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

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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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Fig. 1



Corticobulbar tract


Diffusion tensor tractography


Diffusion tensor imaging


Regions of interest


Intracerebral hemorrhage


Intraventricular hemorrhage


Nasogastric tube


Fractional anisotropy


Tract volume


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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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Correspondence to Jun Young Kim.

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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 (2020). https://doi.org/10.1007/s00455-020-10093-3

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  • Dysphagia
  • Intracerebral hemorrhage
  • Diffusion tensor tractography
  • Corticobulbar tract
  • Deglutition
  • Deglutition disorders