Speakers - NWC 2024

Abstract

Introduction: Swallowing is a vital physiological process for well-being and survival. Despite the cerebellum's well-known role in motor control and coordination, its specific contribution to human swallowing physiology remains inadequately understood. This study aimed to precisely examine the clinical indicators of dysphagia during the oral and pharyngeal stages of swallowing in people with cerebellar strokes. Through a comprehensive clinical assessment, we sought to offer new insights into the cerebellum's involvement in swallowing. Subsequently, the study findings were discussed to advance our understanding of the underlying cerebellar sensorimotor functions that guarantee effective swallowing.

Material and Methods: A sample of 34 people with identified isolated cerebellar strokes was collected through convenience sampling. Stroke localization to the cerebellum was detected using neurological magnetic resonance imaging. A certified speech-language pathologist administered the Mann Assessment of Swallowing Ability to all participants to evaluate swallowing function thoroughly. This clinical assessment procedure determines swallowing ability across various stages, offering meticulous perspectives on oropharyngeal swallowing.

Results: The study indicated that more than half of individuals with cerebellar infarcts experienced compromised swallowing, with a significant association between dysphagia and an increased risk of aspiration. Age showed a notable correlation with dysphagia, while no meaningful relationship was observed between swallowing ability and sex.

Discussion/Conclusion: This study explored swallowing disorders resulting from isolated cerebellar infracts, identifying impaired swallowing skills in over half of the patients, particularly in the oropharyngeal phases. This suggests that the cerebellum is crucial in controlling different aspects of swallowing function. The robust correlation between age and dysphagia severity may be attributed to age-related changes in the cerebellum and brainstem. Notably, dysphagia was linked to an elevated risk of aspiration, particularly in older participants. The reduced gag reflex in most patients raises interesting possibilities of connections between the cerebellar regions and reflex circuits of the brainstem. Consequently, this study offers new evidence that the cerebellum is pivotal for efficient swallowing and that cerebellar infracts can significantly compromise oropharyngeal swallowing, leading to severe swallowing disorders and aspiration, especially in older individuals. Early diagnosis and management of swallowing disorders are therefore imperative in post-cerebellar strokes.