Dysphagia after stroke: research advances in treatment interventions

The Lancet Neurology, Journal Year: 2024, Volume and Issue: 23(4), P. 418 - 428

Published: March 18, 2024

Language: Английский

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Systematic approach to contextualize findings of flexible endoscopic evaluation of swallowing in neurogenic dysphagia– towards an integrated FEES report

Neurological Research and Practice, Journal Year: 2024, Volume and Issue: 6(1)

Published: May 9, 2024

Abstract Flexible endoscopic evaluation of swallowing (FEES) is one the most important methods for instrumental evaluation. The challenging part examination consists in interpretation various observations encountered during endoscopy and deduction clinical consequences. This review proposes framework an integrated FEES-report that systematically moves from salient findings FEES to more advanced domains such as dysphagia severity, phenotypes impairment pathomechanisms. Validated scales scores are used enhance diagnostic yield. In concluding report, FEES-findings put into perspective context. potential etiology conceivable differential diagnoses considered, further steps proposed, treatment options evaluated, a timeframe re-assessment suggested. designed be adaptable open continuous evolution. Additional items, novel protocols, pathophysiological observations, advancements disease-related knowledge, new options, can easily incorporated. Moreover, there customizing this approach report on structural dysphagia.

Language: Английский

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Multimodal deep ensemble classification system with wearable vibration sensor for detecting throat-related events

npj Digital Medicine, Journal Year: 2025, Volume and Issue: 8(1)

Published: Jan. 7, 2025

Dysphagia, a swallowing disorder, requires continuous monitoring of throat-related events to obtain comprehensive insights into the patient's pharyngeal and laryngeal functions. However, conventional assessments were performed by medical professionals in clinical settings, limiting persistent monitoring. We demonstrate feasibility ubiquitous system for autonomously detecting utilizing soft skin-attachable throat vibration sensor (STVS). The STVS accurately records vibrations without interference from surrounding noise, enabling measurement subtle sounds such as swallowing. Out data stream, we automatically classify interest using an ensemble-based deep learning model. proposed model integrates multiple neural networks based on multi-modal acoustic features enhance robustness accuracy classification. performance our outperforms previous studies with classification 95.96%. These results show potential wearable solutions improving dysphagia management patient outcomes outside environments.

Language: Английский

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Exploring the rules of related parameters in acupuncture for post-stroke dysphagia based on data mining

Frontiers in Neurology, Journal Year: 2024, Volume and Issue: 15

Published: May 24, 2024

Background Post-stroke dysphagia (PSD) affects the efficacy and safety of swallowing, causing serious complications. Acupuncture is a promising cost-effective treatment for PSD; however, as number randomized controlled trials increases, scientific analysis parameters acupoint prescription required. Therefore, this study aimed to explore effects acupuncture on related post-stroke (PSD). Methods We searched Cochrane Library, PubMed, Embase, Web Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature, Chongqing VIP Database PSD in last 15 years relevant were analyzed using data mining techniques. Results In total, 3,205 records identified, which 3,507 patients with included 39 studies. The comprehensive demonstrated that closest parameter combinations 0.25 mm × 40 needle size, 30 min retention time, five treatments per week, 4-week total course treatment. Additionally, gallbladder nontraditional meridians, crossing points, head neck sites are most commonly used parameters. core acupoints identified GB20, RN23, EX-HN14, Gongxue, MS6, SJ17, EX-HN12, EX-HN13, combination RN23. Conclusion This patterns PSD-related needling provide evidence-based guidelines clinical acupuncturists treating PSD, potentially benefitting affected patients.

Language: Английский

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Development and Validation of a GULP-Based Predictive Model for Dehydration in Elderly Patients with Post-Stroke Dysphagia

British Journal of Hospital Medicine, Journal Year: 2025, Volume and Issue: unknown, P. 1 - 16

Published: Jan. 14, 2025

Aims/Background The background for establishing and verifying a dehydration prediction model elderly patients with post-stroke dysphagia (PSD) based on General Utility Latent Process (GULP) is as follows: For PSD, GULP technology utilized to build model. This aims improve the accuracy of risk assessment provide clinical intervention, thereby offering scientific basis enhancing patient prognosis. research highlights innovative application in constructing complex medical models addresses special health needs stroke patients. Based criteria, study establish validate following stroke. Methods Two hundred treated at Beijing Rehabilitation Hospital Affiliated Capital Medical University, from January 2020 December 2023, were selected retrospectively. randomly matched ratio 1:4 verification group (n = 40) modelling 160). occurrence dehydration, divided into two groups: 55) non-dehydration 105). Univariate multivariate logistic regression analyses used identify influencing factors after stroke, predictive GULP. value was evaluated using receiver operating characteristic (ROC) curve analysis. Results results univariate showed significant differences age, lesion location, muscle strength grade, homocysteine (Hcy), swallowing function score (p < 0.05). When these included model, slope calibration both training set validation close 1, indicating that predicted consistent actual risk. ROC analysis revealed set, an area under (AUC) 0.934, standard error 0.034, 95% confidence interval (CI) 0.916 0.981. optimal cutoff 0.78, yielding sensitivity 88.84% specificity 90.00%. In AUC 0.867 0.025 CI 0.694 0.934. here 0.66, 80.16% 85.94%. Conclusion successfully established validated GULP-based demonstrating high value.

