Association Between Duration of Dysphagia Recovery and Lesion Location on Magnetic Resonance Imaging in Patients With Middle Cerebral Artery Infarction

• Published in: Annals of rehabilitation medicine Vol. 43; no. 2; pp. 142 - 148
• Main Authors: Kim, Jae Ho, Oh, Se Hyun, Jeong, Ho Joong, Sim, Young Joo, Kim, Dung Gyu, Kim, Ghi Chan
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Academy of Rehabilitation Medicine 01.04.2019; 대한재활의학회
• Subjects: Dysphagia; Infarction; Middle cerebral artery; Original; 재활의학; Dysphagia; Infarction; Middle cerebral artery
• ISSN: 2234-0645; 2234-0653
• DOI: 10.5535/arm.2019.43.2.142

To investigate association between lesion location on magnetic resonance imaging (MRI) performed after an infarction and the duration of dysphagia in middle cerebral artery (MCA) infarction. A videofluoroscopic swallowing study was performed for 59 patients with dysphagia who were diagnosed as cerebral infarction of the MCA territory confirmed by brain MRI. Lesions were divided into 11 regions of interest: primary somatosensory cortex, primary motor cortex, supplementary motor cortex, anterior cingulate cortex, orbitofrontal cortex, parieto-occipital cortex, insular cortex, posterior limb of the internal capsule (PLIC), thalamus, basal ganglia (caudate nucleus), and basal ganglia (putamen). Recovery time was defined as the period from the first day of L-tube feeding to the day that rice porridge with thickening agent was prescribed. Recovery time and brain lesion patterns were compared and analyzed. The mean recovery time of all patients was 26.71±16.39 days. The mean recovery time was 36.65±15.83 days in patients with PLIC lesions and 32.6±17.27 days in patients with caudate nucleus lesions. Only these two groups showed longer recovery time than the average recovery time for all patients. One-way analysis of variance for recovery time showed significant differences between patients with and without lesions in PLIC and caudate (p<0.001). Injury to both PLIC and caudate nucleus is associated with longer recovery time from dysphagia.