Correlation between Duration of Dysphagia and Magnetic Resonance Image Findings in Patients with Stroke

OBJECTIVE: To evaluate the correlation between duration of dysphagia and magnetic resonance image (MRI) findings in patients with stroke. METHOD: Ninety seven patients, who were evaluated by video fluoroscopic swallowing studies (VFSS), were recruited for 28 months. They were divided into two groups (transient group (n=52), prolonged group (n=45)) by removing time of NG tube from onset of stroke. Their MRI findings (lesion location and lesion size) were interpreted by one experienced radiologist retrospectively. RESULTS: The duration of dysphagia had statistically significant correlation with lesion size but there was no statistically significant correlation between lesion location and duration of dysphagia in patients with stroke. Compared with transient group (51.5+/-53.8 cm3), a larger lesion was found in prolonged group (95.5+/-107.7 cm3). CONCLUSION: Lesion size, not lesion location, can be a more important factor to predict early removal of NG tube in patients with stroke. More careful interventions about dysphagia are needed in patients with larger stroke lesion.

The Correlation between Post-stroke Depression and Lesion Location

OBJECTIVE: To localize lesions which correlate with depression after stroke. METHOD: This study was performed in 98 stroke patients who admitted at two hospitals in Daegu in 2006. Lesions on magnetic resonance imaging were reviewed by same neuroradiologist and depression was diagnosed by same phychiatrist using DSM-III-R and ICD-10 criteria. We tried to find the correlation between the lesion location and depression. RESULTS: Depression was not related to age, sex, dominant hemisphere, underlying disease (HTN, DM, heart disease), and many lesions of interest of brain. Lesions in prefrontal area, limbic lobe, cingulate gyrus, post white matter and frontal lobe correlated significantly with depression. CONCLUSION: We found that there was a strong correlation between post stroke depression and the pathologic lesion which is frontal-subcortical circuit except basal ganglion and thalamus.

The Effect of Environmental Factors to the Mobility Disability in Independent Subjects with Stroke

OBJECTIVE: To investigate the effect of environmental factors on the ability of mobility in subjects with chronic stroke who can perform nearly independent activities of daily living (ADL). METHOD: Sixty one patients were divided into three groups (superior, middle, and inferior) by the degree of independent walking. Modified self-administered questionnaire was completed to report how well the patients encountered the environmental elements faced in community mobility. In addition, all patients were assessed to find out the difference of ADL performance, Berg balance scale (BBS), 10 m walking time (10 mWT) and patterns of 'going out' among the three groups. RESULTS: The group 1 (superior group) had shown better performance than group 2 (middle group) and group 3 (inferior group) in performance of ADL, BBS, 10 mWT. Secondly, the group 1 visited more places or destinations per day than the group 2 and 3, and they used more various transportation systems than other groups. Finally, there were significant differences in the distance dimension, the temporal dimension, terrain dimension (except for a 'getting on a elevator' component), and density dimension among the groups. CONCLUSION: Environmental factors as well as functional abilities could affect the mobility of subjects with chronic stroke. This result suggests that any kinds of compensation and the supports of social institutions are needed even in subjects of nearly independent ADL for their improvement of mobility and convenience.