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Yoshikawa K, Nakamori M, Ushio K, Toko M, Yamada H, Nishikawa Y, Fukuoka T, Maruyama H, Mikami Y. Analysis of the suprahyoid muscles during tongue elevation: High-density surface electromyography as a novel tool for swallowing-related muscle assessment. J Oral Rehabil 2024. [PMID: 38736136 DOI: 10.1111/joor.13737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND High-density surface electromyography (HD-sEMG) has enabled non-invasive analysis of motor unit (MU) activity and recruitment, but its application to swallowing-related muscles is limited. OBJECTIVE We aimed to investigate the utility of HD-sEMG for quantitatively evaluating the MU recruitment characteristics of the suprahyoid muscles during tongue elevation. METHODS We measured the sEMG activity of the suprahyoid muscles of healthy participants during tongue elevation using HD-sEMG. Maximum voluntary contraction (MVC) was measured, followed by data collection during sustained and ramp-up tasks to capture suprahyoid muscle activity. Changes in the temporal/spatial MU recruitment patterns within individual suprahyoid muscles were analysed. RESULTS This study enrolled 16 healthy young adults (mean age: 27.8 ± 5.3 years; eight males and eight females). Increasing muscle force corresponded to a decrease in modified entropy and correlation coefficient and an increase in the coefficient of variation. No significant differences were observed between male and female participants. CONCLUSION The results of this study, consistent with those observed in other muscles, such as the vastus lateralis muscle, suggest that HD-sEMG is a valuable and reliable tool for quantitatively evaluating MU recruitment in the suprahyoid muscles. This measurement technique holds promise for novel assessments of swallowing function.
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Affiliation(s)
- Kohei Yoshikawa
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Masahiro Nakamori
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kai Ushio
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Megumi Toko
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hidetada Yamada
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yuichi Nishikawa
- Institute of Science and Engineering, Faculty of Frontier Engineering, Kanazawa University, Kanazawa, Japan
| | - Tatsuyuki Fukuoka
- Department of Rehabilitation, Faculty of Rehabilitation, Hiroshima International University, Higashihiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
| | - Yukio Mikami
- Department of Rehabilitation Medicine, Hiroshima University Hospital, Hiroshima, Japan
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Petrie J, Kowallis LR, Kamhout S, Bills KB, Adams D, Fleming DE, Brown BL, Steffensen SC. Gender-Specific Interactions in a Visual Object Recognition Task in Persons with Opioid Use Disorder. Biomedicines 2023; 11:2460. [PMID: 37760905 PMCID: PMC10525754 DOI: 10.3390/biomedicines11092460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
Opioid use disorder (OUD)-associated overdose deaths have reached epidemic proportions worldwide over the past two decades, with death rates for men reported at twice the rate for women. Using a controlled, cross-sectional, age-matched (18-56 y) design to better understand the cognitive neuroscience of OUD, we evaluated the electroencephalographic (EEG) responses of male and female participants with OUD vs. age- and gender-matched non-OUD controls during a simple visual object recognition Go/No-Go task. Overall, women had significantly slower reaction times (RTs) than men. In addition, EEG N200 and P300 event-related potential (ERP) amplitudes for non-OUD controls were significantly larger for men, while their latencies were significantly shorter than for women. However, while N200 and P300 amplitudes were not significantly affected by OUD for either men or women in this task, latencies were also affected differentially in men vs. women with OUD. Accordingly, for both N200 and P300, male OUD participants exhibited longer latencies while female OUD participants exhibited shorter ones than in non-OUD controls. Additionally, robust oscillations were found in all participants during a feedback message associated with performance in the task. Although alpha and beta power during the feedback message were significantly greater for men than women overall, both alpha and beta oscillations exhibited significantly lower power in all participants with OUD. Taken together, these findings suggest important gender by OUD differences in cognitive processing and reflection of performance in this simple visual task.
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Affiliation(s)
- JoAnn Petrie
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
| | - Logan R. Kowallis
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
| | - Sarah Kamhout
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
| | - Kyle B. Bills
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
- Department of Neuroscience, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA
| | - Daniel Adams
- PhotoPharmics, Inc., 947 So, 500 E, Suite 100, American Fork, UT 84003, USA
| | - Donovan E. Fleming
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
| | - Bruce L. Brown
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
| | - Scott C. Steffensen
- Department of Psychology, Brigham Young University, Provo, UT 84602, USA; (J.P.); (K.B.B.)
