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

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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.

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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-V max :

Maximal velocity of the LPM

LPM-Acmax :

Maximal acceleration of the LPM

MUs:

Motor units

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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.

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Authors and Affiliations

  1. Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, “C. Mondino” Foundation IRCCS, University of Pavia, Pavia, Italy

    Enrico Alfonsi, Mauro Fresia, Arrigo Moglia, Elena Alvisi & Giorgio Sandrini

  2. Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy

    Giuseppe Cosentino, Filippo Brighina & Brigida Fierro

  3. Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy

    Luca Mainardi

  4. Department of Otorhinolaryngology, “L. Sacco” Hospital, University of Milan, Milan, Italy

    Antonio Schindler

  5. Department of Otorhinolaryngology, “San Matteo” Hospital, University of Pavia, Pavia, Italy

    Marco Benazzo

Authors
  1. Enrico Alfonsi
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  2. Giuseppe Cosentino
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  3. Luca Mainardi
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Correspondence to Enrico Alfonsi.

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Alfonsi, E., Cosentino, G., Mainardi, L. et al. Electrophysiological Investigations of Shape and Reproducibility of Oropharyngeal Swallowing: Interaction with Bolus Volume and Age. Dysphagia 30, 540–550 (2015). https://doi.org/10.1007/s00455-015-9634-1

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  • DOI: https://doi.org/10.1007/s00455-015-9634-1

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