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The Mechanistic Role of Respiratory-Swallow Coordination in Chronic Dysphagia Following Cortical Ischemic Stroke

Award Number: R03HD122223
ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 06/16/2026
PERIOD OF PERFORMANCE END DATE: 06/15/2028

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The Mechanistic Role of Respiratory-Swallow Coordination in Chronic Dysphagia Following Cortical Ischemic Stroke - PROJECT SUMMARY/ABSTRACT Stroke is a leading cause of long-term disability, affecting nearly 800,000 individuals each year in the United States. Dysphagia, or difficulty swallowing, occurs in up to 78% of individuals during the acute phase of recovery from stroke and persists in more than half of individuals beyond six months post-stroke, despite spontaneous recovery and rehabilitative intervention. Chronic dysphagia increases the risk of aspiration pneumonia, malnutrition, hospital readmissions, and mortality, and imposes long-lasting burdens on health, independence, and quality of life. Emerging evidence suggests that disrupted respiratory-swallow coordination (RSC) is a critical yet underexplored contributor to chronic dysphagia. The objective of this proposal is to characterize RSC patterns in individuals with chronic post-stroke dysphagia and evaluate their relationship to physiological and patient-centered swallowing outcomes, with the goal of informing the development of mechanism-based interventions for chronic dysphagia. Given the shared neural control of respiration and swallowing and their reliance on precise temporal coordination, it is biologically plausible that ischemic stroke disrupts RSC, contributing to persistent dysphagia. The central hypothesis is that stroke-related damage to brain regions involved in the control of breathing and swallowing results in suboptimal RSC, which in turn contributes to impaired swallowing safety and efficiency. This central hypothesis will be tested by pursuing two specific aims: 1) Characterize RSC and examine its association with physiological swallowing outcomes; and 2) Evaluate the predictive value of RSC as a mechanistic marker of patient-centered swallowing outcomes. Twenty-eight adults with chronic post-stroke dysphagia and 28 age- and sex-matched healthy controls will complete a videofluoroscopic swallowing evaluation with synchronized respiratory monitoring and patient-reported questionnaires. Standardized protocols and validated tools, including the Modified Barium Swallow Impairment Profile, Penetration-Aspiration Scale, and Functional Oral Intake Scale, will be used to promote rigor and reproducibility. This study is innovative in its integration of cross-system physiological and patient-centered assessments to provide the first comprehensive characterization of RSC in post-stroke dysphagia. This research is significant because it addresses a clinically relevant, yet underexplored, mechanism potentially contributing to chronic dysphagia after stroke. By shifting the focus from isolated oropharyngeal impairments to cross-system dysfunction, this work provides a framework for understanding persistent dysphagia and its impact on both physiological and patient-centered outcomes. The findings are expected to contribute to our understanding of cross-system impairments in chronic dysphagia and lay the foundation for a future R01 targeting RSC. Long- term, the mechanistic knowledge gained from this study will guide the development of new interventions that incorporate RSC into dysphagia management to improve health outcomes in stroke survivors.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $315,000 )
2026	2026	OHIO STATE UNIVERSITY, THE	1960 KENNY RD	COLUMBUS	OH	43210	FRANKLIN	USA	Child Health and Human Development Extramural Research	000	1	7/8/2026	NEW	$315,000
														Subtotal = $315,000

Grand Total All Awards = $315,000

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The Mechanistic Role of Respiratory-Swallow Coordination in Chronic Dysphagia Following Cortical Ischemic Stroke

Award Number: R03HD122223

ORGANIZATION: NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 06/16/2026

PERIOD OF PERFORMANCE END DATE: 06/15/2028

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