Assessing the Effect of Fatigue on Swallowing Function in Adults with Acute Stroke. A Pilot Study

These findings indicate that peripheral neuromuscular fatigue is unlikely to be the primary cause of the observed changes, as only 2 of the 6 temporal measures-pharyngeal transit time and pharyngeal delay time-were affected. In cases of peripheral neuromuscular fatigue, one would expect increases across all 6 timing measures due to the integrated nature of the swallowing process. Instead, the results suggest that the inconsistencies may stem from a delayed excitatory response of neurons or a delay in synaptic transmission within the nucleus tractus solitarius, potentially associated with stroke. This delay likely contributes to the prolongation of both pharyngeal transit and pharyngeal delay times. Thus, a model focused solely on peripheral neuromuscular fatigue does not fully account for the findings, highlighting the importance of considering central neural mechanisms in the clinical evaluation of swallowing disorders.