Enteral Nutrition in Neurological Diseases: A Review of Current Evidence
DOI:
https://doi.org/10.12775/JEHS.2026.92.72502Keywords
enteral nutrition, neurological diseases, dementia, dysphagia, nutritional supportAbstract
Introduction
Malnutrition is a frequent and serious complication in patients with neurological disorders, significantly affecting morbidity, mortality, and quality of life. Neurological diseases such as stroke, amyotrophic lateral sclerosis (ALS), Parkinson’s disease, and dementia often impair swallowing (dysphagia), consciousness, or motor function, leading to insufficient oral intake [1,2].
Enteral nutrition (EN) is a well-established method of providing nutrients directly into the gastrointestinal tract via feeding tubes and is preferred over parenteral nutrition due to its physiological benefits, including preservation of gut integrity and reduced risk of complications [2].
In neurological populations, EN plays a crucial role in preventing malnutrition, supporting recovery, and improving clinical outcomes. However, its application varies depending on disease type, stage, and patient condition.
Aim of the Study
The aim of this review is to analyze the current state of knowledge regarding the use of enteral nutrition in various neurological diseases, focusing on its indications, clinical benefits, complications, and disease-specific considerations.
Materials and Methods
This study is a narrative literature review based on scientific publications retrieved from databases such as PubMed, Scopus, and Web of Science.
A total of approximately 35 relevant publications were selected and analyzed.
Conclusion
Enteral nutrition is a fundamental component of care in patients with neurological diseases, particularly those with dysphagia and impaired oral intake.
Its benefits include improved nutritional status, reduced complications, and better clinical outcomes, especially in conditions such as stroke and ALS. However, its use must be individualized, considering disease stage, prognosis, and patient preferences.
Further high-quality randomized controlled trials are needed to strengthen the evidence base, particularly in neurodegenerative diseases.
References
1. Stavroulakis T, McDermott CJ. Enteral feeding in neurological disorders. Pract Neurol. 2016;16(5):352–361. doi: 10.1136/practneurol-2016-001408
2. Doley J. Enteral Nutrition Overview. Nutrients. 2022;14(11):2180. doi: 10.3390/nu14112180
3. Jiang D, Nie L, Xiang X, et al. Effects of enteral nutrition in stroke: an updated review. Front Nutr. 2025;12:1510111. doi: 10.3389/fnut.2025.1510111
4. Gomes CA Jr, et al. Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances. Cochrane database Syst Rev. 22;2015(5):CD008096. doi: 10.1002/14651858.CD008096.pub4
5. Ojo O, Brooke J, The Use of Enteral Nutrition in the Management of Stroke, Nutrients., 2016;20;8(12):827. doi: 10.3390/nu8120827
6. Dennis MS, Lewis SC, Warlow C, Effect of timing and method of enteral tube feeding for dysphagic stroke patients (FOOD): a multicentre randomised controlled trial, Lancet., 2005;365(9461):764-72. doi:10.1016/S0140-6736(05)17983-5
7. Foley N, Teasell R, Salter K, Kruger E, Martino R, Dysphagia treatment post stroke: a systematic review of randomised controlled trials, 2008;37(3):258-64. doi: 10.1093/ageing/afn064
8. Corrigan ML, Escuro AA, Celestin J, Kirby DF, Nutrition in stroke patients. Nutr Clin Pract., 2011;26(3):242-52. doi: 10.1177/0884533611405795
9. ProGas Study Group, Gastrostomy in patients with amyotrophic lateral sclerosis (ProGas): a prospective cohort study, Lancet Neurol. 2015;14(7):702-9. doi: 10.1016/S1474-4422(15)00104-0
10. Miller RG, Jackson CE, Kasarskis EJ, England JD, et al., Practice parameter update: the care of the patient with amyotrophic lateral sclerosis: drug, nutritional, and respiratory therapies (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology, Neurology, 2009;13;73(15):1218-26. doi: 10.1212/WNL.0b013e3181bc0141
11. Silani V, Kasarskis EJ, Yanagisawa N, Nutritional management in amyotrophic lateral sclerosis: a worldwide perspective, J Neurol., 1998;245, Suppl 2:S13-9. doi: 10.1007/pl00014805
