Post-Stroke Dysphagia: Clinical Screening with GUSS and Its Role in , Tailored Nutritional Therapy

Background: This investigation explored the clinical utility of the Gugging Swallowing Screen (GUSS) in identifying swallowing dysfunction following stroke and examined its application in designing individualized nutritional interventions. The study also assessed a set of physiological markers—brain-derived neurotrophic factor (BDNF), salivary cortisol, leptin, and growth differentiation factor-۱۵ (GDF-۱۵)—to determine their relationship with dysphagia severity, neural recovery, and clinical prognosis. Methods: A cohort of ۱۷۴ individuals recovering from stroke underwent swallowing assessments using both the GUSS protocol and the traditional water swallow test (WST). Participants diagnosed with swallowing impairments were randomized into a control group (CG), which received standard medical care, and an observation group (OG), which received additional GUSS-guided stratified feeding regimens. Comparative analyses focused on changes in swallowing ability, emotional well-being, serum and salivary biomarker profiles, and occurrence of medical complications. Findings: GUSS outperformed WST in sensitivity and responsiveness (P < ۰.۰۵), as shown by significantly higher effect size (ES) and standardized response mean (SRM). Patients in the OG exhibited notably greater improvement in deglutition function and fewer adverse outcomes than those in the CG (P < ۰.۰۵). Post-treatment nutritional markers—albumin (Alb), prealbumin (PA), and transferrin (TNF)—were also more favorable in the OG. BDNF and leptin levels showed strong alignment with dysphagia grading, while elevated salivary cortisol was associated with stress-related swallowing issues. GDF-۱۵ levels correlated significantly with dysphagia-related complications. Moreover, quality of life indicators— including mental, physical, and social dimensions—were significantly enhanced in the OG (P < ۰.۰۵). Conclusion: GUSS proves to be a robust tool for early detection of post-stroke swallowing disorders and offers added clinical value when used to guide dietary intervention. The inclusion of stress, neuroplasticity, and inflammatory biomarkers—particularly salivary cortisol and GDF-۱۵—adds depth to severity assessment and supports the development of personalized rehabilitation pathways.

کلیدواژه ها:

Post ، stroke dysphagia GUSS Individualized nutrition Biomarker profiling Neurorehabilitation