Tongue pressure in patients with post-stroke dysphagia

Introduction Tongue pressure is essential for oropharyngeal swallowing, but regional normative and pathological values remain unclear, as do its links to swallowing and aspiration in post-stroke dysphagia (PSD). This study assessed maximal tongue pressure (Pmax) at five sites (anterior, middle, posterior, left anterior, right anterior) in healthy individuals and PSD patients, and examined its correlations with swallowing physiology and aspiration in PSD. Methods We enrolled 70 post-stroke dysphagia patients (DSG), 70 post-stroke non-dysphagia patients (NDSG), and 70 healthy controls (CG). Pmax was compared among groups. Within DSG, correlations between Pmax and VFSS/FEES parameters and aspiration were analyzed. Results In all three groups, posterior Pmax was highest, right anterior lowest ( P < 0.001). Pmax ranked CG > NDSG > DSG at all sites (all P < 0.001). In DSG, posterior Pmax was associated with cricopharyngeal opening ( P = 0.030) and pharyngeal residue ( P = 0.014) on VFSS, but not with any FEES parameter. All five Pmax values negatively correlated with oral transit time (all P < 0.001), strongest in left/right anterior. Soft palate elevation time weakly negatively correlated with left anterior, middle, and right anterior Pmax ( r = -0.252 to -0.248, P < 0.05). Hyoid movement time weakly positively correlated with left anterior, anterior, and right anterior Pmax ( r = 0.251-0.340, P < 0.05). Pharyngeal phase initiation time negatively correlated with middle Pmax ( r = -0.286, P = 0.016) and posterior Pmax ( r = -0.313, P = 0.008). No Pmax site predicted aspiration on VFSS/FEES. PSD, NDSG, and CG all showed highest posterior and lowest right anterior pressure. Discussion In PSD, anterior pressure aids oral transport, posterior pressure relates to pharyngeal function. Tongue pressure poorly predicts aspiration.