Relationships between dysarthria, lesion location, and oral/swallowing function in patients with first-ever stroke

Abstract

Objective: Dysarthria negatively affects quality of life and social communication. This study focused on dysarthria in patients with acute-phase stroke and analyzed the association between lesion locations and oral/swallowing functions.

Methods: Patients with first-ever acute stroke were analyzed. Speech assessments included diadochokinesis rates for "pa," "ta," and "ka," along with reading aloud passages. All patients underwent head magnetic resonance imaging, videofluoroscopic (VF) examinations, and tongue pressure measurements to identify stroke lesions.

Results: We analyzed 82 patients with acute stroke excluding those with bilateral or multi-regional lesions (mean age 67.6 ± 11.5 years, 32 women, NIHSS median 1.5). Dysarthria was diagnosed in 16 patients (19.5 %). The National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [OR] 1.289, 95 % confidence interval [CI] 1.050-1.616) and lesions in the corona radiata (OR 9.981, 95 % CI 1.871 - 60.092) were significant risk factors for dysarthria. Tongue pressure was significantly lower in patients with dysarthria, with a cutoff value of 28.4 kPa for predicting dysarthria (area under of the receiver operating characteristic curve 0.688, p = 0.006). Swallowing assessments via VF examinations showed no significant differences between patients with and without dysarthria.

Conclusion: Lesions in the corona radiata are associated with dysarthria in patients with stroke. Reduced tongue pressure is also linked to dysarthria. These findings underscore the importance of evaluating dysarthria independently of dysphagia.

Keywords: Corona radiata; Stroke; Tongue pressure; Unilateral upper motor neuron dysarthria.