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Factors Influencing Oral Intake Improvement And Feeding Tube Dependency In Patients With Poststroke Dysphagia.

J. Wilmskoetter, L. Bonilha, B. Martin-Harris, J. Elm, Janet Horn, H. Bonilha
Published 2019 · Medicine

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OBJECTIVE To assess ischemic stroke patients regarding the relationship between lesion locations, swallowing impairment, medical and demographic factors and (1) oral intake improvement and (2) feeding tube dependency at discharge from their acute hospital stay. METHODS We conducted an exploratory, retrospective observational longitudinal cohort study of acute, first-ever, ischemic stroke patients. Patients who had an initial nonoral feeding recommendation from a speech and language pathologist and who underwent a modified barium swallow study within their hospital stay were included. Oral intake status was measured with the Functional Oral Intake Scale (FOIS) as the change in FOIS during the hospital stay and as feeding tube dependency at hospital discharge. Associations were assessed with multiple linear regression modeling controlling for age, comorbidities, and hospital length of stay. RESULTS We included 44 stroke patients. At hospital discharge, 93% of patients had oral intake restrictions and 30% were feeding tube dependent. Following multiple linear regression modeling, age, damage to the left superior frontal gyrus, dorsal anterior cingulate gyrus, hypothalamus, and nucleus accumbens were significant predictors for FOIS change. Feeding tube dependency showed no significant associations with any prognostic variables when controlling for confounders. CONCLUSIONS The vast majority of patients with an initial nonoral feeding recommendation are discharged with oral intake restrictions indicating a continued need for swallowing assessments and treatment after discharge. Lesion locations associated with motivation, reward, and drive to consume food as well as swallowing impairment, higher age, and more comorbidities were related to less oral intake improvement.
This paper references
10.3389/fnsys.2015.00090
Lateral hypothalamus, nucleus accumbens, and ventral pallidum roles in eating and hunger: interactions between homeostatic and reward circuitry
Daniel C. Castro (2015)
10.1016/j.neuroimage.2007.10.002
Enantiomorphic normalization of focally lesioned brains
P. Nachev (2008)
10.1053/j.gastro.2011.05.047
Val66Met in brain-derived neurotrophic factor affects stimulus-induced plasticity in the human pharyngeal motor cortex.
V. Jayasekeran (2011)
Lateralization of cortical function in swallowing: a functional MR imaging study.
K. Mosier (1999)
10.1212/WNL.0000000000000764
Current practices in feeding tube placement for US acute ischemic stroke inpatients
B. George (2014)
10.1007/s00221-006-0592-6
Cerebral cortical processing of swallowing in older adults
R. Martin (2006)
What influences outcome of stroke--pyrexia or dysphagia?
J. Sharma (2001)
10.1002/hbm.23511
Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke
M. Galovic (2017)
10.1016/j.nicl.2013.03.005
Predicting outcome and recovery after stroke with lesions extracted from MRI images☆
Thomas M. H. Hope (2013)
10.1161/01.STR.0000190056.76543.eb
Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications
R. Martino (2005)
10.1016/j.pmrj.2010.10.016
Neural Plasticity: The Biological Substrate For Neurorehabilitation
Zuha Warraich (2010)
10.1016/j.nicl.2019.101685
Mapping acute lesion locations to physiological swallow impairments after stroke
J. Wilmskoetter (2019)
10.1016/j.neuroimage.2012.03.020
Age-specific CT and MRI templates for spatial normalization
C. Rorden (2012)
10.1016/j.neuroimage.2012.06.070
Nucleus accumbens response to food cues predicts subsequent snack consumption in women and increased body mass index in those with reduced self-control
N. Lawrence (2012)
10.1044/1092-4388(2008/021)
Swallowing and dysphagia rehabilitation: translating principles of neural plasticity into clinically oriented evidence.
