Swallowing Impairment in Patients with Cerebral Small Vessel Disease

Background: Dysphagia is the important complication related to cerebral small vessel disease (CSVD) including lacunar infarcts (LIs), white matter hyperintensity (WMH), cerebral microbleeds (CMBs) and perivascular spaces (PVS). The aim of this study was to investigate the relationship between swallowing function and CSVD.Methods: This study is based on the authors' prospective registry between 2015 and 2017. We enrolled 352 patients and signs of CSVD on magnetic resonance imaging (MRI). Swallowing function was evaluated using the Repetitive Saliva Swallowing Test and the Modified Water Swallow Test. On MRI, the severity of WMH including deep WMH (DWMH), the number of LIs, CMBs and PVS were assessed.Results: Seventy-nine out of 352 (24.4%) patients exhibited swallowing impairment. Mean age was 70.4±10.6 years and 218 were male (63.4%). Those with dysphagia had higher WMH scores and a greater number of LIs than those without. The severity of whole WMH, frontal and parietal DWMH were associated with dysphagia. After adjustment for age, sex, vascular risk factors, and Mini Mental State Examination, whole WMH severity still associated with dysphagia.Conclusions: WMH, particularly frontal and parietal DWMH, was associated with swallowing impairment.