Stroke victims swallow again

Tens of thousands of people who lose the ability to swallow after a stroke could soon be eating and drinking freely again thanks to a medical breakthrough at Manchester University.

Researchers at Hope Hospital in Salford are working on rehabilitation techniques that will artificially stimulate the brain into resuming swallowing activities. The findings promise to transform the lives of some 30,000 British people affected by stroke-induced dysphagia every year.

Led by David Thompson, professor of gastroenterology, the team has found that the command to swallow comes from the right brain hemisphere in two-thirds of people and from the left in the rest.

Whichever hemisphere remains unharmed by a stroke has the ability to take charge of swallowing, even if it was not responsible for this activity prior to the stroke.

This discovery undermines previous assumptions that the brain works like a circuit and ceases to function if the circuit is broken.

Most rehabilitation work on stroke patients concentrates on recovering the activities of the damaged half of the brain, but the Manchester research relies on reorganising the undamaged part.

"The intact hemisphere somehow kicks in and reinitiates a process previously carried out by the other side," said Shaheen Hamdy, Medical Research Council fellow working on the project.

About 100,000 people are affected by a stroke every year in the United Kingdom. Of these, 30,000 experience difficulties swallowing. For 90 per cent of patients, swallowing resumes spontaneously in three months. For the others the ability never returns. This handicap often leads to malnutrition, which in turn can result in a slower recovery and complications such as pneumonia.

Early next year the team plans to try to awaken the undamaged brain hemisphere by using either a magnetic coil over the normal part of a patient's head or an electric current at the back of the throat.

The findings could help patients with other brain lesions, such as clots, tumours, Parkinson's disease and multiple sclerosis.