Association of Dysphagia With Supratentorial Lesions in Patients With Middle Cerebral Artery Stroke
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objective To determine the supratentorial area associated with poststroke dysphagia, we assessed the diffusion tensor images (DTI) in subacute stroke patients with supratentorial lesions.Methods We included 31 patients with a first episode of infarction in the middle cerebral artery territory. Each subject underwent brain DTI as well as a videofluoroscopic swallowing study (VFSS) and patients divided were into the dysphagia and non-dysphagia groups. Clinical dysphagia scale (CDS) scores were compared between the two groups. The corticospinal tract volume (TV), fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for 11 regions of interest in the supratentorial area—primary motor cortex, primary somatosensory cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule, thalamus, and basal ganglia (putamen and caudate nucleus). DTI parameters were compared between the two groups.Results Among the 31 subjects, 17 were diagnosed with dysphagia by VFSS. Mean TVs were similar across the two groups. Significant inter-group differences were observed in two DTI values: the FA value in the contra-lesional primary motor cortex and the ADC value in the bilateral posterior limbs of the internal capsule (all p<0.05). Conclusion The FA value in the primary motor cortex on the contra-lesional side and the ADC value in the bilateral PLIC can be associated with dysphagia in middle cerebral artery stroke.
Abstract
Objective To determine the supratentorial area associated with poststroke dysphagia, we assessed the diffusion tensor images (DTI) in subacute stroke patients with supratentorial lesions.Methods We included 31 patients with a first episode of infarction in the middle cerebral artery territory. Each subject underwent brain DTI as well as a videofluoroscopic swallowing study (VFSS) and patients divided were into the dysphagia and non-dysphagia groups. Clinical dysphagia scale (CDS) scores were compared between the two groups. The corticospinal tract volume (TV), fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated for 11 regions of interest in the supratentorial area—primary motor cortex, primary somatosensory cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule, thalamus, and basal ganglia (putamen and caudate nucleus). DTI parameters were compared between the two groups.Results Among the 31 subjects, 17 were diagnosed with dysphagia by VFSS. Mean TVs were similar across the two groups. Significant inter-group differences were observed in two DTI values: the FA value in the contra-lesional primary motor cortex and the ADC value in the bilateral posterior limbs of the internal capsule (all p<0.05). Conclusion The FA value in the primary motor cortex on the contra-lesional side and the ADC value in the bilateral PLIC can be associated with dysphagia in middle cerebral artery stroke.
참고문헌 (36)
- Alberts MJ, "Stroke syndrome", pp.213~222 (1995), Cambridge University Press
- Gordon C, "Dysphagia in acute stroke", Br Med J (Clin Res Ed), 295, pp.411~414 (1987)
- Mann G, "Swallowing function after stroke: prognosis and prognostic factors at 6months", Stroke, 30, pp.744~748 (1999)
- Gonzalez-Fernandez M, "Supratentorial regions of acute ischemia associated with clinically important swallowing disorders:a pilot study", Stroke, 39, pp.3022~3028 (2008)
- Mori S, "MRI atlas of human white matter", pp.1~31 (2005), Elsevier
- Basser PJ, "Diffusion-tensor MRI: theory, experimental design and data analysis: a technical review", NMR Biomed, 15, pp.456~467 (2002)
- Basser PJ, "Inferring microstructural features and the physiological state of tissues from diffusion-weighted images", NMR Biomed, 8, pp.333~344 (1995)