- Department of Neuroscience, Noorda College of Osteopathic Medicine, Provo, UT 84606, USA
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Alamer A, Melese H, Nigussie F. Effectiveness of Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials. Clin Interv Aging 2020; 15:1521-1531. [PMID: 32943855 PMCID: PMC7481288 DOI: 10.2147/cia.s262596] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 07/31/2020] [Indexed: 11/27/2022] Open
Abstract
The purpose of this review was to summarize the latest best scientific evidence on the efficacy of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients. A comprehensive systematic search of literature published between November 2014 and May 2020 was performed using the following electronic databases: PubMed/Medline, CINAHL, PEDro, Science Direct, Google Scholar, EMBASE, and Scopus. Only randomized controlled trials (RCT) evaluating the effect of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients were included. Physiotherapy Evidence Database (PEDro) has been used to evaluate the risk of bias of included trials. This review was reported in accordance with PRISMA statement guideline. The methodological quality of the studies was determined using PEDro scale and GRADE approach. Evidence of overall quality was graded from moderate to high. Eleven RCTs involving 784 patients were analyzed. The primary outcome measures of this review were functional dysphagia scale (FDS) and standard swallowing assessment. This review found neuromuscular electrical stimulation (NMES) coupled with traditional swallowing therapy could be an optional intervention to improve swallowing function after stroke in rehabilitation department.
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Affiliation(s)
- Abayneh Alamer
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Haimanot Melese
- Department of Physiotherapy, School of Medicine, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Fetene Nigussie
- Department Of Nursing Institute of Medicine, College of Health Sciences, DebreBerhan University, Debre Berhan, Ethiopia
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Zeng Y, Zheng H, He W. A Commentary on Gender Does Not Matter: Add-on Repetitive Transcranial Magnetic Stimulation Treatment for Female Methamphetamine Dependents. Front Neural Circuits 2020; 14:27. [PMID: 32655377 PMCID: PMC7325321 DOI: 10.3389/fncir.2020.00027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 04/22/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Yan Zeng
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China.,Key Laboratory of Brain and Cognitive Neuroscience, Liaoning, China
| | - Hui Zheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai, China
| | - Weiqi He
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China.,Key Laboratory of Brain and Cognitive Neuroscience, Liaoning, China
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Li WQ, Lin T, Li X, Jing YH, Wu C, Li MN, Ding Q, Lan Y, Xu GQ. TMS brain mapping of the pharyngeal cortical representation in healthy subjects. Brain Stimul 2020; 13:891-899. [PMID: 32289722 DOI: 10.1016/j.brs.2020.02.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 02/25/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Brain mapping is fundamental to understanding brain organization and function. However, a major drawback to the traditional Brodmann parcellation technique is the reliance on the use of postmortem specimens. It has therefore historically been difficult to make any comparison regarding functional data from different regions or hemispheres within the same individual. Moreover, this method has been significant limited by subjective boundaries and classification criteria and therefore suffer from reproducibility issues. The development of transcranial magnetic stimulation (TMS) offers an alternative approach to brain mapping, specifically the motor cortical regions by eliciting quantifiable functional reactions. OBJECTIVE To precisely describe the motor cortical topographic representation of pharyngeal constrictor musculature using TMS and to further map the brain for use as a tool to study brain plasticity. METHODS 51 healthy subjects (20 male/31 female, 19-26 years old) were tested using single-pulse TMS combined with intraluminal catheter-guided high-resolution manometry and a standardized grid cap. We investigated various parameters of the motor-evoked potential (MEP) that include the motor map area, amplitude, latency, center of gravity (CoG) and asymmetry index. RESULTS Cortically evoked response latencies were similar for the left and right hemispheres at 6.79 ± 0.22 and 7.24 ± 0.27 ms, respectively. The average scalp positions (relative to the vertex) of the pharyngeal motor cortical representation were 10.40 ± 0.19 (SE) cm medio-lateral and 3.20 ± 0.20 (SE) cm antero-posterior in the left hemisphere and 9.65 ± 0.24 (SE) cm medio-lateral and 3.18 ± 0.23 (SE) cm antero-posterior in the right hemisphere. The mean motor map area of the pharynx in the left and right hemispheres were 9.22 ± 0.85(SE) cm2and 10.12 ± 1.24(SE) cm2, respectively. The amplitudes of the MEPs were 35.94 ± 1.81(SE)uV in the left hemisphere and 34.49 ± 1.95(SE)uV in the right hemisphere. By comparison, subtle but consistent differences in the degree of the bilateral hemispheric representation were also apparent both between and within individuals. CONCLUSION The swallowing musculature has a bilateral motor cortical representation across individuals, but is largely asymmetric within single subjects. These results suggest that TMS mapping using a guided intra-pharyngeal EMG catheter combined with a standardized gridded cap might be a useful tool to localize brain function/dysfunction by linking brain activation to the corresponding physical reaction.
