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Classification of dysphagia severity after lateral medullary infarction with deep learning
Classification of dysphagia severity after lateral medullary infarction with deep learning
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Classification of dysphagia severity after lateral medullary infarction with deep learning
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Classification of dysphagia severity after lateral medullary infarction with deep learning
Classification of dysphagia severity after lateral medullary infarction with deep learning
Journal Article

Classification of dysphagia severity after lateral medullary infarction with deep learning

2026
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Overview
Dysphagia is a common and debilitating complication in patients with lateral medullary infarction (LMI), affecting up to 100% of cases and significantly impairing quality of life. Accurate classification of early dysphagia severity is essential for timely intervention and personalized rehabilitation planning. This study aimed to develop and validate a deep learning algorithm using acute-phase diffusion-weighted MRI to classify dysphagia severity in LMI patients. A retrospective cohort of 163 patients with confirmed acute LMI was analyzed. Dysphagia severity was determined by videofluoroscopic swallowing studies (VFSS), categorizing patients into severe and non-severe groups. Lesion regions were manually labeled and preprocessed for model training. Transformer-based deep learning architecture, the Hierarchical Vision Transformer (Hier-ViT), was employed due to its capacity to model spatial hierarchies and global image context. The model achieved an accuracy of 0.85, with a precision of 0.70, recall of 0.75, F1-score of 0.72, and an area under the ROC curve (AUC) of 0.69. These findings suggest that Hier-ViT can effectively classify dysphagia severity in LMI patients using early MRI, offering a potential tool for early risk stratification. While the model shows a high accuracy, the modest AUC suggests that further refinement and multi-modal integration are necessary to improve its discriminative power in imbalanced clinical datasets.