.zip
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Prístupové číslo: edsair.doi.dedup.....001bd4ccf0ecc4c02aa9df844062ecc5
Databáza: OpenAIRE
Popis
Abstrakt:Dysphagia is common in patients with middle cerebral artery (MCA) infarctions and associated with malnutrition, pneumonia, and mortality. Besides bedside screening tools, brain imaging findings may help to timely identify patients with swallowing disorders. We investigated whether the Alberta stroke program early CT score (ASPECTS) allows for the correlation of distinct ischemic lesion patterns with dysphagia. We prospectively examined 113 consecutive patients with acute MCA infarctions. Fiberoptic endoscopic evaluation of swallowing (FEES) was performed within 24 h after admission for validation of dysphagia. Brain imaging (CT or MRI) was rated for ischemic changes according to the ASPECT score. 62 patients (54.9%) had FEES-proven dysphagia. In left hemispheric strokes, the strongest associations between the ASPECTS sectors and dysphagia were found for the lentiform nucleus (odds ratio 0.113 [CI 0.028–0.433; p = 0.001), the insula (0.275 [0.102–0.742]; p = 0.011), and the frontal operculum (0.280 [CI 0.094–0.834]; p = 0.022). A combination of two or even all three of these sectors together increased relative dysphagia frequency up to 100%. For right hemispheric strokes, only non-significant associations were found which were strongest for the insula region. The distribution of early ischemic changes in the MCA territory according to ASPECTS may be used as risk indicator of neurogenic dysphagia in MCA infarction, particularly when the left hemisphere is affected. However, due to the exploratory nature of this research, external validation studies of these findings are warranted in future.
ISSN:14320460
0179051X
DOI:10.1007/s00455-020-10204-0