Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector140710.17816/ACEN.1407CKRLSMReviewsОбзорыReview ArticlePost-stroke dysphagiaПостинсультная дисфагияhttps://orcid.org/0000-0002-7465-0677PizovaNataliia V.ПизоваНаталия Вячеславовна
Russian Federation

Dr. Sci. (Med.), Professor, Department of nervous diseases with medical genetics and neurosurgery

д-р мед. наук, профессор каф. нервных болезней с медицинской генетикой и нейрохирургией

pizova@yandex.ruhttps://orcid.org/0000-0002-0522-675XPizovAleksandr V.ПизовАлександр Витальевич
Russian Federation

Cand. Sci. (Biol.), Associate Professor, Department of methods of teaching natural sciences and mathematics in primary schools

канд. биол. наук, доцент каф. методики преподавания естественно-математических дисциплин в начальной школе

avpizov@yandex.ruYaroslavl State Medical UniversityЯрославский государственный медицинский университетK.D. Ushinsky Yaroslavl State Pedagogical UniversityЯрославский государственный педагогический университет имени К.Д. Ушинского3006202620277850508202517112025Copyright ©; 2026, Pizova N.V., Pizov A.V.Copyright ©; 2026, Пизова Н.В., Пизов А.В.2026Pizova N.V., Pizov A.V.Пизова Н.В., Пизов А.В.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/1407

The article presents a global problem in modern neurology: post-stroke dysphagia. The anatomy, physiology, and pathophysiology of swallowing are presented. The prevalence and risk factors of post-stroke dysphagia are shown. The main complications that develop in patients with post-stroke dysphagia are described. The article presents the main diagnostic and therapeutic approaches for ensuring timely prevention and treatment of this serious complication in patients with strokes.

В статье освещена глобальная проблема современной неврологии — постинсультная дисфагия. Представлены анатомия, физиология и патофизиология глотания. Показаны распространённость и факторы риска развития постинсультной дисфагии. Описаны основные осложнения, развивающиеся у пациентов с постинсультной дисфагией. Изложены основные диагностические и терапевтические подходы для обеспечения своевременной профилактики и лечения этого серьёзного осложнения у пациентов с инсультами.

