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Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study

Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population...

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Autores principales: Mihai, Paul Glad, Otto, Mareile, Domin, Martin, Platz, Thomas, Hamdy, Shaheen, Lotze, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153603/
https://www.ncbi.nlm.nih.gov/pubmed/27995067
http://dx.doi.org/10.1016/j.nicl.2016.05.006
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author Mihai, Paul Glad
Otto, Mareile
Domin, Martin
Platz, Thomas
Hamdy, Shaheen
Lotze, Martin
author_facet Mihai, Paul Glad
Otto, Mareile
Domin, Martin
Platz, Thomas
Hamdy, Shaheen
Lotze, Martin
author_sort Mihai, Paul Glad
collection PubMed
description Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population remains uncertain. Here, we investigated 18 patients post-stroke who recovered from dysphagia using an event related functional magnetic resonance imaging (fMRI) study of swallowing. Patients were characterized by initial dysphagia score (mild to severe), lesion mapping, white matter fractional anisotropy (FA) of the pyramidal tracts, and swallowing performance measurement during fMRI scanning. Eighteen age matched healthy participants served as a control group. Overall, patients showed decreased fMRI-activation in the entire swallowing network apart from an increase of activation in the contralesional primary somatosensory cortex (S1). Moreover, fMRI activation in contralesional S1 correlated with initial dysphagia score. Finally, when lesions of the pyramidal tract were more severe, recovered swallowing appeared to be associated with asymmetric activation of the ipsilesional anterior cerebellum. Taken together, our data support a role for increased contralesional somatosensory resources and ipsilesional anterior cerebellum feed forward loops for recovered swallowing after dysphagia following stroke.
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spelling pubmed-51536032016-12-19 Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study Mihai, Paul Glad Otto, Mareile Domin, Martin Platz, Thomas Hamdy, Shaheen Lotze, Martin Neuroimage Clin Article Neurogenic dysphagia frequently occurs after stroke and deglutitive aspiration is one of the main reasons for subacute death after stroke. Although promising therapeutic interventions for neurogenic dysphagia are being developed, the functional neuroanatomy of recovered swallowing in this population remains uncertain. Here, we investigated 18 patients post-stroke who recovered from dysphagia using an event related functional magnetic resonance imaging (fMRI) study of swallowing. Patients were characterized by initial dysphagia score (mild to severe), lesion mapping, white matter fractional anisotropy (FA) of the pyramidal tracts, and swallowing performance measurement during fMRI scanning. Eighteen age matched healthy participants served as a control group. Overall, patients showed decreased fMRI-activation in the entire swallowing network apart from an increase of activation in the contralesional primary somatosensory cortex (S1). Moreover, fMRI activation in contralesional S1 correlated with initial dysphagia score. Finally, when lesions of the pyramidal tract were more severe, recovered swallowing appeared to be associated with asymmetric activation of the ipsilesional anterior cerebellum. Taken together, our data support a role for increased contralesional somatosensory resources and ipsilesional anterior cerebellum feed forward loops for recovered swallowing after dysphagia following stroke. Elsevier 2016-05-10 /pmc/articles/PMC5153603/ /pubmed/27995067 http://dx.doi.org/10.1016/j.nicl.2016.05.006 Text en © 2016 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Mihai, Paul Glad
Otto, Mareile
Domin, Martin
Platz, Thomas
Hamdy, Shaheen
Lotze, Martin
Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study
title Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study
title_full Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study
title_fullStr Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study
title_full_unstemmed Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study
title_short Brain imaging correlates of recovered swallowing after dysphagic stroke: A fMRI and DWI study
title_sort brain imaging correlates of recovered swallowing after dysphagic stroke: a fmri and dwi study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153603/
https://www.ncbi.nlm.nih.gov/pubmed/27995067
http://dx.doi.org/10.1016/j.nicl.2016.05.006
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