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Prognostic Prediction of Dysphagia by Analyzing the Corticobulbar Tract in the Early Stage of Intracerebral Hemorrhage

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Abstract

We investigated the predictive value of the corticobulbar tract (CBT) for dysphagia using diffusion tensor tractography in the early stage of intracerebral hemorrhage (ICH) for dysphagia. Forty-two patients with spontaneous ICH ± intraventricular hemorrhage (IVH) and 22 control subjects were recruited. The patients were classified into three groups: group A—could remove nasogastric tube (NGT) in the acute stage of ICH, group B—could remove NGT within 6 months after onset, and group C—could not remove NGT until 6 months after onset. The CBT were reconstructed, and fractional anisotropy (FA) and tract volume (TV) values were determined. The FA of the CBT in the affected hemisphere in group A was lower than in the control group (p < 0.05). The FA and TV of the CBT in the affected hemisphere in group B were lower than those in the control group (p < 0.05). In group C, the FA and TV in the affected hemisphere and unaffected hemispheres were lower than in the control group (p < 0.05). The TV of the CBT in the affected hemisphere in group B showed a moderate negative correlation with the length of time until NGT removal (r = 0.430, p < 0.05). We found that patients with CBT injuries in both hemispheres were not able to remove the NGT until 6 months after onset, whereas patients who were injured only in the affected hemisphere were able to remove NGT within 6 months of onset. The severity of injury to the CBT in the affected hemisphere appeared to be related to the length of time until NGT removal.

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Abbreviations

CBT:

Corticobulbar tract

DTT:

Diffusion tensor tractography

DTI:

Diffusion tensor imaging

ROI:

Regions of interest

ICH:

Intracerebral hemorrhage

IVH:

Intraventricular hemorrhage

NGT:

Nasogastric tube

FA:

Fractional anisotropy

TV:

Tract volume

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Acknowledgements

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korean Government (MSIP) (No. 2018R1A2B6000996).

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, 317-1, Daemyung dong, Namgu, Taegu, 705-717, Republic of Korea

    Sung Ho Jang, So Young Kwak & Jun Young Kim

  2. Department of Neurosurgery, College of Medicine, Yeungnam University, 317-1, Daemyung dong, Namgu, Taegu, 705-717, Republic of Korea

    Chul Hoon Chang, Young Jin Jung, JongHoon Kim & Seong Ho Kim

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  1. Sung Ho Jang
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Jang, S.H., Kwak, S.Y., Chang, C.H. et al. Prognostic Prediction of Dysphagia by Analyzing the Corticobulbar Tract in the Early Stage of Intracerebral Hemorrhage. Dysphagia 35, 985–992 (2020). https://doi.org/10.1007/s00455-020-10093-3

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