Galovic, M;
Leisi, N;
Pastore-Wapp, M;
Zbinden, M;
Vos, SB;
Mueller, M;
Weber, J;
... Weder, BJ; + view all
(2017)
Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke.
Human Brain Mapping
, 38
(4)
pp. 2165-2176.
10.1002/hbm.23511.
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Abstract
Knowledge about the recovery of oral intake after hemispheric stroke is important to guide therapeutic decisions, including the administration of enteral tube feeding and the choice of the appropriate feeding route. They aimed to determine the localization and connectivity of lesions in impaired recovery versus recovered swallowing after initially dysphagic stroke. Sixty-two acute ischemic hemispheric stroke patients with impaired oral intake were included in a prospective observational cohort study. Voxel-based lesion-symptom mapping and probabilistic tractography were used to determine the association of lesion location and connectivity with impaired recovery of oral intake ≥7 days (indication for early tube feeding) and ≥4 weeks (indication for percutaneous endoscopic gastrostomy feeding) after stroke. Two distinct patterns influencing recovery of swallowing were recognized. Firstly, impaired recovery of oral intake after ≥7 days was significantly associated with lesions of the superior corona radiata (65% of statistical map, P < 0.05). The affected fibers were connected with the thalamus, primary motor, and supplemental motor areas and the basal ganglia. Secondly, impaired recovery of oral intake after ≥4 weeks significantly correlated with lesions of the anterior insula (54% of statistical map, P < 0.05), which was connected to adjacent operculo-insular areas of deglutition. These findings indicate that early swallowing recovery is influenced by white matter lesions disrupting thalamic and corticobulbar projection fibers. Late recovery is determined by specific cortical lesions affecting association fibers. This knowledge may help clinicians to identify patients at risk of prolonged swallowing problems that would benefit from enteral tube feeding. Hum Brain Mapp, 2017. © 2017 Wiley Periodicals, Inc.
| Type: | Article |
|---|---|
| Title: | Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/hbm.23511 |
| Publisher version: | http://doi.org/10.1002/hbm.23511 |
| Language: | English |
| Additional information: | Copyright © 2017 Wiley Periodicals, Inc. All rights reserved. This is the peer reviewed version of the following article: Galovic, M; Leisi, N; Pastore-Wapp, M; Zbinden, M; Vos, SB; Mueller, M; Weber, J; (2017) Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke. Human Brain Mapping , 38 (4) pp. 2165-2176, which has been published in final form at http://doi.org/10.1002/hbm.23511. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. |
| Keywords: | Deglutition disorders, dysphagia, magnetic resonance imaging, rehabilitation, stroke |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1538465 |
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