Coughing in Infratentorial Brain Lesion Patients

Study Overview
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Brief Summary
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To record diaphragm excursion in infratentorial brain lesions patients with dysphagia during coughing and compare them to those with supratentorial brain lesion patients with dysphasia and those with no dysphagia at a university affiliated rehabilitation department.

Detailed Description
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Our previous work has shown that stroke patients with dysphagia have impaired diaphragm excursion in comparison to those with no dysphagia. It has been postulated that respiratory and cough function are primarily controlled by respiratory and swallowing centers located in the brainstem.We postulated that those with infratentorial brain lesions would have more impaired cough and respiratory function than those with non-brainstem lesions and supratentorial brain lesions. However there has been no studies whether those with infratentorial brain lesions have more impaired cough function and decreased diaphragm excursion than those with supratentorial brain lesions.

Official Title
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Cross Sectional Observation Study of Cough Dysfunction in Infratentorial Brain Lesion Patients, as Assessed by M-mode Sonography

Conditions
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Stroke

Intervention / Treatment
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* Other: Not applicable (observational study with no active intervention)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Group 1- Brainstem lesion subjects with dysphagia that would require insertion of a nasogastric tube Group 2- Non-brainstem lesion subjects with dysphagia that would require insertion of a nasogastric tube Group 3- Stroke patients with no evidence of dysphagia Exclusion Criteria: Episode of acute pneumonia or pulmonary embolism at time of enrollment Previous history of chronic respiratory disorders or other systemic disorders that may affect respiratory function ( ex, rheumatoid arthritis, chronic renal disease, spinal cord injury) Stroke patients with multiple brain lesions Episode of Diaphragm weakness due to peripheral polyneuropathy or unilateral phrenic nerve palsy Previous episode of abdominal or thoracic surgery within one year of enrollment Concomitant diagnosis of myopathy, muscular dystrophy or other disorders that may affect respiratory muscles. Episode of rib fracture within one year of enrollment Chronic alcoholism Patient with previous diagnosis of dementia or with impaired cognitive function that may limit full participation at the evaluation Patient with tracheostomy state

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Infratentorial dysphagia patients<br>Infratentorial brain lesion patients with confirmed evidence of dysphagia | |
| Supratentorial dysphagia patients<br>Supratentorial brain lesions\ patients with confirmed evidence of dysphagia | |
| Brain lesion patients without dysphagia<br>Brain lesion patients with no evidence of dysphagia | Other: Not applicable (observational study with no active intervention)<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diaphragm excursion | Diaphragm excursion as assessed by m mode sonography | baseline one time | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Maximal inspiratory pressure |  | baseline one time | 
| Peak cough flow force during voluntary coughing |  | baseline one time | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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brainstem, diaphragm, deglutition disorder, sonography