strokepost-stroke dysphagiarisk factorscomplicationsdiagnostic and therapeutic strategiesинсультпостинсультная дисфагияфакторы рискаосложнениядиагностические и терапевтические стратегииFeigin VL, Brainin M, Norrving B, et al. World Stroke Organization: Global Stroke Fact Sheet 2025. Int J Stroke. 2025;20(2):132–144. doi: 10.1177/17474930241308142Kim DY, Park HS, Park SW, Kim JH. The impact of dysphagia on quality of life in stroke patients. Medicine (Baltimore). 2020;99(34):e21795. doi: 10.1097/MD.0000000000021795Wang Z, Shi R, Moreira P. Post-stroke dysphagia: identifying the evidence missing. Front Med (Lausanne). 2025;12:1494645. doi: 10.3389/fmed.2025.1494645Sasegbon A, Cheng I, Hamdy S. The neurorehabilitation of post-stroke dysphagia: physiology and pathophysiology. J Physiol. 2025;603(3):617–634. doi: 10.1113/JP285564Jean A. Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev. 2001;81(2):929–969. doi: 10.1152/physrev.2001.81.2.929Dantas RO, Kern MK, Massey BT, et al. Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing. Am J Physiol. 1990;258(5 Pt 1):G675–G681. doi: 10.1152/ajpgi.1990.258.5.G675Inamoto Y, Saitoh E, Okada S, et al. The effect of bolus viscosity on laryngeal closure in swallowing: kinematic analysis using 320‐row area detector CT. Dysphagia. 2013;28(1):33–42. doi: 10.1007/s00455-012-9410-4Pongpipatpaiboon K, Inamoto Y, Aihara K, et al. Thin liquid bolus volume alters pharyngeal swallowing: kinematic analysis using 3D dynamic CT. Dysphagia. 2022;37(6):1423–1430. doi: 10.1007/s00455-021-10397-yMichou E, Mastan A, Ahmed S, et al. Examining the role of carbonation and temperature on water swallowing performance: a swallowing reaction‐time study. Chem Senses. 2012;37(9):799–807. doi: 10.1093/chemse/bjs061Otake M, Kurose M, Uchida Y, et al. The interactions between different tastes on initiation of reflex swallow elicited by electrical stimulation in humans. Odontology. 2016;104(3):282–290. doi: 10.1007/s10266-015-0226-1Maeda K, Akagi J. Sarcopenia is an independent risk factor of dysphagia in hospitalized older people. Geriatr Gerontol Int. 2016;16(4):515–521. doi: 10.1111/ggi.12486Feng X, Todd T, Lintzenich CR, et al. Aging‐related geniohyoid muscle atrophy is related to aspiration status in healthy older adults. J Gerontol A Biol Sci Med Sci. 2013;68(7):853–860. doi: 10.1093/gerona/gls225Park JS, You S‐J, Kim JY, et al. Differences in orofacial muscle strength according to age and sex in East Asian healthy adults. Am J Phys Med Rehabil. 2015;94(9):677–686. doi: 10.1097/PHM.0000000000000230Iida T, Tohara H, Wada S, et al. Aging decreases the strength of suprahyoid muscles involved in swallowing movements. Tohoku J Exp Med. 2013;231(3):223–228. doi: 10.1620/tjem.231.223Molfenter SM, Amin MR, Branski RC, et al. Age‐related changes in pharyngeal lumen size: a retrospective MRI analysis. Dysphagia. 2015;30(3):321–327. doi: 10.1007/s00455-015-9602-9Wirth R, Dziewas R, Beck AM, et al. Oropharyngeal dysphagia in older persons — from pathophysiology to adequate intervention: a review and summary of an international expert meeting. Clin Interv Aging. 2016:11:189–208. doi: 10.2147/CIA.S97481Jardine M, Miles A, Allen J. A systematic review of physiological changes in swallowing in the oldest old. Dysphagia. 2020;35(3):509–532. doi: 10.1007/s00455-019-10056-3Platz T. Clinical pathways in stroke rehabilitation: evidence-based clinical practice recommendations. Cham; 2021. doi: 10.1007/978-3-030-58505-1Ko N, Lee HH, Sohn MK, et al. Status of dysphagia after ischemic stroke: a Korean nationwide study. Arch Phys Med Rehabil. 2021;102(12):2343–2352.e3. doi: 10.1016/j.apmr.2021.07.788Banda KJ, Chu H, Kang XL, et al. Prevalence of dysphagia and risk of pneumonia and mortality in acute stroke patients: a meta-analysis. BMC Geriatr. 2022;22(1):420. doi: 10.1186/s12877-022-02960-5Chang MC, Choo YJ, Seo KC, Yang S. The relationship between dysphagia and pneumonia in acute stroke patients: a systematic review and meta-analysis. Front Neurol. 