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Pilot Study of Quantitative Methods for Differentiating Pharyngeal Swallowing Mechanics by Dysphagia Etiology

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Abstract

Quantitative analysis of modified barium swallow (MBS) imaging is useful to determine the impact of various disease states on pharyngeal swallowing mechanics. In this retrospective proof of concept study, kinematic analysis and computational analysis of swallowing mechanics (CASM) were used to demonstrate how these methods differentiate swallowing dysfunction by dysphagia etiology. Ten subjects were randomly selected from four cohorts of dysphagic patients including COPD, head and neck cancer (HNC), motor neuron disease, and stroke. Each subject was age- and gender-matched with healthy, non-dysphagic controls. MBS videos of 5 ml thin and 5 ml thick bolus trials from each subject were used. A MATLAB tracker tool was adapted and updated to collect and compile data for each video (n = 160). For kinematic measurements, a MANOVA was performed with post-hoc analyses to determine group differences. For CASM measurements, a morphometric canonical variate analysis with post hoc analysis was performed to determine group differences. Kinematic analyses indicated statistically significant differences between HNC cohort and controls in distance measurements for hyolaryngeal approximation (p = .001), laryngeal elevation (p = 0.0001), pharyngeal shortening (p = 0.0002), and stage transition duration timing (p = 0.002). Timing differences were noted between the stroke cohort and controls for pharyngeal transit time (p = 0.007). Multivariate morphometric canonical variate analysis showed significant differences between etiology groups (p < 0.0001) with eigenvectors indicating differing patterns of swallowing mechanics. This study demonstrated that swallowing mechanics among cohorts of dysphagic patients can be differentiated using kinematics and CASM, providing different but complementary quantitative methods for investigating the impact of various disease states on swallowing function.

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taken from a single video frame. Mathematical differences in geometric configuration, representing changes in swallowing mechanics, are calculated and plotted

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Acknowledgements

Medical Scholars Program at the Medical College of Georgia provided funding to medical student authors. The following data sets were funded in part by various grants as indicated: Stroke, National Institute On Deafness And Other Communication Disorders of the National Institutes of Health under Award Number R01DC012584 (Kumar); COPD, Entera Health, Inc. (EH5220) (PI: Paoletti); HNC, National Institute on Deafness and Other Communication Disorders of the National Institutes of Health under award number R21DC010480 (PI: Martin-Harris); Normals, Veterans Affairs RR&D under award number CDA-1 1IK1RX001628-01A1 (PI: Garand), the National Institute on Deafness and Other Communication Disorders of the National Institutes of Health under award number K24DC12801 (PI: Martin-Harris), and the South Carolina Clinical & Translational Research (SCTR) Institute, with an academic home at the Medical University of South Carolina, NIH/NCATS Grant number TL1 TR000061 (PI: Brady; Project PI: Garand), and the American Speech-Language-Hearing Foundation (PI: Garand). The content is solely the responsibility of the authors and does not necessarily represent the official views the funding agencies listed above.

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Authors and Affiliations

  1. Medical College of Georgia (MCG), Augusta University, Augusta, Georgia

    Yasasvi Tadavarthi & Pouria Hosseini

  2. College of Allied Health Sciences, Augusta University, Augusta, Georgia

    Stephanie E. Reyes

  3. Department of Speech Pathology and Audiology, University of South Alabama, Mobile, AL, USA

    Kendrea L. (Focht) Garand

  4. Department of Otolaryngology-Head & Neck Surgery, Boston University School of Medicine, Boston, MA, USA

    Jessica M. Pisegna

  5. Department of Cellular Biology and Anatomy, MCG, Augusta University, Augusta, Georgia

    William G. Pearson Jr.

  6. Department of Otolaryngology, MCG, Augusta University, Augusta, Georgia

    Stephanie E. Reyes & William G. Pearson Jr.

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  1. Yasasvi Tadavarthi
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  2. Pouria Hosseini
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  3. Stephanie E. Reyes
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  4. Kendrea L. (Focht) Garand
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  6. William G. Pearson Jr.
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Correspondence to William G. Pearson Jr..

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Tadavarthi, Y., Hosseini, P., Reyes, S.E. et al. Pilot Study of Quantitative Methods for Differentiating Pharyngeal Swallowing Mechanics by Dysphagia Etiology. Dysphagia 36, 231–241 (2021). https://doi.org/10.1007/s00455-020-10123-0

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