J. Robbins (2008)
10.1016/j.jneumeth.2016.03.001
The first step for neuroimaging data analysis: DICOM to NIfTI conversion
X. Li (2016)
10.1016/S0165-1765(01)00479-7
To Peg or Not to Peg? A Simple Model of Exchange Rate Regime Choice in Small Economies
H. Berger (2001)
10.1017/S0029665112000808
Food-induced brain responses and eating behaviour.
P. A. Smeets (2012)
10.1007/s00455-008-9185-9
MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard
Bonnie Martin-Harris (2008)
10.1177/1545968315593808
Success of Anomia Treatment in Aphasia Is Associated With Preserved Architecture of Global and Left Temporal Lobe Structural Networks
L. Bonilha (2016)
10.1507/ENDOCRJ.K10E-077
The role of gut hormones and the hypothalamus in appetite regulation.
K. Suzuki (2010)
10.1016/j.physbeh.2018.05.010
Differences in swallow physiology in patients with left and right hemispheric strokes
J. Wilmskoetter (2018)
10.1016/S1053-8119(03)00285-4
Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing
R. Dziewas (2003)
10.1161/STROKEAHA.109.566133
Relevance of Subcortical Stroke in Dysphagia
M. Cola (2010)
10.1007/s00221-012-3069-9
Functional connectivity and laterality of the motor and sensory components in the volitional swallowing network
Soren Y. Lowell (2012)
10.1016/J.APMR.2004.11.049
Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients.
M. Crary (2005)
10.1159/000457810
MRI-Based Neuroanatomical Predictors of Dysphagia, Dysarthria, and Aphasia in Patients with First Acute Ischemic Stroke
Heather L. Flowers (2017)
10.1016/j.jstrokecerebrovasdis.2012.09.005
Recovery of swallowing after dysphagic stroke: an analysis of prognostic factors.
S. Kumar (2014)
10.1007/s002210100813
Parallel cortical networks for volitional control of swallowing in humans
K. Mosier (2001)
10.1159/000441056
Neuroanatomical, Clinical and Cognitive Correlates of Post-Stroke Dysphagia
M. Toscano (2015)
10.1111/ene.12670
The impact of lesion location on dysphagia incidence, pattern and complications in acute stroke. Part 1: dysphagia incidence, severity and aspiration
S. Suntrup (2015)
10.1044/1092-4388(2008/018)
Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage.
J. Kleim (2008)
10.1016/j.neuroimage.2008.10.012
Neurophysiology of swallowing: Effects of age and bolus type
I. Humbert (2009)
10.1152/JN.1999.81.4.1917
Identification of the cerebral loci processing human swallowing with H2(15)O PET activation.
S. Hamdy (1999)
10.1016/S0967-5868(03)00022-5
Predictors of prolonged dysphagia following acute stroke
S. Broadley (2003)
10.1007/PL00009529
The Role of the Insular Cortex in Dysphagia
S. Daniels (1997)
10.1161/STROKEAHA.108.535468
Swallowing disturbance pattern relates to brain lesion location in acute stroke patients.
V. Steinhagen (2009)
10.1007/PL00009535
The Natural History of Dysphagia following a Stroke
D. Smithard (1997)
10.5535/arm.2012.36.3.347
Correlation between Location of Brain Lesion and Cognitive Function and Findings of Videofluoroscopic Swallowing Study
H. Moon (2012)
10.1161/01.STR.30.4.744
Swallowing function after stroke: prognosis and prognostic factors at 6 months.
G. Mann (1999)
10.1111/ene.13307
The impact of lesion location on dysphagia incidence, pattern and complications in acute stroke. Part 2: Oropharyngeal residue, swallow and cough response, and pneumonia
S. Suntrup-Krueger (2017)
10.1378/CHEST.124.1.328
Aspiration pneumonia and dysphagia in the elderly.
P. Marik (2003)
10.1152/JN.2001.85.2.938
Cerebral cortical representation of automatic and volitional swallowing in humans.
