Abstract：
OBJECTIVE: Post-stroke dysphagia (PSD) is a common functional deficit after stroke. Temporal muscle thickness (TMT) had been proven to be an independent factor for PSD. However, the relationship between TMT and PSD based on quantitative swallowing kinematic analysis remains unexplored. We aimed to investigate the association between TMT and PSD using videofluoroscopic swallow study (VFSS).
METHODS: We retrospectively recruited stroke patients from May 2015 to March 2020 in the tertiary referral hospital. A total of 83 patients with dysphagia met all the enrollment criteria and were included in the study. TMT was measured by non-contrast brain computed tomography (CT) images. Parameters of VFSS were obtained, including penetration-aspiration scale (PAS), oral transit time (OTT), pharyngeal transit time (PTT) and swallowing trigger time (STT) in four standardized barium formulas respectively. The association between TMT and variables of VFSS were analyzed by adjusted linear and logistic multivariate regression models. Subgroup analysis based on age, sex, and premorbid modified Rankin Scale (mRS) stratification was conducted.
RESULTS: TMT was significantly correlated with gender and premorbid mRS as the confounders. Univariate regression showed smaller TMT (p = 0.010) and poorer premorbid mRS (p = 0.018) was associated with prolonged PTT of the thick formula; lesser TMT was associated with prolonged PTT of the paste formula (p = 0.037). Multivariate analyses after confounder-adjustment demonstrated TMT was an independent indicator for PTT in the thick formula (p = 0.028).
CONCLUSIONS: TMT was associated with swallowing kinematic changes in patients diagnosed with PSD. TMT is an independent indicator for delayed pharyngeal stage in the thick standardized formula during deglutition in PSD patients.
METHODS: We retrospectively recruited stroke patients from May 2015 to March 2020 in the tertiary referral hospital. A total of 83 patients with dysphagia met all the enrollment criteria and were included in the study. TMT was measured by non-contrast brain computed tomography (CT) images. Parameters of VFSS were obtained, including penetration-aspiration scale (PAS), oral transit time (OTT), pharyngeal transit time (PTT) and swallowing trigger time (STT) in four standardized barium formulas respectively. The association between TMT and variables of VFSS were analyzed by adjusted linear and logistic multivariate regression models. Subgroup analysis based on age, sex, and premorbid modified Rankin Scale (mRS) stratification was conducted.
RESULTS: TMT was significantly correlated with gender and premorbid mRS as the confounders. Univariate regression showed smaller TMT (p = 0.010) and poorer premorbid mRS (p = 0.018) was associated with prolonged PTT of the thick formula; lesser TMT was associated with prolonged PTT of the paste formula (p = 0.037). Multivariate analyses after confounder-adjustment demonstrated TMT was an independent indicator for PTT in the thick formula (p = 0.028).
CONCLUSIONS: TMT was associated with swallowing kinematic changes in patients diagnosed with PSD. TMT is an independent indicator for delayed pharyngeal stage in the thick standardized formula during deglutition in PSD patients.
摘要：
目的：卒中后吞咽困难（PSD）是卒中后常见的功能缺陷。时间肌肉厚度（TMT）已被证明是PSD的独立因素。然而,基于定量吞咽运动学分析的TMT和PSD之间的关系仍未探索。我们旨在使用视频透视吞咽研究（VFSS）研究TMT和PSD之间的关联。
方法：我们回顾性招募了2015年5月至2020年3月在三级转诊医院接受治疗的卒中患者。共有83例吞咽困难患者符合所有入选标准，并被纳入研究。通过非对比脑计算机断层扫描（CT）图像测量TMT。获得了VFSS的参数，包括渗透-抽吸量表(PAS)，口腔运输时间（OTT），咽部传输时间（PTT）和吞咽触发时间（STT）分别在四个标准化钡公式。通过调整线性和逻辑多元回归模型分析TMT与VFSS变量之间的关联。基于年龄的亚组分析，性别,进行病前改良Rankin量表(mRS)分层。
结果：TMT与性别和病前mRS显著相关。单变量回归显示，较小的TMT（p=0.010）和较差的病前mRS（p=0.018）与厚配方的PTT延长有关；较小的TMT与糊状配方的PTT延长有关（p=0.037）。混杂调整后的多变量分析表明，TMT是厚公式中PTT的独立指标（p=0.028）。
结论：TMT与诊断为PSD的患者吞咽运动学改变有关。在PSD患者吞咽过程中，TMT是厚标准化公式中延迟咽期的独立指标。
方法：我们回顾性招募了2015年5月至2020年3月在三级转诊医院接受治疗的卒中患者。共有83例吞咽困难患者符合所有入选标准，并被纳入研究。通过非对比脑计算机断层扫描（CT）图像测量TMT。获得了VFSS的参数，包括渗透-抽吸量表(PAS)，口腔运输时间（OTT），咽部传输时间（PTT）和吞咽触发时间（STT）分别在四个标准化钡公式。通过调整线性和逻辑多元回归模型分析TMT与VFSS变量之间的关联。基于年龄的亚组分析，性别,进行病前改良Rankin量表(mRS)分层。
结果：TMT与性别和病前mRS显著相关。单变量回归显示，较小的TMT（p=0.010）和较差的病前mRS（p=0.018）与厚配方的PTT延长有关；较小的TMT与糊状配方的PTT延长有关（p=0.037）。混杂调整后的多变量分析表明，TMT是厚公式中PTT的独立指标（p=0.028）。
结论：TMT与诊断为PSD的患者吞咽运动学改变有关。在PSD患者吞咽过程中，TMT是厚标准化公式中延迟咽期的独立指标。