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Affiliation(s)
- Wan-Qi Li
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Tuo Lin
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
| | - Xue Li
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
| | - Ying-Hua Jing
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Cheng Wu
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Meng-Ni Li
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Qian Ding
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China; Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
| | - Guang-Qing Xu
- Department of Rehabilitation Medicine, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
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Levendowski DJ, St Louis EK, Strambi LF, Galbiati A, Westbrook P, Berka C. Comparison of EMG power during sleep from the submental and frontalis muscles. Nat Sci Sleep 2018; 10:431-437. [PMID: 30584382 PMCID: PMC6287659 DOI: 10.2147/nss.s189167] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE Submentalis electromyography (sEMG) and frontalis electromyography (fEMG) muscle activities have been used to assist in the staging of sleep and detection of disruptions in sleep. This study was designed to assess the concordance between sEMG and fEMG power, by and across sleep stages. METHODS Forty-three records with simultaneous acquisition of differential signals from the submental and frontalis muscles were evaluated. Sleep stages were assigned using the poly-somnography signals based on majority agreement of five technicians. The sEMG and fEMG signals were identically filtered and aligned prior to cross-correlation analysis. RESULTS A strong concordance between sEMG and fEMG power was observed, with 95% of the records exhibiting at least moderate agreement. During rapid eye movement (REM) sleep, sEMG power was significantly less than fEMG power, but exhibited four times greater across-subject variability. fEMG power during wake and non-REM (NREM) sleep was greater than sEMG power, but with 50% less variability. Differences in wake and N1 mean power and between the other sleep stages were more distinct in the fEMG recordings. Relative changes in sEMG and fEMG power across wake, NREM, and REM stages were essentially identical with median by-subject cross correlations of 0.98 and interquartile ranges of 0.97 and 0.99, respectively. CONCLUSION The fEMG and sEMG power values were similar during wakefulness and sleep; however, the frontalis exhibits substantially less between-subject variability. This study established face validity for the use of fEMG in the detection of wake and stages of sleep, and for future applications toward assessment of quantitative REM sleep muscle activity in REM sleep behavior disorder.
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Affiliation(s)
| | - Erik K St Louis
- Center for Sleep Medicine, Departments of Neurology and Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Luigi Ferini Strambi
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Galbiati
- Department of Clinical Neurosciences, San Raffaele Scientific Institute, Sleep Disorders Center Università Vita-Salute San Raffaele, Milan, Italy
| | | | - Chris Berka
- Advanced Brain Monitoring, Carlsbad, CA,USA,
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Abstract
OBJECTIVE Lingual strengthening exercises are established to improve lingual function, thereby oral swallowing. This study measured submental muscle activation during maximum isometric pressure (MIP) lingual tasks in healthy adults, tasks that are or can be adopted in lingual strengthening exercises. In addition, the effects of age and gender on submental muscle activation are examined. METHOD Forty-nine participants between the ages of 18 to 35 years and greater than 60 years were included in the study. Participants completed trials of intraoral MIP lingual elevation, protrusion, and depression, during which submental muscle activation was measured using surface electromyography (sEMG). Peak amplitude measures were normalized and log transformed, following which a three-way ANOVA was performed. RESULTS Peak amplitudes of submental muscle activation were highest during lingual MIP protrusion, followed by lingual depression, and were least during lingual elevation. No significant differences in peak amplitudes were observed between older and younger adults, but higher peak amplitudes were recorded in women. CONCLUSION The differential effects of lingual task, age, and gender on peak submental muscle activation are examined. The potential impact of incorporating tasks adopted in this study in lingual strengthening exercises to improve oral and pharyngeal swallowing is discussed.
