Relationship Between DWI-Based Acute Ischemic Stroke Volume, Location and Severity of Dysphagia

Brain Sci. 2024 Nov 26;14(12):1185. doi: 10.3390/brainsci14121185.

Abstract

Background/objectives: The impact of stroke location and volume on the development of post-stroke dysphagia is not fully understood. The aim of this study is to evaluate the relationship between acute ischemic lesions and the severity of dysphagia.

Methods: Brain MRIs were obtained with a 1.5 Tesla MRI system (Magnetom Avanto B13, Siemens, Erlangen, Germany). The brain MRI protocol included axial echo planar diffusion-weighted imaging (DWI). The acute ischemic volume was obtained using DWI by drawing regions of interest (ROIs). The diagnosis and assessment of the severity of dysphagia was carried out by a multidisciplinary team and included the Dysphagia Outcome and Severity Scale (DOSS), the Penetration-Aspiration Scale (PAS), and the Pooling score (P-score). The threshold for statistical significance was set at 5%.

Results: Among all the patients enrolled (n = 64), 28 (43.8%) were males and 36 (56.2%) were females, with a mean age of 78.8 years. Thirty-three (51.6%) of them had mild dysphagia and thirty-one (48.4%) had moderate-severe dysphagia. The total ischemic volume was negatively correlated with the DOSS (r = -0.441, p = 0.0003) and positively with the P-score (rs = 0.3054, p = 0.0328).

Conclusions: There are significant associations between the severity of dysphagia and the quantitative DWI-based data of the acute ischemic volume and anatomical location.

Keywords: DWI; MRI; brain; dysphagia; stroke.

Grants and funding

This research received no external funding.