2022:13:834240. doi: 10.3389/fneur.2022.834240Sun F, Qiao J, Huang X, et al. Characteristics of post-stroke dysphagia: a retrospective study based on FEES. Brain Behav. 2023;13(8):e3161. doi: 10.1002/brb3.3161Gu H, Ren D. Prevalence and risk factors of poststroke dysphagia: a meta-analysis. Cerebrovasc Dis. 2025;54(2):236–259. doi: 10.1159/000538218Wen X, Fan B, Zhan J, et al. Integrated analysis of the prevalence and influencing factors of poststroke dysphagia. Eur J Med Res. 2025;30(1):27. doi: 10.1186/s40001-024-02263-yTanashyan MM, Berdnikovich ES, Lagoda OV. Post-stroke dysphagia: novel treatment approaches. Neurology, neuropsychiatry, psychosomatics. 2018;10(2):57–62. doi: 10.14412/2074-2711-2018-2-57-62Танашян М.М., Бердникович Е.С., Лагода О.В. Нарушения глотания в постинсультном периоде: новые подходы к лечению. Неврология, нейропсихиатрия, психосоматика. 2018;10(2):57–62.Al-Khaled M, Matthis C, Binder A, et al. Dysphagia in patients with acute ischemic stroke: early dysphagia screening may reduce stroke-related pneumonia and improve stroke outcomes. Cerebrovasc Dis. 2016;42 (1-2):81–89. doi: 10.1159/000445299Won SY, Krieger S, Dubinski D, et al. Neurogenic dysphagia in subdural hematoma. Front Neurol. 2022:12:701378. doi: 10.3389/fneur.2021.701378Dziewas R, Michou E, Trapl-Grundschober M, et al. European Stroke Organisation and European Society for Swallowing Disorders guideline for the diagnosis and treatment of post-stroke dysphagia. Eur Stroke J. 2021;6(3):LXXXIX–CXV. doi: 10.1177/23969873211039721Dziewas R, Allescher HD, Aroyo I, et al. Diagnosis and treatment of neurogenic dysphagia — S1 guideline of the German Society of Neurology. Neurol Res Pract. 2021;3(1):23. doi: 10.1186/s42466-021-00122-3Sherman V, Greco E, Martino R. The benefit of dysphagia screening in adult patients with stroke: a meta-analysis. J Am Heart Assoc. 2021;10(12):e018753. doi: 10.1161/JAHA.120.018753Lee SY, Han SH. Relationship between subcortical hemorrhage size and characteristics of dysphagia. Dysphagia. 2019;34(2):155–160. doi: 10.1007/s00455-018-9938-zMiao Y, Xiong Y, Guo J, et al. Risk factors and outcomes of dysphagia among patients hospitalized with acute intracerebral hemorrhage: findings from the Chinese Stroke Center Alliance. Altern Ther Health Med. 2024;30(10):200–205.Fandler S, Gattringer T, Eppinger S, et al. Frequency and predictors of dysphagia in patients with recent small subcortical infarcts. Stroke. 2017;48(1):213. doi: 10.1161/strokeaha.116.015625Henke C, Foerch C, Lapa S. Early screening parameters for dysphagia in acute ischemic stroke. Cerebrovasc Dis. 2017;44(5–6):285–290. doi: 10.1159/000480123Toscano M, Vigano A, Rea A, et al. Sapienza global bedside evaluation of swallowing after stroke: the GLOBE-3S study. Eur J Neurol. 2019;26(4):596–602. doi: 10.1111/ene.13862Song W, Wu M, Wang H, et al. Prevalence, risk factors, and outcomes of dysphagia after stroke: a systematic review and meta-analysis. Front Neurol. 2024;15:1403610. doi: 10.3389/fneur.2024.1403610Eltringham SA, Smith CJ, Pownall S, et al. Variation in dysphagia assessment and management in acute stroke: an interview study. Geriatrics (Basel). 2019;4(4):60. doi: 10.3390/geriatrics4040060Umay E, Eyigor S, Ertekin C, et al. Best practice recommendations for stroke patients with dysphagia: a delphi-based consensus study of experts in Turkey — Part I: management, diagnosis, and follow-up. Dysphagia. 2022;37(2):217–236. doi: 10.1007/s00455-021-10273-9Papanastasiou CA, Theochari CA, Zareifopoulos N, et al. Atrial fibrillation is associated with cognitive impairment, all-cause dementia, vascular dementia, and Alzheimer’s disease: a systematic review and meta-analysis. J Gen Intern Med. 2021;36(10):3122–3135. doi: 10.1007/s11606-021-06954-8Wilmskoetter J, Martin-Harris B, Pearson WG, et al. Differences in swallow physiology in patients with left and right hemispheric strokes. Physiol Behav. 