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Dysphagia

, Volume 30, Issue 5, pp 540–550 | Cite as

Electrophysiological Investigations of Shape and Reproducibility of Oropharyngeal Swallowing: Interaction with Bolus Volume and Age

  • Enrico AlfonsiEmail author
  • Giuseppe Cosentino
  • Luca Mainardi
  • Antonio Schindler
  • Mauro Fresia
  • Filippo Brighina
  • Marco Benazzo
  • Arrigo Moglia
  • Elena Alvisi
  • Brigida Fierro
  • Giorgio Sandrini
Original Article

Abstract

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.

Keywords

Swallowing Dysphagia Electromyography Age Bolus volume Reproducibility 

Abbreviations

SHEMG

EMG activity of the submental/suprahyoid muscles

SHEMG-E

Envelope of the submental/suprahyoid EMG activity

T-shape

Triangular ‘theoretical’ reference shape

SHEMG-E/T-shape

Analytical comparison between SHEMG-E and T-shape

SI

Similarity index

LPM

Laryngeal–pharyngeal mechanogram

SI-SHEMG-E

Similarity index of the SHEMG-E

SI-LPM

Similarity index of the LPM

LPM-Vmax

Maximal velocity of the LPM

LPM-Acmax

Maximal acceleration of the LPM

MUs

Motor units

Notes

Acknowledgments

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.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Enrico Alfonsi
    • 1
    Email author
  • Giuseppe Cosentino
    • 2
  • Luca Mainardi
    • 3
  • Antonio Schindler
    • 4
  • Mauro Fresia
    • 1
  • Filippo Brighina
    • 2
  • Marco Benazzo
    • 5
  • Arrigo Moglia
    • 1
  • Elena Alvisi
    • 1
  • Brigida Fierro
    • 2
  • Giorgio Sandrini
    • 1
  1. 1.Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, “C. Mondino” Foundation IRCCSUniversity of PaviaPaviaItaly
  2. 2.Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC)University of PalermoPalermoItaly
  3. 3.Department of Electronics, Information and BioengineeringPolitecnico di MilanoMilanItaly
  4. 4.Department of Otorhinolaryngology, “L. Sacco” HospitalUniversity of MilanMilanItaly
  5. 5.Department of Otorhinolaryngology, “San Matteo” HospitalUniversity of PaviaPaviaItaly

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