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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
Lateral hypothalamus, nucleus accumbens, and ventral pallidum roles in eating and hunger: interactions between homeostatic and reward circuitry
Daniel C. Castro (2015)
Enantiomorphic normalization of focally lesioned brains
P. Nachev (2008)
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)
Current practices in feeding tube placement for US acute ischemic stroke inpatients
B. George (2014)
Cerebral cortical processing of swallowing in older adults
R. Martin (2006)
What influences outcome of stroke--pyrexia or dysphagia?
J. Sharma (2001)
Diverging lesion and connectivity patterns influence early and late swallowing recovery after hemispheric stroke
M. Galovic (2017)
Predicting outcome and recovery after stroke with lesions extracted from MRI images☆
Thomas M. H. Hope (2013)
Dysphagia After Stroke: Incidence, Diagnosis, and Pulmonary Complications
R. Martino (2005)
Neural Plasticity: The Biological Substrate For Neurorehabilitation
Zuha Warraich (2010)
Mapping acute lesion locations to physiological swallow impairments after stroke
J. Wilmskoetter (2019)
Age-specific CT and MRI templates for spatial normalization
C. Rorden (2012)
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)
Swallowing and dysphagia rehabilitation: translating principles of neural plasticity into clinically oriented evidence.
J. Robbins (2008)
The first step for neuroimaging data analysis: DICOM to NIfTI conversion
X. Li (2016)
To Peg or Not to Peg? A Simple Model of Exchange Rate Regime Choice in Small Economies
H. Berger (2001)
Food-induced brain responses and eating behaviour.
P. A. Smeets (2012)
MBS Measurement Tool for Swallow Impairment—MBSImp: Establishing a Standard
Bonnie Martin-Harris (2008)
Success of Anomia Treatment in Aphasia Is Associated With Preserved Architecture of Global and Left Temporal Lobe Structural Networks
L. Bonilha (2016)
The role of gut hormones and the hypothalamus in appetite regulation.
K. Suzuki (2010)
Differences in swallow physiology in patients with left and right hemispheric strokes
J. Wilmskoetter (2018)
Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing
R. Dziewas (2003)
Relevance of Subcortical Stroke in Dysphagia
M. Cola (2010)
Functional connectivity and laterality of the motor and sensory components in the volitional swallowing network
Soren Y. Lowell (2012)
Initial psychometric assessment of a functional oral intake scale for dysphagia in stroke patients.
M. Crary (2005)
MRI-Based Neuroanatomical Predictors of Dysphagia, Dysarthria, and Aphasia in Patients with First Acute Ischemic Stroke
Heather L. Flowers (2017)
Recovery of swallowing after dysphagic stroke: an analysis of prognostic factors.
S. Kumar (2014)
Parallel cortical networks for volitional control of swallowing in humans
K. Mosier (2001)
Neuroanatomical, Clinical and Cognitive Correlates of Post-Stroke Dysphagia
M. Toscano (2015)
The impact of lesion location on dysphagia incidence, pattern and complications in acute stroke. Part 1: dysphagia incidence, severity and aspiration
S. Suntrup (2015)
Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage.
J. Kleim (2008)
Neurophysiology of swallowing: Effects of age and bolus type
I. Humbert (2009)
Identification of the cerebral loci processing human swallowing with H2(15)O PET activation.
S. Hamdy (1999)
Predictors of prolonged dysphagia following acute stroke
S. Broadley (2003)
The Role of the Insular Cortex in Dysphagia
S. Daniels (1997)
Swallowing disturbance pattern relates to brain lesion location in acute stroke patients.
V. Steinhagen (2009)
The Natural History of Dysphagia following a Stroke
D. Smithard (1997)
Correlation between Location of Brain Lesion and Cognitive Function and Findings of Videofluoroscopic Swallowing Study
H. Moon (2012)
Swallowing function after stroke: prognosis and prognostic factors at 6 months.
G. Mann (1999)
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)
Aspiration pneumonia and dysphagia in the elderly.
P. Marik (2003)
Cerebral cortical representation of automatic and volitional swallowing in humans.
R. Martin (2001)
Lesion Localization in Acute Stroke
S. Daniels (1999)
Cortical input in control of swallowing
E. Michou (2009)
Supratentorial Regions of Acute Ischemia Associated With Clinically Important Swallowing Disorders: A Pilot Study
M. González-Fernández (2008)
A penetration-aspiration scale
J. Rosenbek (2004)
Comparison of dysphagia outcomes between rostral and caudal lateral medullary infarct patients
M. Chun (2017)
Lesion Location Predicts Transient and Extended Risk of Aspiration After Supratentorial Ischemic Stroke
M. Galovic (2013)
Periventricular White Matter Lesions as a Prognostic Factor of Swallowing Function in Older Patients with Mild Stroke
H. Moon (2017)
Dysphagia, Nutrition, and Hydration in Ischemic Stroke Patients at Admission and Discharge from Acute Care
M. Crary (2012)
Post-stroke aphasia prognosis: a review of patient-related and stroke-related factors.
E. Plowman (2012)
Neuroanatomical correlates of tube dependency and impaired oral intake after hemispheric stroke
M. Galovic (2016)
Atlas-based analysis of resting-state functional connectivity: Evaluation for reproducibility and multi-modal anatomy–function correlation studies
Andreia Faria (2012)
Normal Swallowing and Functional Magnetic Resonance Imaging: A Systematic Review
I. Humbert (2007)
"Virtual" lesioning of the human oropharyngeal motor cortex: a videofluoroscopic study.
E. Vérin (2012)
Social and Psychological Burden of Dysphagia: Its Impact on Diagnosis and Treatment
O. Ekberg (2002)
Role of Cerebellum in Deglutition and Deglutition Disorders
Balaji Rangarathnam (2014)
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)
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)
The human basis pontis: motor syndromes and topographic organization.
J. Schmahmann (2004)
Statistical Power Analysis for the Behavioral Sciences
J. Cohen (1969)
Ischemic stroke outcome: A review of the influence of post-stroke complications within the different scenarios of stroke care.
A. Bustamante (2016)
Unilateral suppression of pharyngeal motor cortex to repetitive transcranial magnetic stimulation reveals functional asymmetry in the hemispheric projections to human swallowing
S. Mistry (2007)
Neural activation of swallowing and swallowing‐related tasks in healthy young adults: An attempt to separate the components of deglutition
G. Malandraki (2009)
Overdrinking, swallowing inhibition, and regional brain responses prior to swallowing
P. Saker (2016)
Dysphagia in acute ischaemic stroke: severity, recovery and relationship to stroke subtype
P. Langdon (2007)
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