Electrophysiological Investigations of Shape and Reproducibility of Oropharyngeal Swallowing: Interaction with Bolus Volume and Age
- 481 Downloads
Electrophysiological assessment provides valuable information on physiological and pathophysiological characteristics of human swallowing. Here, new electrophysiological measures for the evaluation of oropharyngeal swallowing were assessed: (1) the activation pattern of the submental/suprahyoid EMG activity (SHEMG); (2) the reproducibility of the oral and pharyngeal phases of swallowing, by calculating the similarity index (SI) of the SHEMG (SI-SHEMG) and of the laryngeal–pharyngeal mechanogram (SI-LPM) during repeated swallows; and (3) kinesiological measures related to the LPM. An electrophysiological–mechanical method for measuring the activation pattern of the SHEMG, the SI-SHEMG, and the SI-LPM, and maximal LPM velocity and acceleration during swallowing was applied in 65 healthy subjects divided into three age groups (18–39, 40–59, 60 years or over). All the measures were assessed during three trials of eight consecutive swallows of different liquid bolus volumes (3, 12, and 20 ml). A high overall reproducibility of oropharyngeal swallowing in healthy humans was recorded. However, while values of SI-SHEMG were similar in all the age groups, the SI-LPM was found to fall significantly in the older age group. Both the SI-SHEMG and the SI-LPM were found to fall with increasing bolus volumes. The activation pattern of the SHEMG and the LPM kinesiological measures were differently modified by bolus volume and age in the older subjects with respect to the others. We describe a new approach to the electrophysiological study of swallowing based on computed semi-automatic analyses. Our findings provide insight into some previously uninvestigated aspects of oropharyngeal swallowing physiology, considered in relation to bolus volume and age. The new electrophysiological measures here described could prove useful in the clinical setting, as it is likely that they could be differently affected in patients with different kinds of dysphagia.
KeywordsSwallowing Dysphagia Electromyography Age Bolus volume Reproducibility
EMG activity of the submental/suprahyoid muscles
Envelope of the submental/suprahyoid EMG activity
Triangular ‘theoretical’ reference shape
Analytical comparison between SHEMG-E and T-shape
Similarity index of the SHEMG-E
Similarity index of the LPM
Maximal velocity of the LPM
Maximal acceleration of the LPM
The authors wish to thank Ms. Catherine Wrenn for the linguistic revision of the manuscript. This study was supported by a Grant from the Italian Ministry of Health related to the Project “Presbyphagia: analysis of diagnostic criteria and identification of potential innovative treatments” RF-2010-231945.
Compliance with Ethical Standards
Conflict of interest
The authors report no conflicts of interest.
- 1.Ertekin C, Aydoğdu I, Yüceyar N, Pehlivan M, Ertaş M, Uludağ B, Celebi G. Effects of bolus volumes on the oropharyngeal swallowing: an electrophysiological study in man. Am J Gastroenterol. 1997;11:2049–53.Google Scholar
- 8.Cichero J. Swallowing from infancy to old age. In: Cichero JAY, Murdoch BE, editors. Dysphagia. Foundation, theory and practice, vol. 6. Chichester: Wiley; 2006. p. 26–46.Google Scholar
- 12.Logemann JA. Evaluation and treatment of swallowing disorders. Austin: ProED; 1983.Google Scholar
- 22.Mainardi L, Sornmo L, Cerutti S. Understanding atrial fibrillation: the signal processing contribution. San Francisco: Morgan & Claypool Publishers; 2008.Google Scholar
- 34.De Luca CJ, Erim Z. Common drive of motor units in regulation of muscle force. Trends Neurosci. 1994;17:229–305.Google Scholar
- 37.Donner M, Jones B. Ageing and neurological disease. In: Jones B, Donner MW, editors. Normal and abnormal swallowing: imaging in diagnosis and therapy. New York: Springer; 1991.Google Scholar