Biomedical subjects

Maryellen McClain

Publications and source records attributed to Maryellen McClain.

3 recordsLinked to original sources

PubMed2004

Apraxia.

In this review, we present a summary of some of the most pertinent new research on aspects of apraxia. Rather than attempt a review of all neurologic syndromes that have been identified as forms of apraxia, such as buccofacial, truncal, apraxia of eye opening, and apraxia of speech, we focus on current literature and trends in the study of limb apraxia. Although the classic empirical approach to the study of apraxia has been through systematic neuropsychologic assessment of various aspects of the syndrome, questions remain regarding the exact neural substrate that forms the foundation of the praxis system. More recent work using sophisticated neuroimaging methods has yielded a wealth of new data that contributes significantly to our understanding of the neuroanatomic correlates of this complex disorder. In addition, the results of recent sophisticated neuropsychologic studies have suggested modifications to classic cognitive models of apraxia. A discussion of current work and directions for future research are also provided.

Apraxias↗

PubMedDate not supplied

Clinical and cognitive predictors of swallowing recovery in stroke.

This retrospective study determined whether specific neurological features were associated with initial and final swallowing outcomes in acute stroke patients. A chart review of 65 acute stroke patients suggested that certain clinical and neurocognitive behaviors were associated with swallowing outcomes. Hemispatial neglect was significantly associated with initial nonoral dietary intake, whereas aphasia was not associated with swallowing outcome. Results from the initial clinical swallowing evaluations suggested that the presence of at least four of six clinical features (cough after swallow, voice change after swallow, abnormal volitional cough, abnormal gag reflex, dysphonia, and dysarthria) were associated with poor initial and final swallowing outcomes. Whether specific lesion location, size, or a combination of clinical neurological deficits are associated with poor initial and final swallowing outcomes is unclear. Prospective studies are warranted for further investigation of these relationships.

Adult↗

PubMedDate not supplied

Dysphagia in stroke: Development of a standard method to examine swallowing recovery.

This study began development of a standard method that uses the videofluoroscopic swallow study for evaluation of swallowing recovery after stroke based on a definition of dysphagia derived from three domains: bolus timing, bolus direction, and bolus clearance. Two experiments were conducted: one that defined normal versus disordered swallowing based on the range of scores in a sample of healthy adults (n = 13), and one that applied these thresholds to nine stroke patients to identify the presence of dysphagia. Results indicate that acute and protracted dysphagia may be more accurately detected by identifying abnormalities on multiple objective measures of swallowing rather than on laryngeal penetration or aspiration alone. Results indicate that our selected measures and use of healthy control subjects to establish normal thresholds may eventually contribute to the definition and differentiation of dysphagic and nondysphagic patients. Further research with a broader sample of healthy controls and stroke patients is mandatory.

Aged↗