The Influence of Balloon Dilation on Brain Functional Connectivity in Patients with Dysphagia after Brainstem Stroke:a Resting-state fMRI and Voxel-wise Functional Connectivity Analysis
CHEN Xiaofeng
WANG Qingbi
JIN Xin
WU Shichang
HE Weina
HUANG Ziping
HUANG Baosheng
LIAO Hongquan
ZHONG Li
LIU Hailan
LI Siming
QIN Tingting
Abstract：Objective:The anterior and posterior central gyri were chosen as seed-based regions of interest(sb-ROI)based on the literature.Resting-state functional magnetic resonance imaging(rs-fMRI)and voxel-wise functional connectivity(FC)analysis were used to evaluate the activation of functional connectivity by balloon dilatation in individuals with cricopharyngeal muscular dysphagia following brainstem stroke.Methods:Forty patients with cricopharyngeal muscle flaccidity dysphagia after brainstem stroke were selected from January 2021 to July 2022,and randomly assigned to the balloon dilatation treatment group and the conventional treatment group,with 20 cases in each group.The treatment time of both groups was 30 days,and the swallowing ability of both groups was assessed before and after treatment by Standardised Swallowing Assessment(SSA)and Modified Barium Swallow Impairment Profile(MBSImp).Eight more healthy subjects were chosen and established as a healthy control group.The balloon dilatation treatment group and the conventional treatment group underwent rs-fMRI one day before the official treatment and within the first day after the end of the treatment.In contrast,the healthy control group underwent a one-time rs-fMRI examination.The dcm2niix software tool was applied to convert the functional and structural image DICOM files of the raw MRI data into NIfTI format.Then the rs-fMRI data were preprocessed and statistically analyzed with the help of matlab,spm 12,and dpabi software.The vegetative body's thresholds for neurological functional activities in brain regions were set as voxel P＜0.005,cluster size≥10,MNI coordinates,number of voxels,and F or T values of meaningful brain regions were displayed.Results:There was a significant difference in SSA and MBSImp scores between before and after treatment at balloon dilatation treatment group and conventional treatment group,and there was a significant difference between the balloon dilatation treatment group and the conventional treatment group at the end of the rehabilitation treatment with SSA scores(P＜0.05)and MBSImp scores(P＜0.001).Before the therapy session,the brain functional connectivity between the right hemisphere precuneus and sb-ROI was enhanced in the balloon dilatation treatment group.At the end of the therapy session,the brain functional connectivity between the left upper middle frontal lobe and sb-ROI was enhanced in the balloon dilatation treatment group.And the cerebral functional connectivity of the frontal lobe,temporal lobe,insula,cuneus,precentral gyrus,postcentral gyrus,cerebellum,chiasmatic nucleus,hippocampus,and caudate nucleus with sb-ROI was improved in the balloon dilatation treatment group in comparison to the conventional treatment group.Conclusions:Balloon dilatation significantly improves swallowing function in patients with cricopharyngeal dysphagia after brainstem stroke.The precuneus and frontal lobes are involved in functional compensation of cricopharyngeal dysphagia after brainstem stroke.Broad cortical-subcortical regions are involved in the rehabilitation of cricopharyngeal dysphagia after brainstem stroke with balloon dilation.
Keywords：brainstem strokedysphagiaballoon dilationresting-state functional magnetic resonance imagingfunctional connectivity
Publication Date：2025-12-25
Online Publishing Date：2026-01-13(First online date of this platform, not the publication date of the document)
Pages：8( 3715-3722 )