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参与吞咽的脑区:横断面研究中中风患者的证据。

Brain regions involved in swallowing: Evidence from stroke patients in a cross-sectional study.

作者信息

Dehaghani Shiva Ebrahimian, Yadegari Fariba, Asgari Ali, Chitsaz Ahmad, Karami Mehdi

机构信息

Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; Department of Speech Therapy, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

出版信息

J Res Med Sci. 2016 Jun 14;21:45. doi: 10.4103/1735-1995.183997. eCollection 2016.

Abstract

BACKGROUND

Limited data available about the mechanisms of dysphagia and areas involving swallow after brain damage; accordingly it is hard to predict which cases are more likely to develop swallowing dysfunction based on the neuroimaging. The aim of this study was to investigate the relationship between brain lesions and dysphagia in a sample of acute conscious stroke patients.

MATERIALS AND METHODS

In a cross-sectional study, 113 acute conscious stroke patients (69 male mean [standard deviation (SD)] age 64.37 [15.1]), participated in this study. Two neurologists and one radiologist localized brain lesions according to neuroimaging of the patients. Swallowing functions were assessed clinically by an expert speech pathologist with the Mann Assessment of Swallowing Ability (MASA). The association of brain region and swallowing problem was statistically evaluated using Chi-square test.

RESULTS

Mean (SD) MASA score for the dysphagic patients was 139.61 (29.77). Swallowing problem was significantly more prevalent in the right primary sensory ( = 0.03), right insula ( = 0.005), and right internal capsule ( = 0.05).

CONCLUSION

It may be concluded from these findings that the right hemisphere lesions associated with occurring dysphagia. Further studies using more advanced diagnostic tools on big samples particularly in a perspective structure are needed.

摘要

背景

关于脑损伤后吞咽困难的机制以及吞咽涉及区域的数据有限;因此,很难根据神经影像学来预测哪些病例更有可能发展为吞咽功能障碍。本研究的目的是在急性意识清醒的中风患者样本中调查脑损伤与吞咽困难之间的关系。

材料与方法

在一项横断面研究中,113名急性意识清醒的中风患者(69名男性,平均[标准差(SD)]年龄64.37[15.1])参与了本研究。两名神经科医生和一名放射科医生根据患者的神经影像学确定脑损伤部位。由一名专业言语病理学家使用曼恩吞咽能力评估(MASA)对吞咽功能进行临床评估。使用卡方检验对脑区与吞咽问题之间的关联进行统计学评估。

结果

吞咽困难患者的平均(SD)MASA评分为139.61(29.77)。吞咽问题在右侧初级感觉区(=0.03)、右侧岛叶(=0.005)和右侧内囊(=0.05)中明显更为普遍。

结论

从这些发现可以得出结论,右侧半球损伤与吞咽困难的发生有关。需要使用更先进的诊断工具对大样本进行进一步研究,尤其是从结构角度进行研究。

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