Swallowing Disorders after Stroke put a Strain on the Psyche

Around a quarter of acute stroke patients experience swallowing disorders, medically known as dysphagia.

The conditions include difficulty in moving food or liquid into the esophagus, which often leads to choking and other serious complications. In severe cases, food particles entering the trachea can result in pneumonia or even suffocation. While the physical dangers of dysphagia are well-known, its psychological impact on stroke survivors is increasingly recognized as an equally pressing concern.

The Psychological Impact of Dysphagia

Recent studies reveal a strong connection between swallowing disorders and mental health challenges such as post-stroke fatigue, depression, and anxiety. Researchers at the Stroke Research Center VASCage and the Department of Neurology at the Medical University of Innsbruck have been exploring these relationships, shedding light on the lesser-known emotional burdens faced by stroke survivors.

Dysphagia and Post-Stroke Fatigue

Post-stroke fatigue, characterized by extreme and persistent exhaustion, affects approximately half of all stroke patients. However, this proportion skyrockets to over 80% in those with severe dysphagia, according to findings published in the scientific journal, European Journal of Neurology. “The special thing about our study is that it is very representative with almost 900 participants and that we were able to clearly prove the connection between swallowing disorders and fatigue. The association was found despite taking into account the severity of the stroke or the degree of disability, which are common risk factors for fatigue,” explains neurologist Anel Karisik, first author of the publication.

Dysphagia, Depression, and Anxiety

Beyond fatigue, dysphagia has been closely tied to the development of depression after stroke and anxiety symptoms. In a previous publication, stroke researchers from VASCage and the Medical University of Innsbruck had already shown an independent link between dysphagia and the occurrence of depressive and anxiety symptoms in the same way. In fact, individuals with dysphagia are four times more likely to require antidepressants, further underscoring the mental health challenges posed by this condition.

Innovative Dysphagia Treatments

To tackle the dual physical and emotional challenges associated with swallowing disorders, researchers are developing cutting-edge therapies:

1. Optimized Dietary Solutions: Collaborating with the University of Soil Science (Boku) in Vienna, Simon Sollereder and other scientists in the VASCage Rehabilitation Team are working to physically standardize and optimize the consistency of diet foods for dysphagia patients. The goal is to make eating more enjoyable, thereby improving overall well-being and reducing psychological distress.
2. Brain-Computer Interface Technology: In partnership with g.tec medical engineering GmbH Austria, scientists are leveraging brain-computer interface technology to enhance swallowing rehabilitation. Using an EEG hood to measure brain waves, this technology provides biofeedback and triggers electrical stimulation in affected muscles. The approach, previously applied to hand motor skills, is now being adapted for swallowing motor skills, offering new hope for patients.

A Holistic Approach to Stroke Recovery

Matthias Ullrich, Managing Director of VASCage, highlights the need for a comprehensive approach to care, “The current study results show how important our holistic research approach is at VASCage. We focus on the needs of patients and their relatives. Therefore, both psychological stress and swallowing disorders after stroke are important research topics for us. Together with partners, we are intensively looking for concrete innovative solutions that make life easier after stroke.”

Recovering from Stroke: Tackling Dysphagia with Care

The effects of dysphagia on both physical and emotional health emphasize the importance of a well-rounded rehabilitation strategy. Conditions like post-stroke fatigue, depression after stroke, and anxiety symptoms highlight the need to address swallowing disorders not only as a physical challenge but also as a critical factor in mental well-being.

Emerging solutions such as optimized diets and brain-computer interface technology are reshaping how we treat swallowing disorders. By embracing these innovative approaches, healthcare providers can support stroke survivors in regaining control over their lives and improving their quality of life.

With a focus on both the body and mind, the path to recovery becomes more accessible, empowering patients to overcome the challenges posed by swallowing disorders and thrive in their post-stroke journey.

Contact Persons

Dr. Anel Karisik, VASCage researcher and neurologist at the Medical University of Innsbruck ;
Email: anel.karisik@i-med.ac.at
Simon Sollereder, Dysphagie-Experte bei VASCage;
Email: simon.sollereder@vascage.at
Phone number: +43 664 1004838

Original Publication 1

Anel Karisik, Kurt Moelgg, Lucie Buergi, Lukas Scherer, Theresa Schneider, Benjamin Dejakum, Silvia Komarek, Christian Boehme, Thomas Toell, Raimund Pechlaner, Simon Sollereder, Sonja Rossi, Michael Thomas Eller, Gudrun Schoenherr, Wilfried Lang, Stefan Kiechl, Michael Knoflach, Lukas Mayer-Suess; for the STROKE-CARD study group

Journal: European Journal of Neurology
Article Title:  Dysphagia increases the risk of post-stroke fatigue
Article Publication Date: 03-Dec-2024
DOI: https://doi.org/10.1111/ene.16570

Original Publication 2

Anel Karisik, Benjamin Dejakum, Kurt Moelgg, Silvia Komarek, Thomas Toell, Lukas Mayer-Suess, Raimund Pechlaner, Stefanie Kostner, Simon Sollereder, Sophia Kiechl, Sonja Rossi, Gudrun Schoenherr, Wilfried Lang, Stefan Kiechl, Michael Knoflach, Christian Boehme; for the STROKE‐CARD Registry study group

Journal: European Journal of Neurology
Article Title:  Association between dysphagia and symptoms of depression and anxiety after ischemic stroke
Article Publication Date: 02-Feb-2024
DOI:  https://doi.org/10.1111/ene.16224