Department of Neurology and Psiquiatry, Sao Paulo State University-UNESP, Botucatu SP, Brazil.
Department of Medicine, Marilia University - UNIMAR, Marilia SP, Brazil.
J Stroke Cerebrovasc Dis. 2021 Apr;30(4):105349. doi: 10.1016/j.jstrokecerebrovasdis.2020.105349. Epub 2021 Feb 5.
INTRODUCTION/OBJECTIVE: The aim of this study is to analyze the influence of sour taste and cold temperature in the initiation of the pharyngeal swallow (IPS) and bolus location at pharyngeal swallow onset in individuals after stroke.
Cross-sectional prospective study. The study included 52 individuals with unilateral ischemic stroke. Each individual was assessed by videofluoroscopic swallowing study with 5ml of paste bolus offering four different stimuli (natural, cold, sour, and sour-cold). The individuals were divided into two groups according to the offer sequence. Group 1 (G1) - received a randomized sequence of stimuli (24 individuals), and Group 2 (G2) -the stimuli were offered in the following order: natural, cold, sour, and sour-cold(28 individuals). The IPS time and bolus location at pharyngeal swallow onset were analyzed. The bolus location at pharyngeal swallow onset was defined using six different levels.
Individuals in G1 did not show a significant difference in IPS time between stimuli. However, individuals in G2 presented a significantly shorter IPS time with the sour and sour-cold stimuli than with natural or cold stimuli. The bolus location at pharyngeal swallow onset did not show significant difference between stimuli in both groups. On the other hand, in the G2 it was observed higher frequency of swallowing with sour-cold stimulus at level 1 (the bolus head was located in any region between the fauces pillar and the point where the tongue crosses the inferior border of the mandible).
The sour and sour-cold stimuli influenced the IPS time when they were offered in a sequential order. Moreover, both the IPS time and bolus location at pharyngeal swallow onset were not influenced by the sour and sour cold-bolus when offered in a random sequence.
简介/目的：本研究旨在分析酸刺激和冷刺激对脑卒中后个体咽期吞咽（IPS）起始的影响以及食团在咽期吞咽起始时的位置。
这是一项横断面前瞻性研究。研究纳入了 52 名单侧缺血性脑卒中患者。每位患者均接受 5ml 糊剂食团的视频透视吞咽研究，并提供四种不同的刺激（自然、冷、酸和酸冷）。根据刺激提供顺序将患者分为两组。组 1（G1）- 接受随机刺激顺序（24 名患者），组 2（G2）- 刺激按以下顺序提供（28 名患者）：自然、冷、酸和酸冷。分析 IPS 时间和咽期吞咽起始时食团的位置。咽期吞咽起始时食团的位置使用六个不同的水平来定义。
G1 组患者在不同刺激之间的 IPS 时间无显著差异。然而，G2 组患者在酸刺激和酸冷刺激时的 IPS 时间明显短于自然刺激或冷刺激时的 IPS 时间。两组患者在不同刺激之间的咽期吞咽起始时食团位置均无显著差异。另一方面，在 G2 组中，观察到在酸冷刺激时，1 级（食团头部位于会厌皱襞和舌越过下颌骨下缘之间的任何区域）的吞咽频率更高。
当刺激按顺序提供时，酸刺激和酸冷刺激会影响 IPS 时间。此外，当以随机顺序提供酸和酸冷食团时，IPS 时间和咽期吞咽起始时食团位置不受影响。
