Evaluation Of Bilateral Submental Muscle Activity Of Dysphagia Secondary To Unilateral Brainstem Stroke

Objective:The incidence of dysphasia after stroke is very high,it accounts for 30%to 65%,and the probability of dysphagia after brainstem stroke occurred is also high,especially for patients with dysphagia caused by brainstem lesions of the medulla oblongata,the incidence even reached 80%.The aim of this study was to observe which is secondary to unilateral brainstem stroke in the surface electromyographic(sEMG)characteristics of the bilateral submental muscle in dysphagia.Methods:A total of 33 subjects were recruited,of which 11 patients with left brainstem stroke in dysphagia secondary,11 patients with right brainstem stroke in dysphagia secondary and 11 healthy subjects matched the facts of age and gender.The parameters evaluated during swallowing were amplitude and duration.There were three swallow models examined: resting state at rest,voluntary single swallows of saliva(dry swallow)and voluntary single swallows of 5 ml water.Results:There were no significant differences in amplitude and duration between left and right sides in healthy controls in 3 swallow models.The amplitude of submental muscle activities in 3 swallow models in patients showed that the ipsilateral side was significantly higher than the contralateral side(p<0.05),but there were no differences in duration between the ipsilateral and contralateral sides.And both amplitude and duration,the ipsilateral side of stroke patients were higher than healthy subjects.However,in the contralateral side of stroke patients,amplitude was higher than health,interestingly,there were no significantly differences in duration.Under the three swallowing modes,the receiver operating characteristics of amplitude and duration of the contralateral submental muscle contraction were higher than 0.5 and had a high sensitivity and specificity.Conclusions:In patients with unilateral stroke experience dysphagia,the swallowing function of bilateral submental muscles was impaired,and ipsilateral damage was more severe than that of the opposite side.And sEMG had a great value to diagnostic dysphagia.