The Effect of Swallowing Action Observation Therapy on Resting fMRI in Stroke Patients with Dysphagia

Ming Zeng; Zhongli Wang; Xuting Chen; Meifang Shi; Meihong Zhu; Jingmei Ma; Yunhai Yao; Yao Cui; Hua Wu; Jie Shen; Lingfu Xie; Jianming Fu; Xudong Gu

doi:10.1155/2023/2382980

The Effect of Swallowing Action Observation Therapy on Resting fMRI in Stroke Patients with Dysphagia

Neural Plast. 2023 Apr 21:2023:2382980. doi: 10.1155/2023/2382980. eCollection 2023.

Authors

Ming Zeng¹, Zhongli Wang¹, Xuting Chen¹, Meifang Shi¹, Meihong Zhu¹, Jingmei Ma¹, Yunhai Yao¹, Yao Cui², Hua Wu¹, Jie Shen¹, Lingfu Xie³, Jianming Fu¹, Xudong Gu¹

Affiliations

¹ Department of Rehabilitation Medicine, The Second Affiliated Hospital of Jiaxing University, The Second Hospital of Jiaxing City, Jiaxing, Zhejiang Province 314000, China.
² Department of Physical Therapy, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Capital Medical University School of Rehabilitation Medicine, Beijing 100068, China.
³ First Clinical Medical College, Nanchang University, Nanchang, Jiangxi Province 330031, China.

Abstract

Objective: Many stroke victims have severe swallowing problems. Previous neuroimaging studies have found that several brain regions scattered in the frontal, temporal, and parietal lobes, such as Brodmann's areas (BA) 6, 21, and 40, are associated with swallowing function. This study sought to investigate changes in swallowing function and resting-state functional magnetic resonance imaging (rs-fMRI) in stroke patients with dysphagia following action observation treatment. It also sought to detect changes in brain regions associated with swallowing in stroke patients.

Methods: In this study, 12 healthy controls (HCs) and 12 stroke patients were recruited. Stroke patients were given 4 weeks of action observation therapy. In order to assess the differences in mfALFF values between patients before treatment and HCs, the fractional amplitude of low-frequency fluctuations (fALFF) in three frequency bands (conventional frequency band, slow-4, and slow-5) were calculated for fMRI data. The significant brain regions were selected as regions of interest (ROIs) for subsequent analysis. The mfALFF values were extracted from ROIs of the three groups (patients before and after treatment and HCs) and compared to assess the therapeutic efficacy.

Results: In the conventional band, stroke patients before treatment had higher mfALFF in the inferior temporal gyrus and lower mfALFF in the calcarine fissure and surrounding cortex and thalamus compared to HCs. In the slow-4 band, there was no significant difference in related brain regions between stroke patients before treatment and HCs. In the slow-5 band, stroke patients before treatment had higher mfALFF in inferior cerebellum, inferior temporal gyrus, middle frontal gyrus, and lower mfALFF in calcarine fissure and surrounding cortex compared to HCs. We also assessed changes in aberrant brain activity that occurred both before and after action observation therapy. The mfALFF between stroke patients after therapy was closed to HCs in comparison to the patients before treatment.

Conclusion: Action observation therapy can affect the excitability of certain brain regions. The changes in brain function brought about by this treatment may help to further understand the potential mechanism of network remodeling of swallowing function.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Deglutition
Deglutition Disorders* / diagnostic imaging
Deglutition Disorders* / etiology
Humans
Magnetic Resonance Imaging / methods
Motor Cortex
Stroke* / complications
Stroke* / diagnostic imaging
Stroke* / therapy