R. Martin (2001)
10.1111/jon19999291
Lesion Localization in Acute Stroke
S. Daniels (1999)
10.1097/MOO.0b013e32832b255e
Cortical input in control of swallowing
E. Michou (2009)
10.1161/STROKEAHA.108.518969
Supratentorial Regions of Acute Ischemia Associated With Clinically Important Swallowing Disorders: A Pilot Study
M. González-Fernández (2008)
10.1007/BF00417897
A penetration-aspiration scale
J. Rosenbek (2004)
10.1080/00207454.2017.1282479
Comparison of dysphagia outcomes between rostral and caudal lateral medullary infarct patients
M. Chun (2017)
10.1161/STROKEAHA.113.001690
Lesion Location Predicts Transient and Extended Risk of Aspiration After Supratentorial Ischemic Stroke
M. Galovic (2013)
10.1007/s00455-017-9788-0
Periventricular White Matter Lesions as a Prognostic Factor of Swallowing Function in Older Patients with Mild Stroke
H. Moon (2017)
10.1007/s00455-012-9414-0
Dysphagia, Nutrition, and Hydration in Ischemic Stroke Patients at Admission and Discharge from Acute Care
M. Crary (2012)
10.1111/j.1365-2753.2011.01650.x
Post-stroke aphasia prognosis: a review of patient-related and stroke-related factors.
E. Plowman (2012)
10.1111/ene.12964
Neuroanatomical correlates of tube dependency and impaired oral intake after hemispheric stroke
M. Galovic (2016)
10.1016/j.neuroimage.2012.03.078
Atlas-based analysis of resting-state functional connectivity: Evaluation for reproducibility and multi-modal anatomy–function correlation studies
Andreia Faria (2012)
10.1007/s00455-007-9080-9
Normal Swallowing and Functional Magnetic Resonance Imaging: A Systematic Review
I. Humbert (2007)
10.1016/j.apmr.2011.10.020
"Virtual" lesioning of the human oropharyngeal motor cortex: a videofluoroscopic study.
E. Vérin (2012)
10.1007/s00455-001-0113-5
Social and Psychological Burden of Dysphagia: Its Impact on Diagnosis and Treatment
O. Ekberg (2002)
10.1007/s12311-014-0584-1
Role of Cerebellum in Deglutition and Deglutition Disorders
Balaji Rangarathnam (2014)
10.1023/A:1025671914949
Cortical Control Mechanisms in Volitional Swallowing: The Bereitschaftspotential
Maggie-Lee Huckabee (2004)
Effects of early intervention of swallowing therapy on recovery from dysphagia following stroke
Jalal Bakhtiyari (2015)
10.1161/STR.0b013e318284056a
Guidelines for the Early Management of Patients With Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association
E. Jauch (2013)
10.1093/BRAIN/AWH138
The human basis pontis: motor syndromes and topographic organization.
J. Schmahmann (2004)
10.2307/2529115
Statistical Power Analysis for the Behavioral Sciences
J. Cohen (1969)
10.1016/j.ejim.2015.11.030
Ischemic stroke outcome: A review of the influence of post-stroke complications within the different scenarios of stroke care.
A. Bustamante (2016)
10.1113/jphysiol.2007.144592
Unilateral suppression of pharyngeal motor cortex to repetitive transcranial magnetic stimulation reveals functional asymmetry in the hemispheric projections to human swallowing
S. Mistry (2007)
10.1002/hbm.20743
Neural activation of swallowing and swallowing‐related tasks in healthy young adults: An attempt to separate the components of deglutition
G. Malandraki (2009)
10.1073/pnas.1613929113
Overdrinking, swallowing inhibition, and regional brain responses prior to swallowing
P. Saker (2016)
10.1016/j.jocn.2006.04.009
Dysphagia in acute ischaemic stroke: severity, recovery and relationship to stroke subtype
P. Langdon (2007)



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