Establishment of unified swallowing function evaluation, usefulness of tongue pressure, and elucidation of brain localization of dysphagia

• Project/Area Number: 18K10746
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 59010:Rehabilitation science-related
• Research Institution: Hiroshima University
• Principal Investigator: Hosomi Naohisa 広島大学, 原爆放射線医科学研究所, 研究員 (70363190)
• Co-Investigator(Kenkyū-buntansha): 吉川 峰加 広島大学, 医系科学研究科(歯), 准教授 (00444688) ; 青木 志郎 広島大学, 病院(医), 助教 (10457236) ; 栢下 淳 県立広島大学, 人間文化学部, 教授 (40312178) ; 吉田 光由 広島大学, 医系科学研究科(歯), 准教授 (50284211)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2020: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000); Fiscal Year 2019: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
• Keywords: 脳卒中 / 嚥下障害 / 誤嚥 / 嚥下造影検査 / 舌圧

Outline of Final Research Achievements

We aimed to assess stroke lesions, which play a key role in determining swallowing dysfunction, and findings of videofluoroscopy (VF), which provides the most accurate instrumental assessment for evaluating swallowing function, in patients with acute stroke. We enrolled 342 patients with first-time acute stroke (age 70.4 ± 12.6 years, 142 female). All patients underwent cranial magnetic resonance imaging to identify the location of stroke lesion, VF, and tongue pressure measurement. Aspiration was detected in 45 (13.2%) patients. Multivariate analysis identified parietal lobe lesion and the National Institutes of Health Stroke Scale (NIHSS) score as independent significant factors for aspiration. Parietal lobe lesions are associated with aspiration and basal ganglia lesions with swallowing reflex delay.

Academic Significance and Societal Importance of the Research Achievements

日本人の死亡原因第４位である脳卒中の、特にその死亡に至る原因の一翼を担っている誤嚥性肺炎に対して適切な介入を行うためには、正確にその病態を把握し、介入方法を検討する必要がある。また、脳障害に伴い嚥下障害を認める脳領域を特定しえたことから、更なる検討に向けた一助となる結果が得られたと考える。

