Electrophysiological Investigations of Shape and Reproducibility of Oropharyngeal Swallowing: Interaction with Bolus Volume and Age.
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.
Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy. enrico.alfonsi@mondino.it.
Enrico
E
Alfonsi
Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy.
Giuseppe
G
Cosentino
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Luca
L
Mainardi
Department of Otorhinolaryngology, "L. Sacco" Hospital, University of Milan, Milan, Italy.
Antonio
A
Schindler
Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy.
Mauro
M
Fresia
Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy.
Filippo
F
Brighina
Department of Otorhinolaryngology, "San Matteo" Hospital, University of Pavia, Pavia, Italy.
Marco
M
Benazzo
Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy.
Arrigo
A
Moglia
Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy.
Elena
E
Alvisi
Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Palermo, Italy.
Brigida
B
Fierro
Department of Neurophysiopathology and Neurorehabilitation, National Institute of Neurology, "C. Mondino" Foundation IRCCS, University of Pavia, Pavia, Italy.
Giorgio
G
Sandrini
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003679:Deglutition; D003680:Deglutition Disorders / Q000503:physiopathology; D004576:Electromyography; D005260:Female; D006801:Humans; D007821:Laryngeal Muscles / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000502:physiology*; D015203:Reproducibility of Results; D055815:Young Adult
Age; Bolus volume; Dysphagia; Electromyography; Reproducibility; Swallowing