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

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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Fig. 1

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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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 35, 985–992 (2020). https://doi.org/10.1007/s00455-020-10093-3

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Keywords

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