Coughing in Infratentorial Brain Lesion Patients

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

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.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Other: Not applicable (observational study with no active intervention)

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 42

Contacts and Locations

Study Locations

• Korea, Republic of
  • Gyonngido
    • Bucheon, Gyonngido, Korea, Republic of, 420-717
      • Bucheon St Mary's Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Dysphagia patients due to brain lesions at a university affiliated hospital

Description

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

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Infratentorial dysphagia patients; Infratentorial brain lesion patients with confirmed evidence of dysphagia
Supratentorial dysphagia patients; Supratentorial brain lesions\ patients with confirmed evidence of dysphagia
Brain lesion patients without dysphagia; Brain lesion patients with no evidence of dysphagia	Other: Not applicable (observational study with no active intervention)

What is the study measuring?

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	Time Frame
Maximal inspiratory pressure	baseline one time
Peak cough flow force during voluntary coughing	baseline one time

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
maximal expiratory pressure		baseline one time
spirometry findings		baseline one time
Cough force during reflexive coughing	Peak flow force during reflexive coughing	baseline one time

Collaborators and Investigators

• Sponsor: The Catholic University of Korea
• Investigators: Principal Investigator: Sun Im, MD PhD, The Catholic University of Korea

Study record dates

Study Major Dates

• Study Start: September 1, 2013
• Primary Completion (Actual): June 1, 2014
• Study Completion (Actual): August 1, 2014

Study Registration Dates

• First Submitted: March 4, 2014
• First Submitted That Met QC Criteria: March 5, 2014
• First Posted (Estimate): March 7, 2014

Study Record Updates

• Last Update Posted (Estimate): February 24, 2015
• Last Update Submitted That Met QC Criteria: February 22, 2015
• Last Verified: February 1, 2015

More Information

Terms related to this study

• Keywords: sonography; diaphragm; brainstem; deglutition disorder
• Other Study ID Numbers: HC 13OISE0066_1