12. Heffernan C, et al., Nutritional management in MND/ALS patients: an evidence based review, Amyotroph Lateral Scler. 2004;5:72–83. doi: 10.1080/14660820410020349
13. Volkert D, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr. 2015;34:1052–1073. doi: 10.1016/j.clnu.2015.09.004
14. Finucane TE, et al. Tube feeding in advanced dementia. JAMA. 1999;282:1365–1370. doi: 10.1001/jama.282.14.1365
15. Sampson EL, et al. Enteral tube feeding for older people with advanced dementia, Cochrane Database Syst Rev. 2009;CD007209. doi: 10.1002/14651858.CD007209.pub2
16. Michou E, Hamdy S, Dysphagia in Parkinson’s disease: a therapeutic challenge? Expert Rev Neurother. 2010;10(6):875-8. doi: 10.1586/ern.10.60
17. Kalf JG, et al. Prevalence of oropharyngeal dysphagia in Parkinson’s disease. Parkinsonism Relat Disord. 2012;18:311–315. doi: 10.1016/j.parkreldis.2011.11.006
18. Suttrup I, Warnecke T. Dysphagia in Parkinson’s disease. J Neurol. 2016;263:103–112. doi: 10.1055/s-0042-107245
19. Burgos R, et al. ESPEN guideline clinical nutrition in neurology. Clin Nutr. 2018;37:354–396. doi: 10.1016/j.clnu.2017.09.003
20. Singer P, et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019;38:48–79. doi: 10.1016/j.clnu.2018.08.037
21. Casaer MP, Van den Berghe G. Nutrition in the acute ohase of critical illness. N Engl J Med. 2014;370:1223–1233. doi: 10.1056/NEJMra1304623
22. Marik PE, Zaloga GP, Early enteral nutrition in acutely ill patients: a systematic review, Crit Care Med., 2001;29(12):2264-70. doi: 10.1097/00003246-200112000-00005
23. Popovich JM, It’s alimentary: early enteral nutrition is better, Crit Care Med., 2001;29(12):2387-8. doi: 10.1097/00003246-200112000-00025
24. Braga M, Gianotti L, Cestari A, Vignali A, Pellegatta F, Dolci A, Di Carlo V, Gut function and immune and inflammatory responses in patients perioperatively fed with supplemented enteral formulas, Arch Surg., 1996;131(12):1257-64. doi: 10.1001/archsurg.1996.01430240011001
25. Gramlich L, et al. Does enteral nutrition compared to parenteral nutrition result in better outcomes in critically ill adult patients? A systematic review of the literature, Nutrition. 2004;20:843–848. doi: 10.1016/j.nut.2004.06.003
26. Gomes F, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients, Clin Nutr. 2018;37:336–353. doi: 10.1016/j.clnu.2017.06.025
27. Lochs H, et al. ESPEN guidelines on enteral nutrition: Gastroenterology, Clin Nutr. 2006;25:260-74. doi: 10.1016/j.clnu.2006.01.007
28. Stroud M, et al. Guidelines for enteral feeding in adult hospital patients, Gut. 2003;22:533–547. doi: 10.1136/gut.52.suppl_7.vii1
29. Cederholm T, et al. GLIM criteria for the diagnosis of malnutrition – A consensus report from the global clinical nutrition community, Clin Nutr. 2019;38:1–9. doi: 10.1016/j.clnu.2018.08.002
30. Bahat G, Erdogan T, Karan MA, At which Hoehn&Yahr stage of Parkinson's disease should the patients be screened for dysphagia? Clin Nutr., 2020;39(1):313. doi: 10.1016/j.clnu.2019.11.020
31. Hucl T, Spicak J, Complications of percutaneous endoscopic gastrostomy., Best Pract Res Clin Gastroenterol., 2016;30(5):769-781. doi: 10.1016/j.bpg.2016.10.002
32. Davies N, et al. Enteral tube feeding for people with severe dementia., Cochrane Database Syst Rev., 2021;13;8(8):CD013503. doi: 10.1002/14651858.CD013503.pub2
33. Mizock BA, Risk of aspiration in patients on enteral nutrition: frequency, relevance, relation to pneumonia, risk factors, and strategies for risk reduction., Curr Gastroenterol Rep., 2007;9(4):338-44. doi: 10.1007/s11894-007-0039-7
34. Bianchi VE, Herrera PF, Laura R, Effect of nutrition on neurodegenerative diseases. A systematic review., Nutr Neurosci., 2021;24(10):810-834. doi: 10.1080/1028415X.2019.1681088
35. Wang R, Cao L, He Y, Zhang P, Feng L, Nutrition-associated markers and outcomes among patients receiving enteral nutrition after ischemic stroke: a retrospective cohort study, BMC Neurol., 2024;0;24(1):303. doi: 10.1186/s12883-024-03812-y
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Karolina Szamocka, Tomasz Kuliński, Wiktor Zawadziński, Kinga Mehal, Weronika Martyna Pielich, Michalina Bąk, Natalia Balicka-Dworczak, Natalia Siusta, Karolina Stróżyk
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 49
Number of citations: 0
