title: Atrophy of Swallowing Muscles Is Associated With Severity of Dysphagia and Age in Patients With Acute Stroke.
abstract: OBJECTIVE
  Sarcopenia has been identified as an independent risk factor for dysphagia. Dysphagia is one of the most important and prognostically relevant complications of acute stroke. The role of muscle atrophy as a contributing factor for the occurrence of poststroke dysphagia is yet unclear.
  
  
  OBJECTIVE
  To assess whether there is a correlation between age and muscle volume and whether muscle volume is related to dysphagia in acute stroke patients.
  
  
  METHODS
  This retrospective, single-center study included 73 patients with acute ischemic or hemorrhagic stroke who underwent computed tomography angiography on admission and an objective dysphagia assessment by Fiberoptic Endoscopic Evaluation of Swallowing within 72 hours from admission. With the help of semiautomated muscle segmentation and 3-dimensional reconstruction volumetry of the digastric, temporal, and geniohyoid muscles was performed. For further analysis, participants were first divided into 4 groups according to their age (<61 years, n = 12; 61-75 years, n = 16; 76-85 years, n = 28; ≥86 years, n = 17), secondly into 3 different groups according to their dysphagia severity using the Fiberoptic Endoscopic Dysphagia Severity Scale (FEDSS) (FEDSS 1 and 2, n = 25; FEDSS 3 and 4, n = 32; FEDSS 5 and 6, n = 16).
  
  
  METHODS
  Correlation of muscle volumes with age and dysphagia severity.
  
  
  RESULTS
  Muscle volumes of single muscles (except for geniohyoid and the right digastric muscles) as well as the sum muscle volume were significantly and inversely related to dysphagia severity. We found a significant decline of muscle volume with advancing age for most muscle groups and, in particular, for the total muscle volume.
  
  
  CONCLUSIONS
  Apart from features being determined by the acute stroke itself (eg, site and size of stroke), also premorbid conditions, in particular age-related muscle atrophy, have an impact on the complex pathophysiology of swallowing disorders poststroke.
authors.affiliation: Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany. Electronic address: Peter.Sporns@ukmuenster.de.
authors.forename: Peter B
authors.initials: PB
authors.lastname: Sporns
authors.affiliation: Department of Neurology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Paul
authors.initials: P
authors.lastname: Muhle
authors.affiliation: Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Hanning
authors.affiliation: Department of Neurology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Suntrup-Krueger
authors.affiliation: Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schwindt
authors.affiliation: Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Julian
authors.initials: J
authors.lastname: Eversmann
authors.affiliation: Department of Neurology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Warnecke
authors.affiliation: Department of Geriatric Medicine, Universitätsklinikum Marien Hospital Herne, Ruhr-University of Bochum, Bochum, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Wirth
authors.affiliation: Department of Clinical Radiology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Zimmer
authors.affiliation: Department of Neurology, University Hospital of Muenster, Muenster, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Dziewas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition; D003680:Deglutition Disorders / Q000209:etiology* / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*
keywords: Oropharyngeal dysphagia; dysphagia; muscle atrophy; presbyphagia; sarcopenia; stroke