Language: Английский

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Predictors and lesion patterns of dysphagia and swallowing outcomes after acute intracerebral hemorrhage

Therapeutic Advances in Neurological Disorders, Journal Year: 2025, Volume and Issue: 18

Published: Jan. 1, 2025

Dysphagia is a common complication following intracerebral hemorrhage (ICH) and associated with an increased risk of aspiration pneumonia poor outcomes. This study aimed to explore lesion patterns contributing factors post-ICH dysphagia, predict dysphagia outcomes ICH. A multicenter, prospective study. Patients ICH from two stroke centers within 72 h symptom onset received baseline bedside swallowing evaluations. Dysphagia-related were identified using support-vector regression-based lesion-symptom mapping. Predictors impairment on the 7th 30th day, as well stroke-associated (SAP), determined through multiple logistic regression analyses, nomograms developed. total 153 patients included in final analysis. Of those, 28 had dysphagia. lesions predominantly affected bilateral subcortical adjacent cortical regions. Stroke severity, hematoma expansion, basal ganglia significantly initial Baseline age independent predictors impaired function days 7 30, SAP. Moreover, volume was correlated day SAP occurrence. Midline shift remained 30. Predictive models for SAP, demonstrated strong calibration discriminatory ability, C indices 0.867, 0.895, 0.773, respectively. Post-ICH can be predicted based hemorrhage. Incorporating imaging evaluation further improve identification at high both 1 week month after

Language: Английский

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Dysphagie und Trachealkanülen-Management auf der Neuro-ICU – Ursachen, Erkennen, Handling und therapeutische Ansätze

Sprache · Stimme · Gehör, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 24, 2025

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Volume-viscosity swallow test to facilitate individualized dietary modifications for dysphagia following intracerebral hemorrhage

European Archives of Oto-Rhino-Laryngology, Journal Year: 2025, Volume and Issue: unknown

Published: Jan. 25, 2025

Language: Английский

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Symptoms, Imaging Features, Treatment Decisions, and Outcomes of Patients with Top of the Basilar Artery Syndrome: Experiences from a Comprehensive Stroke Center

Neurocritical Care, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 7, 2025

From visual, ocular, and pupillomotor abnormalities to qualitative more importantly rapid quantitative disturbances of consciousness, top the basilar artery syndrome (TOBS) represents a diagnostic challenge in neurocritical care. In this monocentric retrospective cross-sectional study, we will describe particular patient group detail highlight its variability associated implications. Consecutive patients with radiologically confirmed TOBS presenting our comprehensive stroke center were analyzed from 2010 2022. Baseline parameters at admission, including clinical symptoms, National Institutes Health Stroke Scale (NIHSS) score, Glasgow Coma (GCS) imaging (mode success recanalization measured by Thrombolysis Cerebral Infarction [TICI] extent infarct, infarct localization), assessed. Functional dependence discharge was modified Rankin scale (mRS) Barthel Index. We assessed 96 eligible mean age 70 (SD ± 14) years, 41.67% whom female. The median NIHSS score admission 19 (interquartile range [IQR] 8-35), GCS 7 (IQR 3-15). Dysphagia identified 51.72% patients, significant number discharged nasogastric tubes. Most received both intravenous thrombolysis (IVT) mechanical thrombectomy (MT) (47%), whereas 32% MT only, 10% no acute recanalizing therapy. Patients receiving IVT had higher frequencies successful vessel revascularization (higher TICI scores) better outcomes compared those only (median mRS 4 [IQR 2-5] vs. 5 2-6], p = 0.046). Multivariable regression analysis that (TICI) key predictors functional outcomes. A large proportion severely affected reduction vigilance, condition persists absence is then relevant dependency.

Language: Английский

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Dual-Task (Cognitive Plus Sucking) Training for Stroke Patients: A Randomized Controlled Study

Perceptual and Motor Skills, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 25, 2025

Our aim in this study was to determine the effect of applying dual-task training cognitive rehabilitation and sucking activities for stroke patients. We selected 118 patients from Neurology Department a class 3, grade A hospital between August 2020 January 2022; we randomly assigned them into either (DT) group or control group. The DT received cognition combined with based on conventional nursing guidelines; only neurologic procedures. After 4-week intervention period, swallowing ability, force, Swallowing Quality-of-Life Questionnaire (SWAL-QOL) scores, Mini-Mental State Examination (MMSE) scores improved significantly both groups ( p = .010, < .001, .001). And incidence clinical aspiration pneumonia much lower than .024). concluded that short-term effectively abilities, SWAL-QOL, functions these patients, important implications other

Language: Английский

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