Ischemic Lesion Location Based on the ASPECT Score for Risk Assessment of Neurogenic Dysphagia.
Sriramya Lapa, Christian Foerch, Oliver C Singer and 2 others
PMID 33159258WHAT IT FOUND
In acute stroke, damage to the left lentiform nucleus and insula strongly predicted swallowing problems.
These patients had a high risk of dysphagia regardless of standard screening scores, suggesting they should be referred immediately for instrumental assessment.
Key findings
01Damage to the left lentiform nucleus and insula was independently associated with dysphagia, with odds ratios of 0.089 and 0.209 respectively.
02When the left lentiform nucleus, insula, and frontal operculum were all affected, 100% of patients had dysphagia.
03Lower ASPECT scores were associated with dysphagia in the left hemisphere, but this association disappeared when adjusted for the NIHSS score.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not include enough patients with right-sided strokes to draw firm conclusions about that hemisphere. The association between ASPECT scores and dysphagia was largely explained by the overall severity of the stroke (NIHSS), meaning ASPECT did not add extra predictive value beyond the standard clinical score. The finding regarding the frontal operculum did not remain statistically significant after correcting for multiple comparisons. The study was exploratory and needs external validation before these findings can be widely applied.
Declared interests
Not reported in the provided text.
The easy way to misread this
Do not use ASPECT scores as a substitute for clinical swallowing screening. The study showed that the ASPECT score's ability to predict dysphagia was largely due to its correlation with overall stroke severity (NIHSS), and it did not predict the severity of the swallowing problem or the risk of pneumonia.