Evidence map›Paper›PMID 39577333›Full record

Observational studyNeuroImage. Clinical2024

Cerebral small vessel disease is an independent determinant of dysphagia after acute stroke.

Janina Wilmskoetter, Heather Bonilha, Bethany J Wolf, Emma Tracy, Allen Chang, Bonnie Martin-Harris, Christine Anne Holmstedt, Leonardo Bonilha

Abstract readObservational Study
In one paragraph

Observational study in NeuroImage. Clinical, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Risk factors and prediction model of dysphagia in patients with recent small subcortical infarct.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Janina WilmskoetterMedical University of South Carolina, SC, USA. Electronic address: wilmskoe@musc.edu.
Heather BonilhaUniversity of South Carolina, SC, USA.
Bethany J WolfMedical University of South Carolina, SC, USA.
Emma TracyMedical University of South Carolina, SC, USA.
Allen ChangMedical University of South Carolina, SC, USA.
Bonnie Martin-HarrisNorthwestern University, IL, USA.
Christine Anne HolmstedtMedical University of South Carolina, SC, USA.
Leonardo BonilhaUniversity of South Carolina, SC, USA.

Funding

South Carolina Clinical & Translational Research Institute (SCTR)UL1TR001450 · NCATS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI BRADY, KATHLEEN T., FLUME, PATRICK A · 2015 to 2024
$41.1M
Telerehab for Aphasia (TERRA)P50DC014664 · NIDCD · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI FRIDRIKSSON, JULIUS · 2016 to 2025
$25.0M
Cortical and Subcortical Organization of Language-Related Semantic Processing in Alzheimer's DiseaseR01DC014021 · NIDCD · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI BONILHA, LEONARDO F · 2014 to 2023
$4.7M
Speech Entrainment for Aphasia Recovery (SpARc)U01DC017521 · NIDCD · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI BONILHA, LEONARDO F, FRIDRIKSSON, JULIUS · 2019 to 2023
$4.2M
NCATS NIH HHS UL1 TR001450NIDCD NIH HHS P50 DC014664NIDCD NIH HHS R01 DC014021NIDCD NIH HHS U01 DC017521
6 · The paper itself

Abstract

backgroundThe high incidence of dysphagia after acute stroke is likely the result of cumulative effects of the stroke and pre-stroke brain health. While cerebral small vessel disease (cSVD) is recognized as a marker of compromised brain health, it's unclear which neuroanatomical pathologies of cSVD impact post-stroke dysphagia. We assessed the relation between cSVD pathologies, i.e., brain atrophy, white matter hyperintensities (WMH), perivascular spaces, as markers for brain integrity at the time of the stroke, and acute post-stroke dysphagia measured with the Modified Barium Swallow Study (MBSS).

methodsWe conducted a retrospective, observational study of 40 individuals with an acute first-ever ischemic stroke. We segmented T1-weighted images into gray matter, white matter, and cerebrospinal fluid (CSF) to derive brain atrophy estimates. We scored the presence and severity of periventricular and deep WMH using the Fazekas scale and counted perivascular spaces in the basal ganglia following standard guidelines. Swallow impairments were determined with the Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale, and timing measures (oral (OTT), and pharyngeal transit times (PTT)). We performed regression to assess the relation between cSVD pathologies and swallowing while controlling for the stroke overlap with the right and left corticobulbar tracts, stroke volume, and the number of days between the MRI and MBSS.

resultsWorse brain atrophy and more severe periventricular WMH were related to more severe MBSImP pharyngeal total scores, and worse deep WMH were related to aspiration events. More severe perivascular spaces in the basal ganglia were related to longer OTT and PTT, with a high explanatory value (27.5% and 25.1%, respectively), even when controlling for chronological age.

conclusionsOur results suggest that several aspects of pre-stroke brain health impact dysphagia severity after acute stroke independent of the stroke site and size. These findings contribute to our understanding of mechanisms underlying the variability of post-stroke dysphagia and emphasize the importance of brain structural integrity before the stroke. Future larger studies are warranted.

Indexed as

Cerebral Small Vessel DiseasesDeglutition DisordersMagnetic Resonance ImagingAgedAged, 80 and overAtrophyFemaleHumansIschemic StrokeMaleMiddle AgedRetrospective StudiesStrokeWhite MatterDysphagiaModified barium swallow studySmall vessel diseaseStroke

Identifiers

PMID39577333
PMCPMC11616564

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.