Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Dysphagia
Published in: Dysphagia 4/2017

01-08-2017 | Original Article

Periventricular White Matter Lesions as a Prognostic Factor of Swallowing Function in Older Patients with Mild Stroke

Authors: Hyun Im Moon, Je-Shik Nam, Min Jeong Leem, Kee Hoon Kim

Published in: Dysphagia | Issue 4/2017

Login to get access

Abstract

Older patients with stroke have poor functional prognosis compared to younger patients. Patients with stroke who have severe white matter (WM) lesions have been reported to have poor functional prognosis such as cognitive dysfunction, increased propensity for falling, and gait and balance problems. The aim of this study was to determine whether WM lesions exert negative effects on swallowing function in older patients with mild stroke. We conducted a retrospective analysis of 63 patients aged >65 years who had a National Institutes of Health Stroke Scale score ≤5 and who underwent videofluoroscopic swallowing examination after their first stroke. Linear regression analysis showed that oral transit time tended to increase as Fazekas grade increased (p = 0.003). In addition, inadequate mastication was related to the presence of lesions in the left hemisphere (p = 0.039). The presence of penetration could also be predicted by Fazekas grade (p = 0.015). Our findings suggest that WM lesions observed in brain magnetic resonance imaging scans can impact swallowing problems in older patients with mild stroke, regardless of initial stroke severity or other factors associated with lesion location. Accordingly, our data indicate that WM lesions are a predictive factor by which patients can be stratified into favorable or unfavorable outcomes with respect to dysphagia.
Literature
1.
Denti L, Scoditti U, Tonelli C, Saccavini M, Caminiti C, Valcavi R, et al. The poor outcome of ischemic stroke in very old people: a cohort study of its determinants. J Am Geriatr Soc. 2010;58(1):12–7.CrossRefPubMed
2.
Kammersgaard LP, Jorgensen HS, Reith J, Nakayama H, Pedersen PM, Olsen TS, et al. Short- and long-term prognosis for very old stroke patients. The copenhagen stroke study. Age Ageing. 2004;33(2):149–54.CrossRefPubMed
3.
Feigin VL, Barker-Collo S, Parag V, Senior H, Lawes CM, Ratnasabapathy Y, et al. Auckland stroke outcomes study. part 1: gender, stroke types, ethnicity, and functional outcomes 5 years poststroke. Neurology. 2010;75(18):1597–607.CrossRefPubMed
4.
Shi Q, Presutti R, Selchen D, Saposnik G. Delirium in acute stroke: a systematic review and meta-analysis. Stroke. 2012;43(3):645–9.CrossRefPubMed
5.
Forti P, Maioli F, Procaccianti G, Nativio V, Lega MV, Coveri M, et al. Independent predictors of ischemic stroke in the elderly: prospective data from a stroke unit. Neurology. 2013;80(1):29–38.CrossRefPubMed
6.
Liou LM, Chen CF, Guo YC, Cheng HL, Lee HL, Hsu JS, et al. Cerebral white matter hyperintensities predict functional stroke outcome. Cerebrovasc Dis. 2010;29(1):22–7.CrossRefPubMed
7.
Sonohara K, Kozaki K, Akishita M, Nagai K, Hasegawa H, Kuzuya M, et al. White matter lesions as a feature of cognitive impairment, low vitality and other symptoms of geriatric syndrome in the elderly. Geriatr Gerontol Int. 2008;8(2):93–100.CrossRefPubMed
8.
Srikanth V, Beare R, Blizzard L, Phan T, Stapleton J, Chen J, et al. Cerebral white matter lesions, gait, and the risk of incident falls: a prospective population-based study. Stroke. 2009;40(1):175–80.CrossRefPubMed
9.
Inzitari D, Pracucci G, Poggesi A, Carlucci G, Barkhof F, Chabriat H, et al. Changes in white matter as determinant of global functional decline in older independent outpatients: three year follow-up of LADIS (leukoaraiosis and disability) study cohort. BMJ. 2009;339:b2477.CrossRefPubMedPubMedCentral
10.
Levine R, Robbins JA, Maser A. Periventricular white matter changes and oropharyngeal swallowing in normal individuals. Dysphagia. 1992;7(3):142–7.CrossRefPubMed
