Stroke Clinical Trial
Official title:
Acute Stroke Patients With Dysphagia After Different Swallowing Therapies: Videofluoroscopy Findings and Brain Plasticity in Magnetic Resonance Imaging
Dysphagia after stroke is associated to increased pulmonary complications and mortality. The swallowing therapies could decrease the pulmonary complications and improve the quality of life after stroke. The swallowing therapies include dietary modifications, thermal stimulation, compensatory positions, and oropharyngeal muscle stimulation. Most researchers used clinical assessments and videofluoroscopy to evaluate the effect of the swallowing therapies. Some authors performed functional magnetic resonance imaging (fMRI) to investigate the brain neuroactivity during swallowing with tasks in normal adults and unilateral hemispheric stroke patients. The aim of this study is to explore the effect of swallowing therapies not only in clinical swallowing function but also brain plasticity of acute stroke patients with dysphagia by videofluoroscopy and fMRI.
In the study, 10 healthy controls and 48 patients with a single and acute hemispheric or
brain stem stroke will be enrolled. Both 24 hemispheric and 24 brain stem stroke patients
will be divided into 3 groups. General swallowing therapy, oropharyngeal neuromuscular
electrical stimulation (NMES), and combined general and NMES therapies will be randomly
provided for the 3 groups. Each patient will receive clinical assessment of food oral intake
scale, functional dysphagia scale of videofluoroscopy, and brain neuroactivity in fMRI.
The investigators hope to find the benefit of the swallowing therapies both in clinical
swallowing function and in brain functional neuroactivity/reorganization after acute stroke.
While comparing the 3 swallowing therapies, different functional neuroactivity may be
facilitated by different swallowing therapies. Finally, the investigators could also find
out the most effective swallowing therapy among the 3 therapies in acute stroke patients
with dysphagia according to the findings of videofluoroscopy and fMRI.
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