Percepção de sabores em pacientes com acidente vascular encefálico
Taste perception in stroke patients
Leda Maria Tavares Alves; Roberto Oliveira Dantas
Resumo
Objetivo: avaliar a percepção dos sabores amargo, azedo, doce e neutro.
Método: foram estudados 36 pacientes com Acidente Vascular Encefálico (AVE) (5 hemorrágicos e 31 isquêmicos) e 30 sujeitos controles. Foi realizada avaliação fonoaudiológica estrutural e funcional incluindo postura, vedamento labial, presença de resíduos, tosse, engasgo, e ausculta cervical. Cada sujeito deglutiu em sequência aleatória 5 mL de líquido com os 4 sabores [chá de boldo (amargo), suco de limão diluído (azedo), sacarose diluída (doce) e água (neutro)] na temperatura ambiente. Entre as deglutições os participantes eram questionados sobre a dificuldade em deglutir e qual o sabor do líquido daquela deglutição.
Resultados: entre os pacientes houve maior freqüência de erros na identificação dos sabores amargo (controles: 16,7%, AVE: 47,3%, p=0,01) e azedo (controles: 6,7%, AVE: 27,8%, p=0,05), sem diferenças para o sabores neutro (controles: 10,0%, AVE: 16,7%, p=0,50) e doce (controles: 13,3%, AVE: 16,7%, p=0,80). Os pacientes com AVE tiveram maior dificuldade para deglutir os líquidos do que os controles (p<0,04).
Conclusão: houve maior dificuldade na percepção dos sabores amargo e azedo no grupo com AVE do que nos controles.
Palavras-chave
Abstract
Purpose: to assess the perception of bitter, sour, sweet and neutral flavors in stroke patients.
Method: we studied 36 patients with stroke (5 hemorrhagic and 31 ischemic) and had a 30 subjects' control group. We performed a structural and functional oral and pharyngeal evaluation including posture, lip sealing, presence of residues, cough, choking, and cervical auscultation. Five ml of fluids with the 4 flavors ["boldus" tea (bitter), diluted lemon juice (sour), diluted sucrose (sweet), and water (neutral)] were offered in random sequence under room temperature. Participants were questioned, between swallows, on the difficulty in swallowing and which flavor they had just swallowed.
Results: patients with stroke had greater difficulty in swallowing the fluids than control group (p<0.04). Patients made more mistakes in identifying bitter (control: 16.7%, stroke: 47.3%, p=0.01) and sour (control: 6.7%, stroke: 27.8%, p=0.05) flavors, without differences in the identification of neutral (control: 10.0%, stroke: 167%, p=0.50) and sweet (control: 13.3%, stroke: 16.7%, p=0,80).
Conclusion: the group with stroke had more difficulty in perceiving bitter and sour flavors than the control group subjects.
Keywords
Referencias
1. Aithal GP, Nylander D, Dwarakanath AD, Tanner AR. Subclinical esophageal peristaltic dysfunction during the early phase following a stroke. Dig Dis Sci 1999; 44(2): 274-8.
2. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clin Neurophysiol 2003; 114 (2): 226-44.
3. Costa MMB, Santana E, Almeida J. Oral taste recognition in health volunteers. Arq Gastroenterol 2010; 47(2): 152-8.
4. Leow LP, Huckabee ML, Sharma S, Tooley TP. The influence of taste on swallowing apnea, oral preparation time, and duration and amplitude of submental muscle contraction. Chem Senses. 2007; 32(2): 119-28.
5. Heckmann JG, Stössel C, Lang CJG, Neundörfer B, Tomandl B, Hummel T. Taste disorders in acute stroke – a prospective observational study on taste disorders in 102 stroke patients. Stroke. 2005; 36(8): 1690-4.
6. Lundy RF Jr. Gustatory hedonic value: potential function for forebrain control of brainstem taste processing. Neurosci Biobehav Rev. 2008; 32(8): 1601-6.
7. Cola PC, Gatto AR, Silva RG, Spadotto AA, Schelp AO, Henry MACA. The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke. Arq Gastroenterol. 2010; 47(1): 18-21.
8. Gatto AR. Efeito do sabor azedo e da temperatura fria na fase oral da deglutição no acidente vascular encefálico. [Dissertação de Mestrado] Universidade Estadual Paulista, Faculdade de Medicina de Botucatu: 2010.
9. Aviv JE, Martin JH, Sacco RL, Zagar D, Diamond B, Keen MS, et al. Supraglottic and pharyngeal sensory abnormalities in stroke patients with dysphagia. Ann Otol Rhinol Laryngol 1996; 105(2): 92-7.
10. Nilsson B. Taste acuity on human palate: II. Studies with electrogustometry on subjects in different age groups. Acta Odontol Scand. 1979; 37(4): 217-34.
11. Pelletier CA, Dhanaraj GE. The effect of taste and palatability on lingual swallowing pressure. Dysphagia. 2006; 21(2): 121-8.
12. Lim J, Green BG. Tactile interaction with taste localization: Influence of gustatory quality and Intensity. Chem Senses. 2008; 33(2): 137–43.
13. Landis BN, Leuchter I, Ruíz San Millán D, JS Lacroix, Landis T. Transient hemiaegusia in cerebrovascular lateral pontine lesions. J Neurol Neurosurg Psychiatry. 2006, 77 (5): 680-3.
14. André JM, Beis JM, Morin N, Paysant J. Buccal hemineglect. Arch Neurol. 2000; 57(12): 1734-41.
15. Goto N, T Yamamoto, Kaneko M e H Tomita. Primary pontine hemorragi and gustatory disturbance: clinicoanatomic study. Stroke 1983; 14(4): 507-11.
16. Barritt AW, Smithard DG. Role of cerebral cortex plasticity in the recovery of swallowing function following dysphagic stroke. Dysphagia. 2009; 24(1): 83-90.
Submitted date:
28/07/2010
Accepted date:
04/04/2011
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