- Mori S, "Principles of diffusion tensor imaging and its applications to basic neuroscience research", Neuron, 51, pp.527~539 (2006)
- Pierpaoli C, "Diffusion tensor MR imaging of the human brain", Radiology, 201, pp.637~648 (1996)
- Beaulieu C, "The basis of anisotropic water diffusion in the nervous system: a technical review", NMR Biomed, 15, pp.435~455 (2002)
- Granziera C, "Long-term monitoring of post-stroke plasticity after transient cerebral ischemia in mice using in vivo and ex vivo diffusion tensor MRI", Open Neuroimag J, 1, pp.10~17 (2007)
- van der Steen JT, "Severe dementia and adverse outcomes of nursing home-acquired pneumonia: evidence for mediation by functional and pathophysiological decline", J Am Geriatr Soc, 50, pp.439~448 (2002)
- Buchholz D, "Neurologic causes of dysphagia", Dysphagia, 1, pp.152~156 (1987)
- Robbins JA, "Swallowing and speech production in Parkinson’s disease", Ann Neurol, 19, pp.283~287 (1986)
- Kim H, "Normative data on the Korean version of the Western Aphasia Battery", J Clin Exp Neuropsychol, 26, pp.1011~1020 (2004)
- Schenkenberg T, "Line bisection and unilateral visual neglect in patients with neurologic impairment", Neurology, 30, pp.509~517 (1980)
- Albert ML, "A simple test of visual neglect", Neurology, 23, pp.658~664 (1973)
- 한태륜, "연하곤란식이의 표준화", 대한뇌졸중학회지, 2(2), pp.191~195 (2000), 대한뇌졸중학회
- 정세희, "비디오 투시 연하 검사에 근거한 연하곤란 임상 척도의 타당도 평가", Annals of Rehabilitation Medicine, 29(4), pp.343~350 (2005), 대한재활의학회
- Lee JS, "Fiber tracking by diffusion tensor imaging in corticospinal tract stroke: topographical correlation with clinical symptoms", Neuroimage, 26, pp.771~776 (2005)
- 장성호, "Somatotopic Arrangement and Location of the Corticospinal Tract in the Brainstem of the Human Brain", Yonsei Medical Journal, 52(4), pp.553~557 (2011), 연세대학교의과대학
- Broadley S, "Predictors of prolonged dysphagia following acute stroke", J Clin Neurosci, 10, pp.300~305 (2003)
- Carnaby G, "Behavioural intervention for dysphagia in acute stroke: a randomised controlled trial", Lancet Neurol, 5, pp.31~37 (2006)
- Horner J, "Aspiration following stroke: clinical correlates and outcome", Neurology, 38, pp.1359~1362 (1988)
- Kern MK, "Cerebral cortical representation of reflexive and volitional swallowing in humans", Am J Physiol Gastrointest Liver Physiol, 280, pp.G354~G360 (2001)
- Hamdy S, "The cortical topography of human swallowing musculature in health and disease", Nat Med, 2, pp.1217~1224 (1996)
- Mosier KM, "Lateralization of cortical function in swallowing: a functional MR imaging study", AJNR Am J Neuroradiol, 20, pp.1520~1526 (1999)
- Daniels SK, "The role of the insular cortex in dysphagia", Dysphagia, 12, pp.146~156 (1997)
- Meguro K, "Atrophy of the corpus callosum correlates with white matter lesions in patients with cerebral ischaemia", Neuroradiology, 42, pp.413~419 (2000)
- Buchkremer-Ratzmann I, "Electrophysiological transcortical diaschisis after cortical photothrombosis in rat brain", Stroke, 27, pp.1105~1111 (1996)
- Witte OW, "Delayed and remote effects of focal cortical infarctions: secondary damage and reactive plasticity", Adv Neurol, 73, pp.207~227 (1997)
- Andrews RJ, "Transhemispheric diaschisis: a review and comment", Stroke, 22, pp.943~949 (1991)
- Dobkin JA, "Evidence for transhemispheric diaschisis in unilateral stroke", Arch Neurol, 46, pp.1333~1336 (1989)
- Buffon F, "Longitudinal diffusion changes in cerebral hemispheres after MCA infarcts", J Cereb Blood Flow Metab, 25, pp.641~650 (2005)
- Ogawa T, "Secondary thalamic degeneration after cerebral infarction in the middle cerebral artery distribution:evaluation with MR imaging", Radiology, 204, pp.255~262 (1997)
- Schroeder MF, "Clinical and cognitive predictors of swallowing recovery in stroke", J Rehabil Res Dev, 43, pp.301~310 (2006)