Dysphagia, Stroke
Conditions
Brief summary
This study evaluates changes in swallowing using endoscopic swallowing studies and measuring of pharyngeal sensitivity, taste and smell in stroke patients. Younger (\<60 years) and older (\>60 years) volunteers will serve as control.
Detailed description
Stroke is the second leading cause of death. At least 50% of stroke patients develop dysphagia, leading to aspiration pneumonia, which is the main cause of death in stroke \[2\]. It is assumed that normal sensitivity is vital for aspiration-free swallowing and for the triggering of the swallowing reflex. Ali et al. demonstrated aspiration-free swallowing in healthy volunteers who underwent local anaesthesia of oral and pharyngeal structures \[1\]. Power et al. showed a reduced sensitivity of pharyngeal structures in stroke patients prone to aspiration \[3\]. By combining measuring sensitivity and flexible endoscopic swallowing studies, this study further investigates the role of sensitivity in swallowing Neuropsychological deficits of swallowing, such as swallowing apraxia or buccal hemineglect, is assessed by neuropsychological testing. Additionally, there is no systematic research investigating the change in smell and taste in correlation with changes in stroke patients
Interventions
Endoscopical swallowing study in stroke patients only
Determining sensitivity threshold using a pudendal electrode
Taste-/smell-test
Neuropsychological testing for neglect, agnosia
Sponsors
Study design
Eligibility
Inclusion criteria
Volunteers: * informed consent Stroke patients: * informed consent * new supratentorial stroke (\<72 hours old) confirmed by CT (computed tomography) or MRI (magnetic resonance imaging)
Exclusion criteria
* pre-existing stroke oder dysphagia * extensive white matter lesions in CT- or MRI-scan * allergies to odorous substances or flavoring * contraindications for FEES (flexible endoscopic evaluation of swallowing), CT or MRI (stroke patients only)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dysphagia | 96 hours after initial symptoms | Changes found in endoscopic swallowing study : Presence and severity of dysphagia (measured with Rosenbek's Penetration/Aspiration-scale) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Neuropsychological deficits | 96 hours after initial symptoms | Agnosia, neglect |
| Lesion site | 96 hours after initial symptoms | Side, vascular territory, swallowing relevant structures |
| Sensitivity | 96 hours after initial symptoms | Sensitivity of faucial pillar region |
| Taste/Smell | 96 hours after initial symptoms | Smell-/Taste-score |
Countries
Germany