2018;194:144–152. doi: 10.1016/j.physbeh.2018.05.010Jones CA, Colletti CM, Ding MC. Post-stroke dysphagia: recent insights and unanswered questions. Curr Neurol Neurosci Rep. 2020;20(12):61. doi: 10.1007/s11910-020-01081-zPatel DA, Krishnaswami S, Steger E, et al. Economic and survival burden of dysphagia among inpatients in the United States. Dis Esophagus. 2018;31(1):1–7. doi: 10.1093/dote/dox131Martino R, Foley N, Bhogal S, et al. Dysphagia after stroke: incidence, diagnosis, and pulmonary complications. Stroke. 2005;36(12):2756–2763. doi: 10.1161/01.STR.0000190056.76543.ebGromova DO, Zakharov VV. Dysphagia after stroke. Neurology, neuropsychiatry, psychosomatics. 2015;7(4):50–56. doi: 10.14412/2074-2711-2015-4-50-56Громова Д.О., Захаров В.В. Нарушения глотания после инсульта. Неврология, нейропсихиатрия, психосоматика. 2015;7(4):50–56.Li H, Li J, Wang X, Zhang Z. A systematic review and meta-analysis of acupuncture in aspiration caused by post-stroke dysphagia. Front Neurol. 2024;15:1305056. doi: 10.3389/fneur.2024.1305056Ramsey D, Smithard D, Kalra L. Silent aspiration: what do we know? Dysphagia. 2005;20(3):218–225. doi: 10.1007/s00455-005-0018-9Perry L, Love CP. Screening for dysphagia and aspiration in acute stroke: a systematic review. Dysphagia. 2001;16(1):7–18. doi: 10.1007/pl00021290Wakasugi Y, Tohara H, Hattori F, et al. Screening test for silent aspiration at the bedside. Dysphagia. 2008;23(4):364–370. doi: 10.1007/s00455-008-9150-7Krishnamurthy R, Balasubramanium RK, Premkumar PK. Systematic review and meta-analysis of dysphagia and associated pneumonia in patients with stroke from India: a call to arms. Am J Speech Lang Pathol. 2022;31(1):502–514. doi: 10.1044/2021_AJSLP-21-00175Eltringham SA, Kilner K, Gee M, et al. Factors associated with risk of stroke-associated pneumonia in patients with dysphagia: a systematic review. Dysphagia. 2020;35(5):735–744. doi: 10.1007/s00455-019-10061-6Kishore KA, Vail A, Chamorro A, et al. How is pneumonia diagnosed in clinical stroke research? A systematic review and meta-analysis. Stroke. 2015;46(5):1202–1209. doi: 10.1161/STROKEAHA.114.007843Hannawi Y, Hannawi B, Rao CPV, et al. Stroke-associated pneumonia: major advances and obstacles. Cerebrovasc Dis. 2013;35(5):430–443. doi: 10.1159/000350199Eltringham S, Kilner K, Gee M, et al. Impact of dysphagia assessment and management on risk of stroke-associated pneumonia: a systematic review. Cerebrovasc Dis. 2018;46(3–4):99–107. doi: 10.1159/000492730Baijens LW, Clavé P, Cras P, et al. European Society for Swallowing Disorders — European Union Geriatric Medicine Society white paper: oropharyngeal dysphagia as a geriatric syndrome. Clin Interv Aging. 2016;11:1403–1428. doi: 10.2147/CIA.S107750Logemann JA, Pauloski BR, Rademaker AW, et al. Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men. J Speech Lang Hear Res. 2000;43(5):1264–1274. doi: 10.1044/jslhr.4305.1264Martino R, Pron G, Diamant N. Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines. Dysphagia. 2000;15(1):19–30. doi: 10.1007/s004559910006Terré R, Mearin F. Oropharyngeal dysphagia after the acute phase of stroke: predictors of aspiration. Neurogastroenterol Motil. 2006;18(3):200–205. doi: 10.1111/j.1365-2982.2005.00729.xBours GJ, Speyer R, Lemmens J, et al. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs. 2009;65(3):477–493. doi: 10.1111/j.1365-2648.2008.04915.xPerry L. Screening swallowing function of patients with acute stroke. Part one: identification, implementation and initial evaluation of a screening tool for use by nurses. J Clin Nurs. 2001;10(4):463–473. doi: 10.1046/j.1365-2702.2001.00501.xPerry L. Screening swallowing function of patients with acute stroke. Part two: detailed evaluation of the tool used by nurses. J Clin Nurs. 2001;10(4):474–481. doi: 10.1046/j.1365-2702.2001.00502.xRiera SA, Marin S, Serra-Prat M, et al. A systematic and a scoping review on the psychometrics and clinical utility of the Volume-Viscosity Swallow Test (V-VST) in the clinical screening and assessment of oropharyngeal dysphagia. Foods. 