Association of Dysphagia With Supratentorial Lesions in Patients With Middle Cerebral Artery Stroke.
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).


CONCLUSIONS
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.
Department of Rehabilitation Medicine, Konkuk University School of Medicine & Konkuk University Medical Center, Seoul, Korea.
Bo-Ram
0000-0002-5463-1268
BR
Kim
Department of Radiology, Konkuk University School of Medicine & Konkuk University Medical Center, Seoul, Korea.
Won-Jin
0000-0002-8925-7376
WJ
Moon
Department of Rehabilitation Medicine, Konkuk University School of Medicine & Konkuk University Medical Center, Seoul, Korea.
Hyuntae
0000-0001-9230-9977
H
Kim
Department of Rehabilitation Medicine, Konkuk University School of Medicine & Konkuk University Medical Center, Seoul, Korea.
Eunhwa
0000-0003-4331-7369
E
Jung
Department of Rehabilitation Medicine, Konkuk University School of Medicine & Konkuk University Medical Center, Seoul, Korea.
Jongmin
0000-0001-8718-0099
J
Lee
Deglutition disorders; Diffusion tensor imaging (DTI); Middle cerebral artery; Stroke