Mylohyoid motor evoked potentials can effectively predict persistent dysphagia 3 months poststroke. Issue 7 (13th March 2018)

• Record Type: Journal Article
• Authors: Lee, K. M.; Joo, M. C.; Yu, Y. M.; Kim, M.‐S.
• Is Part Of: Neurogastroenterology & motility. Volume 30:Issue 7(2018)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2018-03-13
• Subjects: deglutition disorders -- motor evoked potentials -- neck muscle -- prognosis -- stroke; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.13323
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: The purpose of this study was to investigate the association between mylohyoid motor‐evoked potentials (MH‐MEP) and swallowing function and determine the value of MH‐MEP for predicting aspiration 3 months poststroke. Methods: Subacute patients within a month of their first stroke were enrolled up for 2 consecutive years. Videofluoroscopic swallowing studies (VFSS) were performed twice. Patients were evaluated during VFSS using the penetration aspiration scale (PAS) and videofluoroscopic dysphagia scale (VDS). MH‐MEP was recorded in the mylohyoid muscles. The active electrode was positioned submentally, 2 cm lateral to midline. Magnetic stimulation was performed on the contralateral motor cortex, 2‐4 cm anterior and 4‐6 cm lateral to the cranial vertex. The resting motor threshold (rMT), latency, and amplitude stimulation at 120% (amp120) and 150% (amp150) of the rMT were assessed. The ratio of each parameter was also estimated. The relationship between MH‐MEP and VFSS findings was analyzed. Key Results: Sixty‐eight patients completed the study. On VFSS at 3 months poststroke, 24 (35.3%) patients showed aspiration. The rMT, rMT ratio, amp120 and amp120 ratio were significantly correlated with the PAS and VDS ( P < .05). The rMT ratio (OR = 1.208, P = .001) and amp120 ratio (OR = 0.821, P = .002) were independent predictors of aspiration at 3 months. The optimal cut‐off value of the rMT ratio was 126.1 (AUC = 0.94, sensitivity = 0.92, specificity = 0.89); that of the amp120 ratio was 66.5 (AUC = 0.89, sensitivity = 0.88, specificity = 0.86). Conclusions and Inferences: MH‐MEP was well‐correlated with dysphagia severity assessed by VFSS. The rMT ratio and amplitude ratio of MH‐MEP can effectively predict persistent dysphagia 3 months poststroke. Abstract : The purpose of this study was to investigate the association between MH‐MEP and swallowing function and determine the value of MH‐MEP for predicting aspiration three months post‐stroke. MH‐MEP was well correlated with dysphagia severity assessed by VFSS. The MH‐MEP can effectively predict persistent dysphagia 3 months post‐stroke.