2021;10(8):1900. doi: 10.3390/foods10081900Felix CC, Joseph ME, Daniels SK. Clinical decision making in patients with stroke-related dysphagia. Semin Speech Lang. 2019;40(3):188–202. doi: 10.1055/s-0039-1688815Steele CM, Alsanei WA, Ayanikalath S, et al. The influence of food texture and liquid consistency modification on swallowing physiology and function: a systematic review. Dysphagia. 2015;30(1):2–26. doi: 10.1007/s00455-014-9578-xFang WJ, Zheng F, Zhang LZ, et al. Research progress of clinical intervention and nursing for patients with post-stroke dysphagia. Neurol Sci. 2022;43(10):5875–5884. doi: 10.1007/s10072-022-06191-9Houdijk H, ter Hoeve N, Nooijen C, et al. Energy expenditure of stroke patients during postural control tasks. Gait Posture. 2010;32(3):321–326. doi: 10.1016/j.gaitpost.2010.05.016Serra MC, Treuth MS, Hafer-Macko CE, Ryan AS. Increased energy cost of mobility in chronic stroke. J Gerontol Geriatr Res. 2016;5(6):356. doi: 10.4172/2167-7182.1000356Nagano A, Yamada Y, Miyake H, et al. Increased resting energy expenditure after endovascular coiling for subarachnoid hemorrhage. J Stroke Cerebrovasc Dis. 2016;25(4):813–818. doi: 10.1016/j.jstrokecerebrovasdis.2015.12.008Cheng I, Sasegbon A, Hamdy S. A systematic review and meta‐analysis of the effects of intraoral treatments for neurogenic oropharyngeal dysphagia. J Oral Rehabil. 2022;49(1):92–102. doi: 10.1111/joor.13274Robbins J, Kays SA, Gangnon RE, et al. The effects of lingual exercise in stroke patients with dysphagia. Arch Phys Med Rehabil. 2007;88(2):150–158. doi: 10.1016/j.apmr.2006.11.002Park J‐S, Lee S‐H, Jung S‐H, et al. Tongue strengthening exercise is effective in improving the oropharyngeal muscles associated with swallowing in community‐dwelling older adults in South Korea: a randomized trial. Medicine (Baltimore). 2019;98(40):e17304. doi: 10.1097/MD.0000000000017304Peck KK, Branski RC, Lazarus C, et al. Cortical activation during swallowing rehabilitation maneuvers: a functional MRI study of healthy controls. Laryngoscope. 2010;120(11):2153–2159. doi: 10.1002/lary.21125Sutcliffe L, Flynn D, Price CI. Percutaneous endoscopic gastrostomy and mortality after stroke in England from 2007 to 2018: a retrospective cohort study. Stroke. 2020;51(12):3658–3663. doi: 10.1161/STROKEAHA.120.030502Cheng I, Sasegbon A, Hamdy S. Effects of neurostimulation on poststroke dysphagia: a synthesis of current evidence from randomized controlled trials. Neuromodulation. 2021;24(8):1388–1401. doi: 10.1111/ner.13327Restivo DA, Hamdy S. Pharyngeal electrical stimulation device for the treatment of neurogenic dysphagia: technology update. Med Devices (Auckl). 2018;11:21–26. doi: 10.2147/MDER.S122287Chen YW, Chang KH, Chen HC, et al. The effects of surface neuromuscular electrical stimulation on post-stroke dysphagia: a systemic review and meta-analysis. Clin Rehabil. 2016;30(1):24–35. doi: 10.1177/0269215515571681Humbert IA, Poletto CJ, Saxon KG, et al. The effect of surface electrical stimulation on hyolaryngeal movement in normal individuals at rest and during swallowing. J Appl Physiol. 2006;101(6):1657–1663. doi: 10.1152/japplphysiol.00348.2006Pisegna JM, Kaneoka A, Pearson WG, et al. Effects of non-invasive brain stimulation on post-stroke dysphagia: a systematic review and meta-analysis of randomized controlled trials. Clin Neurophysiol. 2016;127(1):956–968. doi: 10.1016/j.clinph.2015.04.069Liao X, Xing G, Guo Z, et al. Repetitive transcranial magnetic stimulation as an alternative therapy for dysphagia after stroke: a systematic review and meta-analysis. Clin Rehabil. 2017;31(3):289–298. doi: 10.1177/0269215516644771