11.
Cola MG, Daniels SK, Corey DM, Lemen LC, Romero M, Foundas AL. Relevance of subcortical stroke in dysphagia. Stroke. 2010;41(3):482–6.CrossRefPubMed
12.
Fandler S, Gattringer T, Eppinger S, Doppelhofer K, Pinter D, Niederkorn K. Frequency and predictors of dysphagia in patients with recent small subcortical infarcts. Stroke. 2016;48(1):213–5.CrossRefPubMed
13.
Shaker R. Principles of deglutition: a multidisciplinary text for swallowing and its disorders. New York: Springer; 2013.CrossRef
14.
Martino R, Foley N, Bhogal S, Diamant N, Speechley M, Teasell R. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–63.CrossRefPubMed
15.
Leslie P, Drinnan MJ, Ford GA, Wilson JA. Swallow respiratory patterns and aging: presbyphagia or dysphagia? J Gerontol A Biol Sci Med Sci. 2005;60(3):391–5.CrossRefPubMed
16.
Aviv JE. Effects of aging on sensitivity of the pharyngeal and supraglottic areas. Am J Med. 1997;103(5A):74S–6S.CrossRefPubMed
17.
Cook IJ, Weltman MD, Wallace K, Shaw DW, McKay E, Smart RC, et al. Influence of aging on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study. Am J Physiol. 1994;266(6 Pt 1):G972–7.PubMed
18.
19.
Daggett A, Logemann J, Rademaker A, Pauloski B. Laryngeal penetration during deglutition in normal subjects of various ages. Dysphagia. 2006;21(4):270–4.CrossRefPubMed
20.
Lee KM, Jang YH, Kim YH, Moon SK, Park JH, Park SW, Yu HJ, Lee SG, Chun MH, Han TR. Reliability and validity of Korean version of national institutes of health stroke scale. J Korean Acad Rehab Med. 2004;28:422–35.
21.
Logemann JA. Swallowing physiology and pathophysiology. Otolaryngol Clin North Am. 1988;21(4):613–23.PubMed
22.
Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol. 1987;149(2):351–6.CrossRefPubMed
23.
Yokoyama M, Mitomi N, Tetsuka K, Tayama N, Niimi S. Role of laryngeal movement and effect of aging on swallowing pressure in the pharynx and upper esophageal sphincter. Laryngoscope. 2000;110(3 Pt 1):434–9.CrossRefPubMed
24.
Rademaker AW, Pauloski BR, Colangelo LA, Logemann JA. Age and volume effects on liquid swallowing function in normal women. J Speech Lang Hear Res. 1998;41(2):275–84.CrossRefPubMed
25.
McKee GJ, Johnston BT, McBride GB, Primrose WJ. Does age or sex affect pharyngeal swallowing? Clin Otolaryngol Allied Sci. 1998;23(2):100–6.CrossRefPubMed
26.
Nilsson H, Ekberg O, Olsson R, Hindfelt B. Quantitative aspects of swallowing in an elderly nondysphagic population. Dysphagia. 1996;11(3):180–4.CrossRefPubMed
27.
Toscano M, Cecconi E, Capiluppi E, Vigano A, Bertora P, Campiglio L, et al. Neuroanatomical, clinical and cognitive correlates of post-stroke dysphagia. Eur Neurol. 2015;74(3–4):171–7.CrossRefPubMed
28.
Murray ME, Vemuri P, Preboske GM, Murphy MC, Schweitzer KJ, Parisi JE, et al. A quantitative postmortem MRI design sensitive to white matter hyperintensity differences and their relationship with underlying pathology. J Neuropathol Exp Neurol. 2012;71(12):1113–22.CrossRefPubMedPubMedCentral
29.
Mitchell GF. Effects of central arterial aging on the structure and function of the peripheral vasculature: implications for end-organ damage. J Appl Physiol. 2008;105(5):1652–60.CrossRefPubMedPubMedCentral
30.
Bisschops RH, van der Graaf Y, Mali WP, van der Grond J, group Ss. High total cerebral blood flow is associated with a decrease of white matter lesions. J Neurol. 2004;251(12):1481–5.CrossRefPubMed
31.
Nudo RJ. Postinfarct cortical plasticity and behavioral recovery. Stroke. 2007;38(2 Suppl):840–5.CrossRefPubMed
32.
Madden DJ, Bennett IJ, Song AW. Cerebral white matter integrity and cognitive aging: contributions from diffusion tensor imaging. Neuropsychol Rev. 2009;19(4):415–35.CrossRefPubMedPubMedCentral
33.
Gunning-Dixon FM, Brickman AM, Cheng JC, Alexopoulos GS. Aging of cerebral white matter: a review of MRI findings. Int J Geriatr Psychiatry. 2009;24(2):109–17.CrossRefPubMedPubMedCentral
34.