Research Products

• [Journal Article] Association between stroke lesions and videofluoroscopic findings in acute stroke patients. (2021)
  • Author(s): Nakamori M, Hosomi N, Imamura E, Matsushima H, Maetani Y, Yoshida M, Yoshikawa M, Takeda C, Nagasaki T, Masuda S, Kayashita J, Tsuga K, Tanimoto K, Wakabayashi S, Maruyama H.
  • Journal Title: J Neurol. Volume: 268 Issue: 3 Pages: 1025-1035
  • DOI: 10.1007/s00415-020-10244-4
  • Peer Reviewed
• [Journal Article] Serum immunoglobulin G antibody titer to Fusobacterium nucleatum is associated with unfavorable outcome after stroke. (2020)
  • Author(s): Nishi H, Hosomi N, Ohta K, Aoki S, Nakamori M, Nezu T, Shigeishi H, Shintani T, Obayashi T, Ishikawa K, Kinoshita N, Shiga Y, Sugiyama M, Ohge H, Maruyama H, Kawaguchi H, Kurihara H
  • Journal Title: Clin Exp Immunol. Volume: 200 Issue: 3 Pages: 302-309
  • DOI: 10.1111/cei.13430
  • Peer Reviewed
• [Journal Article] Effects of vascular compression on the rostral ventrolateral medulla for blood pressure variability in stroke patients (2020)
  • Author(s): Tomohisa Nezu, Naohisa Hosomi, Daisuke Kuzume , Hiroyuki Naito, Shiro Aoki, Yuko Morimoto, Masato Kinboshi, Yuji Shiga, Naoto Kinoshita, Hiroki Ueno, Hirofumi Maruyama
  • Journal Title: J Hypertens . Volume: 38 Issue: 12 Pages: 2443-2450
  • DOI: 10.1097/hjh.0000000000002575
  • Peer Reviewed
• [Journal Article] Prognostic role of the Controlling Nutritional Status score in acute ischemic stroke among stroke subtypes. (2020)
  • Author(s): Naito H, Hosomi N, Kuzume D, Nezu T, Aoki S, Morimoto Y, Kinboshi M, Yoshida T, Shiga Y, Kinoshita N, Ueno H, Noma K, Maruyama H.
  • Journal Title: J Neurol Sci. Volume: 416 Pages: 116984-116984
  • DOI: 10.1016/j.jns.2020.116984
  • Peer Reviewed
• [Journal Article] Serum IgG titers to periodontal pathogens predict 3-month outcome in ischemic stroke patients. (2020)
  • Author(s): Aoki S, Hosomi N, Nishi H, Nakamori M, Nezu T, Shiga Y, Kinoshita N, Ueno H, Ishikawa K, Imamura E, Shintani T, Ohge H, Kawaguchi H, Kurihara H, Maruyama H.
  • Journal Title: PLoS One. Volume: 15 Issue: 8 Pages: e0237185-e0237185
  • DOI: 10.1371/journal.pone.0237185
  • Peer Reviewed / Open Access
• [Journal Article] Lobar microbleeds are associated with cognitive impairment in patients with lacunar infarction. (2020)
  • Author(s): Nakamori M, Hosomi N, Tachiyama K, Kamimura T, Matsushima H, Hayashi Y, Imamura E, Wakabayashi S, Maruyama H.
  • Journal Title: Sci Rep. Volume: 10 Issue: 1 Pages: 16410-16410
  • DOI: 10.1038/s41598-020-73404-6
  • Peer Reviewed / Open Access
• [Journal Article] Association between periodontal disease due to Campylobacter rectus and cerebral microbleeds in acute stroke patients (2020)
  • Author(s): Yuji Shiga, Naohisa Hosomi, Tomohisa Nezu, Hiromi Nishi, Shiro Aoki, Masahiro Nakamori, Kenichi Ishikawa, Naoto Kinoshita, Eiji Imamura, Hiroki Ueno, Tomoaki Shintani, Hiroki Ohge, Hiroyuki Kawaguchi, Hidemi Kurihara, Shinichi Wakabayashi, Hirofumi Maruyama
  • Journal Title: PLoS One . Volume: 15 Issue: 10 Pages: e0239773-e0239773
  • DOI: 10.1371/journal.pone.0239773
  • Peer Reviewed / Open Access
• [Journal Article] Serum IgG titers against periodontal pathogens are associated with cerebral hemorrhage growth and 3-month outcome. (2020)
  • Author(s): Nakamori M, Hosomi N, Nishi H, Aoki S, Nezu T, Shiga Y, Kinoshita N, Ishikawa K, Imamura E, Shintani T, Ohge H, Kawaguchi H, Kurihara H, Wakabayashi S, Maruyama H.
  • Journal Title: PLoS One. Volume: 15 Issue: 10 Pages: e0241205-e0241205
  • DOI: 10.1371/journal.pone.0241205
  • Peer Reviewed / Open Access
• [Journal Article] Delayed Swallowing Reflex is Overlooked in Swallowing Screening Among Acute Stroke Patients. (2020)
  • Author(s): Takeda C, Yoshida M, Nakamori M, Hosomi N, Nagasaki T, Yoshikawa M, Kayashita J, Masuda S, Maruyama H, Tsuga K.
  • Journal Title: J Stroke Cerebrovasc Dis. Volume: 29 Issue: 12 Pages: 105303-105303
  • DOI: 10.1016/j.jstrokecerebrovasdis.2020.105303
  • Peer Reviewed
• [Journal Article] Effect of tooth loss and nutritional status on outcomes after ischemic stroke (2020)
  • Author(s): Shiga Yuji、Nezu Tomohisa、Hosomi Naohisa、Aoki Shiro、Nishi Hiromi、Naito Hiroyuki、Kinoshita Naoto、Ueno Hiroki、Maruyama Hirofumi
  • Journal Title: Nutrition Volume: 71 Pages: 110606-110606
  • DOI: 10.1016/j.nut.2019.110606
  • Peer Reviewed
• [Journal Article] Increased blood pressure variability during the subacute phase of ischemic stroke is associated with poor functional outcomes at 3 months (2020)
  • Author(s): Naito Hiroyuki、Hosomi Naohisa、Kuzume Daisuke、Nezu Tomohisa、Aoki Shiro、Morimoto Yuko、Kinboshi Masato、Yoshida Takeshi、Shiga Yuji、Kinoshita Naoto、Ueno Hiroki、Noma Kensuke、Yamasaki Masahiro、Maruyama Hirofumi
  • Journal Title: Scientific Reports Volume: 10 Issue: 1 Pages: 1-7
  • DOI: 10.1038/s41598-020-57661-z
  • Peer Reviewed / Open Access
• [Journal Article] Increased blood pressure variability during the subacute phase in patients with ischemic stroke presenting with a low ankle-brachial index. (2020)
  • Author(s): Naito H, Hosomi N, Kuzume D, Nezu T, Aoki S, Morimoto Y, Kinboshi M, Yoshida T, Shiga Y, Kinoshita N, Ueno H, Noma K, Maruyama H.
  • Journal Title: Geriatr Gerontol Int. Volume: 20 Issue: 5 Pages: 448-454
  • DOI: 10.1111/ggi.13897
  • Peer Reviewed
• [Journal Article] Warm Front Passage on the Previous Day Increased Ischemic Stroke Events (2019)
  • Author(s): Shimomura Ryo、Hosomi Naohisa、Tsunematsu Miwako、Mukai Tomoya、Sueda Yoshimasa、Shimoe Yutaka、Ohshita Tomohiko、Torii Tsuyoshi、Nezu Tomohisa、Aoki Shiro、Kakehashi Masayuki、Matsumoto Masayasu、Maruyama Hirofumi
  • Journal Title: Journal of Stroke and Cerebrovascular Diseases Volume: 28 Issue: 7 Pages: 1873-1878
  • DOI: 10.1016/j.jstrokecerebrovasdis.2019.04.011
  • Peer Reviewed