Personalized biomechanical tongue models based on diffusion-weighted MRI and validated using optical tracking of range of motion

The effect of simulated radiation induced fibrosis on tongue protrusion

Radiation therapy (RT) is an important adjuvant and primary treatment modality for head and neck cancers. A severe side effect of RT is fibrosis or scarring of muscle tissues of the oral cavity including the tongue. Previous studies have demonstrated that increased radiation doses to the oral cavity structures have led to decrements in function, hypothesized to result from changes in muscle tissue properties that affect the tongue's function. To understand the complex relationship between tongue muscle fibrosis and tongue function, the current study used a virtual biomechanical model of the tongue. Fibrosis parameters including density (high, low), area (large, small) and location (946 node centres) were systematically varied in the model to test its impact on a target tongue tip motion (protrusion). The impact of fibrosis lesion parameters on three directional components of the tip (anterior-inferior, lateral-medial, and superior-inferior) were analyzed using multi linear regression models. Increases in density and area of fibrosis significantly predicted tongue protrusion movements compared to baseline. In the anterior-posterior direction, reductions in the tongue protrusion were observed. In the inferior-superior direction, the tongue height remained above baseline for the majority of cases. In the lateral-medial direction, ipsilateral deviations were observed. The location of fibrosis modulated these three main effects by either amplifying the observed effect or minimizing it. The findings support the hypothesis that changes in muscle tissue properties because of fibrosis impact tongue function. Increases in density and area of fibrosis impact key muscles in the target motion. The range of modulating effects of the lesion location (i.e., either amplifying or minimizing certain impact patterns) highlights the intricacy of tongue anatomy/soft tissue biomechanics and may suggest that lesions in any location will compromise the tongue's movement.

Biomechanical and Cortical Control of Tongue Movements During Chewing and Swallowing

Tongue function is vital for chewing and swallowing and lingual dysfunction is often associated with dysphagia. Better treatment of dysphagia depends on a better understanding of hyolingual morphology, biomechanics, and neural control in humans and animal models. Recent research has revealed significant variation among animal models in morphology of the hyoid chain and suprahyoid muscles which may be associated with variation in swallowing mechanisms. The recent deployment of XROMM (X-ray Reconstruction of Moving Morphology) to quantify 3D hyolingual kinematics has revealed new details on flexion and roll of the tongue during chewing in animal models, movements similar to those used by humans. XROMM-based studies of swallowing in macaques have falsified traditional hypotheses of mechanisms of tongue base retraction during swallowing, and literature review suggests that other animal models may employ a diversity of mechanisms of tongue base retraction. There is variation among animal models in distribution of hyolingual proprioceptors but how that might be related to lingual mechanics is unknown. In macaque monkeys, tongue kinematics-shape and movement-are strongly encoded in neural activity in orofacial primary motor cortex, giving optimism for development of brain-machine interfaces for assisting recovery of lingual function after stroke. However, more research on hyolingual biomechanics and control is needed for technologies interfacing the nervous system with the hyolingual apparatus to become a reality.

Robust cortical encoding of 3D tongue shape during feeding in macaques

Dexterous tongue deformation underlies eating, drinking, and speaking. The orofacial sensorimotor cortex has been implicated in the control of coordinated tongue kinematics, but little is known about how the brain encodes-and ultimately drives-the tongue's 3D, soft-body deformation. Here we combine a biplanar x-ray video technology, multi-electrode cortical recordings, and machine-learning-based decoding to explore the cortical representation of lingual deformation. We trained long short-term memory (LSTM) neural networks to decode various aspects of intraoral tongue deformation from cortical activity during feeding in male Rhesus monkeys. We show that both lingual movements and complex lingual shapes across a range of feeding behaviors could be decoded with high accuracy, and that the distribution of deformation-related information across cortical regions was consistent with previous studies of the arm and hand.

RF Coil Setup for 31P MRSI in Tongue Cancer in vivo at 7 T

Surgery for tongue cancer often results in a major loss in quality of life. While MRI may be used to minimise the volume of excised tissue, often the full tumour extent is missed. This tumour extent may be detected with metabolic imaging. One of the main reasons for the lack of metabolic information on tongue cancer would be the absence of an x-nuclear coil with the tongue as a focus target. Metabolic MRI through ³¹P MRSI is known as a powerful tool to non-invasively study elevated cell proliferation and disturbed energy metabolism in tumours. Severe magnetic field non-uniformities are inherently caused by the substantial difference in magnetic susceptibilities of tissue and air in the mouth and its environs. Despite this, the wide chemical shift dispersion of ³¹P could still facilitate precise detection of the cell proliferation biomarkers, phospomonoesters and diesters, as well as energy metabolites ATP, inorganic phosphate, and phosphocreatine potentially mapped over the tongue or tumour in vivo. In this study, we present the first ³¹P MRSI data of the human tongue in vivo from healthy volunteers and a patient with a tongue tumour at 7 T MRI using a ¹H 8-channel transceiver setup placed inside a body ³¹P transmitter, which is able to get a uniform excitation from the tongue while providing comfortable access to the patient. In addition, a user-friendly external ³¹P receiver array is used to provide high sensitivity (80%) comparable to an uncomfortable inner mouth loop coil positioned on the tongue. The primary aim is the demonstration of ³¹P metabolite profiles in the tongue and the differences between healthy and malignant tissue. Indeed, clear elevated cell proliferation expressed as enhanced phosphomonoesters is observed in the tumour vs. the healthy part of the tongue. This can be performed within a total scan duration of 30 min, comparable to clinical scans, with a spatial resolution of 1.5 cm for the 10-min ³¹P MRSI scan.

The Application Value of MRI in the Training and Physical Rehabilitation of Gastrocnemius with Acute Sports Injury

The purpose of this study was to analyze the magnetic resonance imaging (MRI) signs of acute gastrocnemius injury and to provide the basis for clinical diagnosis. Thirty-two patients with acute gastrocnemius muscle injury (19 males and 13 females, aged 18-63 years, mean 46 years) were recruited, and MRI scans were performed. The results showed that all the lesions of calf gastrocnemius were detected in 32 patients, including first-degree injury in 15 cases, second-degree injury in 15 cases, and third-degree injury in 2 cases. MRI can display the location and pathological changes of acute gastrocnemius injury, providing good imaging data for clinical diagnosis and treatment.