de Groot M, Ikram MA, Akoudad S, Krestin GP, Hofman A, van der Lugt A, et al. Tract-specific white matter degeneration in aging: the Rotterdam Study. Alzheimers Dement. 2015;11(3):321–30.CrossRefPubMed
35.
Moon HI, Choi SY, Tae WS, Pyun SB. Effects of age on cortical activation during swallowing: an fMRI study. J Korean Dysphagia Soc. 2016;6(1):26–33.
36.
Martin R, Barr A, MacIntosh B, Smith R, Stevens T, Taves D, et al. Cerebral cortical processing of swallowing in older adults. Exp Brain Res. 2007;176(1):12–22.CrossRefPubMed
37.
Humbert IA, Fitzgerald ME, McLaren DG, Johnson S, Porcaro E, Kosmatka K, et al. Neurophysiology of swallowing: effects of age and bolus type. Neuroimage. 2009;44(3):982–91.CrossRefPubMed
38.
van den Heuvel DM, ten Dam VH, de Craen AJ, Admiraal-Behloul F, Olofsen H, Bollen EL, et al. Increase in periventricular white matter hyperintensities parallels decline in mental processing speed in a non-demented elderly population. J Neurol Neurosurg Psychiatry. 2006;77(2):149–53.CrossRefPubMedPubMedCentral
39.
Wright CB, Festa JR, Paik MC, Schmiedigen A, Brown TR, Yoshita M, et al. White matter hyperintensities and subclinical infarction: associations with psychomotor speed and cognitive flexibility. Stroke. 2008;39(3):800–5.CrossRefPubMedPubMedCentral
40.
Secil Y, Arici S, Incesu TK, Gurgor N, Beckmann Y, Ertekin C. Dysphagia in Alzheimer’s disease. Neurophysiol Clin. 2016;46(3):171–8.CrossRefPubMed
41.
Boccardi V, Ruggiero C, Patriti A, Marano L. Diagnostic assessment and management of dysphagia in patients with Alzheimer’s disease. J Alzheimers Dis. 2016;50(4):947–55.CrossRefPubMed
42.
Rosler A, Pfeil S, Lessmann H, Hoder J, Befahr A, von Renteln-Kruse W. Dysphagia in dementia: influence of dementia severity and food texture on the prevalence of aspiration and latency to swallow in hospitalized geriatric patients. J Am Med Dir Assoc. 2015;16(8):697–701.CrossRefPubMed
43.
Suh MK, Kim H, Na DL. Dysphagia in patients with dementia: alzheimer versus vascular. Alzheimer Dis Assoc Disord. 2009;23(2):178–84.CrossRefPubMed
44.
Lee CK, Kim JA. Pattern of post-stroke swallowing disorder according to the brain lesion. J Korean Acad Rehab Med. 2001;25:193–201.
45.
Steinhagen V, Grossmann A, Benecke R, Walter U. Swallowing disturbance pattern relates to brain lesion location in acute stroke patients. Stroke. 2009;40(5):1903–6.CrossRefPubMed
46.
Graff-Radford J, Jones DT, Strand EA, Rabinstein AA, Duffy JR, Josephs KA. The neuroanatomy of pure apraxia of speech in stroke. Brain Lang. 2014;129:43–6.CrossRefPubMedPubMedCentral
47.
Wakasugi Y, Tohara H, Hattori F, Motohashi Y, Nakane A, Goto S, et al. Screening test for silent aspiration at the bedside. Dysphagia. 2008;23(4):364–70.CrossRefPubMed
48.
Martino R, Silver F, Teasell R, Bayley M, Nicholson G, Streiner DL, et al. The toronto bedside swallowing screening test (TOR-BSST): development and validation of a dysphagia screening tool for patients with stroke. Stroke. 2009;40(2):555–61.CrossRefPubMed
Metadata
Title
Periventricular White Matter Lesions as a Prognostic Factor of Swallowing Function in Older Patients with Mild Stroke
Authors
Hyun Im Moon
Je-Shik Nam
Min Jeong Leem
Kee Hoon Kim
Publication date
01-08-2017
Publisher
Springer US
Published in
Dysphagia / Issue 4/2017
Print ISSN: 0179-051X
Electronic ISSN: 1432-0460
DOI
https://doi.org/10.1007/s00455-017-9788-0

Other articles of this Issue 4/2017

Dysphagia 4/2017 Go to the issue

Original Article

Biodegradable Stents for Caustic Esophageal Strictures: Do They Work?

Original Article

Swallowing Preparation and Execution: Insights from a Delayed-Response Functional Magnetic Resonance Imaging (fMRI) Study

Review Article

Swallowing Disorders in Schizophrenia

Original Article

Maximum Tongue Pressure is Associated with Swallowing Dysfunction in ALS Patients

Clinical Conundrum

Dysphagia in a Patient with Cervical Dystonia

Original Article

The Anxiety Level of Caregivers of Neurological Patients with Dysphagia