Post-stroke Dysphagia: Recent Insights and Unanswered Questions
- PDF / 539,824 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 80 Downloads / 198 Views
(2020) 20:61
NEUROREHABILITATION AND RECOVERY (J. KRAKAUER AND T. KITAGO, SECTION EDITORS)
Post-stroke Dysphagia: Recent Insights and Unanswered Questions Corinne A. Jones 1,2
&
Christina M. Colletti 1 & Ming-Chieh Ding 1
Accepted: 19 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review We explored themes in recent post-stroke dysphagia literature, focusing on the following questions: (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of post-stroke dysphagia? Recent Findings There have been several improvements in quantitative descriptions of swallowing physiology using standard and new evaluation techniques. These descriptions have been correlated with lesion locations, and several factors can predict development of post-stroke dysphagia and its sequelae. Novel treatment paradigms have leveraged post-stroke neuroplastic improvements using neurostimulation and biofeedback techniques. Despite recent findings, the field is limited by lack of standardization and unanswered questions on rehabilitation variables. Summary Our improved understanding of post-stroke dysphagia will enhance our ability to prevent, identify, and treat it. Future work should be grounded in swallowing physiology and continue refining treatments, particularly in the acute stage. Keywords Stroke . Deglutition . Dysphagia . Rehabilitation
Introduction Swallowing is a complex sensorimotor process involving the coordination of multiple muscle groups to propel a bolus of food or liquid from the mouth to the stomach while protecting the airway and minimizing residue. Swallowing pattern-generating neural circuitry is situated in the rostral medulla [1], with widespread cortical and subcortical activation associated with movement preparation and sensory processing [2••]. Thus, strokerelated lesions in either cortical hemisphere, subcortical control circuits, or in the brainstem can result in difficulty swallowing or dysphagia [2••, 3]. See Felix and colleagues’ recent review for a tutorial on current This article is part of the Topical Collection on Neurorehabilitation and Recovery * Corinne A. Jones [email protected] 1
Neurology; Dell Medical School, The University of Texas, 1601 Trinity St. Bldg. B, Stop Z0700, Austin, TX 78712, USA
2
Speech, Language, & Hearing Sciences; Moody College of Communication, The University of Texas, Austin, TX, USA
practice for screening, evaluation, and treatment of post-stroke dysphagia [4••]. Review of recent literature regarding post-stroke dysphagia underscores four themes of research questions: (1) What does post-stroke dysphagia look like?; (2) Who gets post-stroke dysphagia?; (3) What are the consequences of post-stroke dysphagia?; and (4) How can we improve treatment of poststroke dysphagia? This review will focus on publications that explored these questions with discussions of potential for implementation i
Data Loading...
