Relationships between dysarthria, lesion location, and oral/swallowing function in patients with first-ever stroke

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-04-29 DOI:10.1016/j.clineuro.2025.108928

Masahiro Nakamori , Eiji Imamura , Hayato Matsushima , Keisuke Tachiyama , Tomoko Ayukawa , Masami Nishino , Mineka Yoshikawa , Mitsuyoshi Yoshida , Hirofumi Maruyama

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引用次数: 0

Abstract

Objective

Dysarthria negatively affects quality of life and social communication. This study focused on dysarthria in patients with acute-phase stroke and analyzed the association between lesion locations and oral/swallowing functions.

Methods

Patients with first-ever acute stroke were analyzed. Speech assessments included diadochokinesis rates for "pa," "ta," and "ka," along with reading aloud passages. All patients underwent head magnetic resonance imaging, videofluoroscopic (VF) examinations, and tongue pressure measurements to identify stroke lesions.

Results

We analyzed 82 patients with acute stroke excluding those with bilateral or multi-regional lesions (mean age 67.6 ± 11.5 years, 32 women, NIHSS median 1.5). Dysarthria was diagnosed in 16 patients (19.5 %). The National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [OR] 1.289, 95 % confidence interval [CI] 1.050–1.616) and lesions in the corona radiata (OR 9.981, 95 % CI 1.871 – 60.092) were significant risk factors for dysarthria. Tongue pressure was significantly lower in patients with dysarthria, with a cutoff value of 28.4 kPa for predicting dysarthria (area under of the receiver operating characteristic curve 0.688, p = 0.006). Swallowing assessments via VF examinations showed no significant differences between patients with and without dysarthria.

Conclusion

Lesions in the corona radiata are associated with dysarthria in patients with stroke. Reduced tongue pressure is also linked to dysarthria. These findings underscore the importance of evaluating dysarthria independently of dysphagia.

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首次中风患者构音障碍、病变部位和口腔/吞咽功能之间的关系

目的构音障碍对生活质量和社会交往产生不良影响。本研究关注急性期脑卒中患者的构音障碍，并分析病变部位与口腔/吞咽功能之间的关系。方法对首次急性脑卒中患者进行分析。语言评估包括“pa”、“ta”和“ka”的发音障碍率，以及大声朗读段落的情况。所有患者均接受了头部磁共振成像、视频透视（VF）检查和舌压测量，以确定脑卒中病变。结果我们分析了82例急性脑卒中患者，不包括双侧或多区域病变患者（平均年龄67.6 ± 11.5岁，女性32例，NIHSS中位数1.5）。16例确诊构音障碍（19.5 %）。美国国立卫生研究院卒中量表（NIHSS）评分（比值比[OR] 1.289, 95 %可信区间[CI] 1.050-1.616）和放射状冠病变（比值比[OR] 9.981, 95 % CI 1.871 - 60.092）是发音障碍的显著危险因素。构音障碍患者舌压明显降低，预测构音障碍的临界值为28.4 kPa（受者工作特征曲线下面积0.688,p = 0.006）。吞咽评估通过VF检查显示无构音障碍和有构音障碍的患者之间无显著差异。结论脑卒中患者放射冠病变与构音障碍有关。舌压降低也与构音障碍有关。这些发现强调了独立评估构音障碍和吞咽困难的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.