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Affiliation(s)
- E R Oommen
- Elizabeth R. Oommen, Speech Pathology and Audiology Department, Calvin College, 1810 East Beltline Avenue SE, Grand Rapids, Michigan, 49546. Phone: 616-526-6016, E-mail:
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8
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Gamboa NA, Miralles R, Valenzuela S, Santander H, Cordova R, Bull R, Espinoza DA, Martínez CA. Comparison of muscle activity between subjects with or without lip competence: Electromyographic activity of lips, supra- and infrahyoid muscles. Cranio 2016; 35:385-391. [PMID: 27997289 DOI: 10.1080/08869634.2016.1261441] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM This study compares the electromyographic (EMG) activity of the muscles from the lips and hyoid bone in subjects with or without lip competence. METHODOLOGY Two groups of 20 subjects each, with or without lip competence were studied. EMG activity of the superior orbicularis oris (SOO), inferior orbicularis oris (IOO), suprahyoid (SH) and infrahyoid (IH) muscles was recorded with the subject seated in the upright position during the following tasks: (1) at rest; (2) speaking; (3) swallowing; (4) forced deep breathing; (5) maximal voluntary clenching; and (6) chewing. RESULTS EMG activity was significantly higher in subjects without competent lips than with competent lips in the SOO and IOO muscles during tasks 3 and 4, SOO during task 2 and IOO during task 6. EMG activity was similar in the SOO and IOO muscles during tasks 1 and 5, SOO during task 6 and IOO during task 2. Activity of the SH and IH muscles was similar in both groups for all tasks. CONCLUSIONS Higher activity in subjects without competent lips implies a higher muscular effort due to the requirement of lip sealing during functional activities. Hyoid muscular activity was not modified by the presence or absence of lip competence.
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Affiliation(s)
- Natalia Andrea Gamboa
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile.,b Oral Physiology Laboratory, Faculty of Medicine , Biomedical Sciences Institute, University of Chile , Santiago , Chile
| | - Rodolfo Miralles
- b Oral Physiology Laboratory, Faculty of Medicine , Biomedical Sciences Institute, University of Chile , Santiago , Chile
| | - Saúl Valenzuela
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile.,b Oral Physiology Laboratory, Faculty of Medicine , Biomedical Sciences Institute, University of Chile , Santiago , Chile
| | - Hugo Santander
- b Oral Physiology Laboratory, Faculty of Medicine , Biomedical Sciences Institute, University of Chile , Santiago , Chile
| | - Rosa Cordova
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile.,b Oral Physiology Laboratory, Faculty of Medicine , Biomedical Sciences Institute, University of Chile , Santiago , Chile.,c Faculty of Medicine , Diego Portales University , Santiago , Chile
| | - Ricardo Bull
- b Oral Physiology Laboratory, Faculty of Medicine , Biomedical Sciences Institute, University of Chile , Santiago , Chile
| | - Diego Alejandro Espinoza
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile
| | - Catalina Andrea Martínez
- a Faculty of Dentistry , Institute for Research in Dental Sciences, University of Chile , Santiago , Chile
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Zaretsky E, Pluschinski P, Sader R, Birkholz P, Neuschaefer-Rube C, Hey C. Identification of the most significant electrode positions in electromyographic evaluation of swallowing-related movements in humans. Eur Arch Otorhinolaryngol 2016; 274:989-995. [PMID: 27581722 DOI: 10.1007/s00405-016-4288-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/26/2016] [Indexed: 12/11/2022]
Abstract
Surface electromyography (sEMG) is a well-established procedure for recording swallowing-related muscle activities. Because the use of a large number of sEMG channels is time consuming and technically sophisticated, the aim of this study was to identify the most significant electrode positions associated with oropharyngeal swallowing activities. Healthy subjects (N = 16) were tested with a total of 42 channels placed in M. masseter, M. orbicularis oris, submental and paralaryngeal regions. Each test subject swallowed 10 ml of water five times. After having identified 16 optimal electrode positions, that is, positions with the strongest signals quantified by the highest integral values, differences to 26 other ones were determined by a Mann-Whitney U test. Kruskal-Wallis H test was utilized for the analysis of differences between single subjects, subject subgroups, and single electrode positions. Factors associated with sEMG signals were examined in a linear regression. Sixteen electrode positions were chosen by a simple ranking of integral values. These positions delivered significantly higher signals than the other 26 positions. Differences between single electrode positions and between test subjects were also significant. Sixteen most significant positions were identified which represent swallowing-related muscle potentials in healthy subjects.
