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BMC Neurology
Published in: BMC Neurology 1/2011

Open Access 01-12-2011 | Research article

Cortical swallowing processing in early subacute stroke

Authors: Inga K Teismann, Sonja Suntrup, Tobias Warnecke, Olaf Steinsträter, Maren Fischer, Agnes Flöel, E Bernd Ringelstein, Christo Pantev, Rainer Dziewas

Published in: BMC Neurology | Issue 1/2011

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Abstract

Background

Dysphagia is a major complication in hemispheric as well as brainstem stroke patients causing aspiration pneumonia and increased mortality. Little is known about the recovery from dysphagia after stroke. The aim of the present study was to determine the different patterns of cortical swallowing processing in patients with hemispheric and brainstem stroke with and without dysphagia in the early subacute phase.

Methods

We measured brain activity by mean of whole-head MEG in 37 patients with different stroke localisation 8.2 +/- 4.8 days after stroke to study changes in cortical activation during self-paced swallowing. An age matched group of healthy subjects served as controls. Data were analyzed by means of synthetic aperture magnetometry and group analyses were performed using a permutation test.

Results

Our results demonstrate strong bilateral reduction of cortical swallowing activation in dysphagic patients with hemispheric stroke. In hemispheric stroke without dysphagia, bilateral activation was found. In the small group of patients with brainstem stroke we observed a reduction of cortical activation and a right hemispheric lateralization.

Conclusion

Bulbar central pattern generators coordinate the pharyngeal swallowing phase. The observed right hemispheric lateralization in brainstem stroke can therefore be interpreted as acute cortical compensation of subcortically caused dysphagia. The reduction of activation in brainstem stroke patients and dysphagic patients with cortical stroke could be explained in terms of diaschisis.
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Metadata
Title
Cortical swallowing processing in early subacute stroke
Authors
Inga K Teismann
Sonja Suntrup
Tobias Warnecke
Olaf Steinsträter
Maren Fischer
Agnes Flöel
E Bernd Ringelstein
Christo Pantev
Rainer Dziewas
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2011
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-11-34

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