# Characteristics and Clinical Analysis of Dysphagia Caused by Pontine Infarction: A Video Fluoroscopic Swallowing Study

## TL;DR

This study examines how different areas of pontine infarction affect swallowing difficulties, finding that lower pontine infarctions cause more severe issues.

## Contribution

The study identifies distinct dysphagia characteristics based on the specific location of pontine infarction using VFSS and MBSImP assessments.

## Key findings

- Lower pontine infarction patients show more severe oropharyngeal dysfunction compared to upper/middle infarctions.
- MBSImP scores indicate worse impairments in oral and pharyngeal stages for lower pontine infarctions.
- Key swallowing issues include impaired lip closure, tongue control, and laryngeal elevation in lower pontine cases.

## Abstract

To investigate the characteristics of a video fluoroscopic swallowing study (VFSS) in patients with dysphagia caused by different parts of pontine infarction and to analyze the relationship between the severity of dysphagia and the parts of pontine infarction.

This study included 60 patients diagnosed with acute pontine infarction in the Department of Neurology and Rehabilitation Medicine of Handan Central Hospital from August 2022 to August 2023. Pontine infarction was divided into an upper pontine infarction group, middle pontine infarction group, and lower pontine infarction group according to the distribution characteristics of diffusion‐weighted imaging (DWI). The VFSS evaluation results of patients with dysphagia brought on by infarction in different areas of the pons were calculated and analyzed to summarize the characteristics of dysphagia. The odified barium swallow impairment profile (MBSImP) was used to assess the severity of swallowing impairment in patients with pontine infarction at different locations.

Compared with the upper and middle pontine infarction groups, the lower pontine infarction group was more prone to oropharyngeal swallowing disorder, and the incidence of lip closure, tongue control during bolus hold, oral residue, initiation of the pharyngeal swallow, laryngeal elevation, and tongue base retraction showed statistically significant differences among the three patient groups (p < 0.05). Compared with the suprapontine and middle infarct groups, the lower pontine infarct group had a higher MBSImP score in the oral and pharyngeal stages of swallowing disorders and a heavier degree of lip closure, tongue control during bolus hold, oral residue, initiation of the pharyngeal swallow, laryngeal elevation, and tongue base retraction, with statistical significance (p < 0.05).

Patients with subpontine infarction with dysphagia had relatively independent biological characteristics.

This study investigates dysphagia characteristics in pontine infarction patients using video fluoroscopic swallowing study (VFSS), categorizing infarcts into upper, middle, and lower pons regions. Key findings reveal that lower pontine infarction patients exhibit significantly more severe oropharyngeal dysfunction, with higher incidences of impaired lip closure, tongue control, laryngeal elevation, and tongue base retraction compared to upper/middle infarcts (p < 0.05). VFSS‐based modified barium swallow impairment profile (MBSImP) scores confirmed worse oral/pharyngeal stage impairments in lower pons lesions, highlighting their distinct clinical profile. The results underscore the critical role of infarct location in dysphagia severity, advocating for targeted rehabilitation strategies.