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Affiliation(s)
- E Zaretsky
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Marburg, Baldingerstr. 1, 35032, Marburg, Germany
| | - P Pluschinski
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Marburg, Baldingerstr. 1, 35032, Marburg, Germany
| | - R Sader
- Center of Surgery, Clinic for Oral, Dental and Cosmetic Facial Surgery, University Hospital of Frankfurt/Main, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - P Birkholz
- Institute for Acoustics and Speech Communication, Faculty for Electrical Engineering and Information Technology, Technische Universität Dresden, Helmholtzstr. 10, 01069, Dresden, Germany
| | - C Neuschaefer-Rube
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Christiane Hey
- Department of Phoniatrics and Pediatric Audiology, University Hospital of Marburg, Baldingerstr. 1, 35032, Marburg, Germany.
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Wallentin M, Skakkebæk A, Bojesen A, Fedder J, Laurberg P, Østergaard JR, Hertz JM, Pedersen AD, Gravholt CH. Klinefelter syndrome has increased brain responses to auditory stimuli and motor output, but not to visual stimuli or Stroop adaptation. Neuroimage Clin 2016; 11:239-251. [PMID: 26958463 PMCID: PMC4773384 DOI: 10.1016/j.nicl.2016.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 01/24/2016] [Accepted: 02/10/2016] [Indexed: 11/20/2022]
Abstract
Klinefelter syndrome (47, XXY) (KS) is a genetic syndrome characterized by the presence of an extra X chromosome and low level of testosterone, resulting in a number of neurocognitive abnormalities, yet little is known about brain function. This study investigated the fMRI-BOLD response from KS relative to a group of Controls to basic motor, perceptual, executive and adaptation tasks. Participants (N: KS = 49; Controls = 49) responded to whether the words "GREEN" or "RED" were displayed in green or red (incongruent versus congruent colors). One of the colors was presented three times as often as the other, making it possible to study both congruency and adaptation effects independently. Auditory stimuli saying "GREEN" or "RED" had the same distribution, making it possible to study effects of perceptual modality as well as Frequency effects across modalities. We found that KS had an increased response to motor output in primary motor cortex and an increased response to auditory stimuli in auditory cortices, but no difference in primary visual cortices. KS displayed a diminished response to written visual stimuli in secondary visual regions near the Visual Word Form Area, consistent with the widespread dyslexia in the group. No neural differences were found in inhibitory control (Stroop) or in adaptation to differences in stimulus frequencies. Across groups we found a strong positive correlation between age and BOLD response in the brain's motor network with no difference between groups. No effects of testosterone level or brain volume were found. In sum, the present findings suggest that auditory and motor systems in KS are selectively affected, perhaps as a compensatory strategy, and that this is not a systemic effect as it is not seen in the visual system.
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Affiliation(s)
- Mikkel Wallentin
- Center of Functionally Integrative Neuroscience, Aarhus University Hospital, building 10-G-5, Nørrebrogade, 8000 Aarhus C, Denmark; Center for Semiotics, Aarhus University, Denmark.
| | - Anne Skakkebæk
- Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital, 8000 Aarhus C, Denmark; Department of Clinical Genetics, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Anders Bojesen
- Department of Clinical Genetics, Vejle Hospital, Sygehus Lillebaelt, 7100 Vejle, Denmark; Institute of Regional Health Research, University of Southern Denmark, 5000 Odense C, Denmark
| | - Jens Fedder
- Centre of Andrology & Fertility Clinic, Department D, Odense University Hospital, 5000 Odense C, Denmark
| | - Peter Laurberg
- Department of Endocrinology, Aalborg University Hospital, 9000 Aalborg, Denmark
| | - John R Østergaard
- Centre for Rare Diseases, Department of Pediatrics, Aarhus University Hospital, Denmark
| | - Jens Michael Hertz
- Department of Clinical Genetics, Odense University Hospital, 5000 Odense, Denmark
| | - Anders Degn Pedersen
- Vejlefjord Rehabilitation Center, 7140 Stouby, Denmark; Department of Psychology and Behavioral Sciences, Aarhus University, 8000 Aarhus, Denmark
| | - Claus Højbjerg Gravholt
- Department of Endocrinology and Internal Medicine (MEA), Aarhus University Hospital, 8000 Aarhus C, Denmark; Department of Molecular Medicine, Aarhus University Hospital, 8200 Aarhus N, Denmark
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