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Relationship Between Frequency of Spontaneous Swallowing and Salivary Substance P Level in Patients with Acute Stroke

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Abstract

The frequency of spontaneous swallowing is useful for screening of dysphagia in acute stroke. Low levels of substance P (SP) in saliva attenuate the swallowing reflex. The aim of this study was to determine the relationship between the frequency of spontaneous swallowing and salivary SP levels. In 40 subjects, saliva was collected within 72 h after stroke onset and salivary SP levels were measured using ELISA kit at a later date. The frequency of spontaneous swallowing was measured over 1 h using a microphone placed on the neck. Pneumonia was diagnosed by the presence of pyrexia and at least two respiratory problems of four categories (sputum, cough or breathing pattern, breath sound, and gas change). The presence of detectable levels of SP in the saliva was confirmed in 17 patients (high SP group), whereas the level was below the detection limit of the ELISA kit in 23 patients (low SP group). The frequency of spontaneous swallowing was significantly lower in low SP group (16.1 ± 11.6 per hour) than in the high SP group (30.4 ± 20.4, p = 0.016). As the result of multiple regression analysis, salivary SP levels were correlated with frequency of spontaneous swallowing independently of age, NIHSS, and GCS. The incidence of pneumonia was significantly higher in the low than high SP group (p < 0.001). In conclusion, the frequency of spontaneous swallowing was decreased in acute stroke patients with low salivary SP levels. Salivary SP levels can be potentially a useful biomarker of risk of stroke-associated pneumonia in the acute stage.

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Funding

This study was funded partly by Tokyo Metropolitan Clinical Research Grant (No. H27040308).

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, The Jikei University School of Medicine, 3-25-8, Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan

    Masachika Niimi, Takatoshi Hara, Naoki Yamada & Masahiro Abo

  2. Department of Rehabilitation Medicine, Tokyo Metropolitan Bokutoh Hospital, 4-23-15, Kotobashi, Sumida-Ku, Tokyo, 130-8575, Japan

    Gentaro Hashimoto

  3. Department of Internal Medicine, Tokyo Metropolitan Bokutoh Hospital, 4-23-15, Kotobashi, Sumida-Ku, Tokyo, 130-8575, Japan

    Hiroto Fujigasaki

  4. Department of Neurosurgery, Tokyo Metropolitan Bokutoh Hospital, 4-23-15, Kotobashi, Sumida-Ku, Tokyo, 130-8575, Japan

    Takafumi Ide

Authors
  1. Masachika Niimi
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  2. Gentaro Hashimoto
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  3. Takatoshi Hara
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  4. Naoki Yamada
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  5. Masahiro Abo
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  6. Hiroto Fujigasaki
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  7. Takafumi Ide
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Correspondence to Masachika Niimi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Niimi, M., Hashimoto, G., Hara, T. et al. Relationship Between Frequency of Spontaneous Swallowing and Salivary Substance P Level in Patients with Acute Stroke. Dysphagia 33, 414–418 (2018). https://doi.org/10.1007/s00455-017-9867-2

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  • DOI: https://doi.org/10.1007/s00455-017-9867-2

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