Introduction
The aim of our diffusion tensor tractography study was to determine whether degeneration of the corticobulbar (CBT) is associated with the presence of poststroke dysphagia in patients with middle cerebral artery (MCA) infarction.
Material & Methods
Seventeen patients with dysphagia after unilateral MCA infarction were enrolled. We reviewed Videofluoroscopic Swallowing Study (VFSS) findings performed in the subacute rehabilitation of stroke, and the severity of dysphagia was evaluated using the dysphagia outcome and severity scale (DOSS). Probabilistic tractography was performed using FSL's ProbtrackX program. The two regions of interest (ROIs) were placed over cortex and brainstem to reconstruct the CBT. The seed ROI was located on the lip and tongue representing area corresponding to Homunculus from axial slices. The way ROI was located where the corticobulbar tract lies at mid-pontine level. Tract volume was calculated by multiplying the voxel volume by the number of traced voxels during fiber tracking. Comparison between the affected and unaffected CBT volume were conducted to explore the role of CBT on poststroke dysphagia. Correlation analysis was conducted to determine the association between the DOSS and the integrity of CBT.
Results
Demographic characteristics were as follows; mean age, 65.6 ± 12.5 years; time to VFSS, 22.7 ± 15.5 days, time to DTI acquisition, 32.9 ± 17.1 days, mean DOSS, 4.2 ± 1.8. The volume of affected CBT was smaller than those of unaffected one (affected vs. unaffected CBT, 2774 ± 3839 vs 8029 ± 6090 mm3, p = 0.005). No significant correlation was found between the DOSS and the affected CBT volume.
Conclusions
Degeneration of the affected CBT may be associated with poststroke dysphagia in patients with MCA infarction. The integrity of the affected CBT was not associated with the severity of dysphagia. |
