Research on swallowing dysfunction in neurological disease, from bedside scoring to neuroimaging, breath biomarkers, and AI.
Five interconnected areas, unified by the goal of understanding neurogenic dysphagia and making assessment more quantitative, accessible, and clinically meaningful.
The FEES Dysphagia Index (FDI) provides a bias-resilient, continuous severity score derived from PAS and Yale residue ratings. Validated in 2,943 patients across two temporal cohorts, FDI-C captures expert clinical judgment and maps linearly onto functional oral intake levels. Complementary work uses large language models to extract structured severity ratings from free-text FEES reports at near-perfect agreement. A multi-center survey identified key sources of FEES practice variation across German centers.
Oral stereognosis, the ability to perceive and manipulate a bolus in the oral cavity, is essential for safe swallowing but poorly understood at the neural level. Our fMRI work identified fronto-parietal networks and cerebellar activations underlying oral object recognition, with implications for stroke and Alzheimer's disease. In collaboration with the Swallowing Research Lab (Dr. Ulrike Frank, University of Potsdam), we are building healthy normative data and investigating clinical populations to establish oral stereognosis as a diagnostic marker for dysphagia risk.
Electronic nose (e-nose) technology analyzes volatile organic compounds in exhaled breath and may detect aspiration risk without instrumentation. Our proof-of-concept study in 42 patients with Parkinson's disease and acute stroke demonstrated statistically significant discrimination between safe and unsafe swallowers (balanced accuracy 67–68%, p = 0.018), with bidirectional cross-disease generalizability suggesting shared biological signatures.
DysphAISENSE (BMBF, 13GW0774F) develops an AI-supported therapy system for neurogenic dysphagia, integrating endoscopic assessment with individualized treatment planning. Separately, AI-based virtual patient simulations enable medical students to practice clinical communication with cognitively impaired patients in a safe, structured environment.
In large cohorts of ischemic stroke patients treated with mechanical thrombectomy, we investigate determinants and consequences of post-stroke dysphagia, including the role of swallowing muscle mass (sarcopenia), timing of early FEES, and the relationship between neurogenic dysphagia, pneumonia, and functional outcome. The FDI framework serves as the central instrument for tracking swallowing trajectories across acute, rehabilitative, and outpatient settings.
DysphagiaLab research is embedded in a network of clinical and academic partners.
Co-chair S3 guideline clinical nutrition in dysphagia (DGEM). Integrated FEES report framework. FEES-Registry.
Oral stereognosis: healthy normative cohort, clinical validation. Quantitative swallowing assessment.
FDI external validation, ENT perspective on FEES scoring in head and neck populations.
FDI external validation in geriatric populations. Co-author Lancet Healthy Longevity review on neurogeriatric dysphagia.
Core collaborator across all research strands. Neuroimaging, FEES methodology, Huntington's disease, thrombectomy cohorts.
Post-thrombectomy dysphagia cohorts, swallowing muscle mass, early FEES after mechanical thrombectomy.
DysphagiaLab is the research platform of Cornelius J. Werner, MD, neurologist and geriatrician. His clinical and research work bridges instrumental swallowing assessment, dysphagia scoring methodology, neuroimaging, and AI-assisted clinical decision support.
Current affiliations include the Department of Neurology, RWTH Aachen University, the Department of Neurology and Geriatrics at Johanniter-Krankenhaus Stendal (academic teaching hospital of OvGU Magdeburg). Cooperations exist with the Institute of Cognitive Neurology and Dementia Research (IKND) at Otto von Guericke University Magdeburg.
Active projects include the FEES Dysphagia Index (FDI), AI-supported dysphagia therapy (DysphAISENSE, BMBF), LLM-based clinical FEES report extraction, e-nose aspiration screening, and neuroimaging-based dysphagia research in cooperation with the Swallowing Research Lab at the University of Potsdam.