Article

Swallowing dysfunction is intractable after acute stroke. Our
understanding of the alterations in neural networks of patients with neurogenic
dysphagia is still developing. The aim was to investigate cerebral
cortical functional connectivity and subcortical structural connectivity related
to swallowing in unilateral hemispheric stroke patients with dysphagia. METHODS:
We combined a resting-state functional connectivity with a white matter tract
connectivity approach, recording 12 hemispheric stroke patients with dysphagia,
12 hemispheric stroke patients without dysphagia, and 12 healthy controls.
Comparisons of the patterns in swallowing-related functional connectivity maps
between patient groups and control subjects included (a) seed-based functional
connectivity maps calculated from the primary motor cortex (M1) and the
supplementary motor area (SMA) to the entire brain, (b) a swallowing-related
functional connectivity network calculated among 20 specific regions of interest
(ROIs), and (c) structural connectivity described by the mean fractional
anisotropy of fibers bound through the SMA and M1. RESULTS: Stroke patients with
dysphagia exhibited dysfunctional connectivity mainly in the
sensorimotor-insula-putamen circuits based on seed-based analysis of the left and
right M1 and SMA and decreased connectivity in the bilateral swallowing-related
ROIs functional connectivity network. Additionally, white matter tract
connectivity analysis revealed that the mean fractional anisotropy of the white
matter tract was significantly reduced, especially in the left-to-right SMA and
in the corticospinal tract. CONCLUSIONS: Our results indicate that dysphagia
secondary to stroke is associated with disruptive functional and structural
integrity in the large-scale brain networks involved in motor control, thus
providing new insights into the neural remodeling associated with this disorder.

Langue : ANGLAIS