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Moon KS, Kang JS, Lee SQ, Thompson J, Satterlee N. Wireless Mouth Motion Recognition System Based on EEG-EMG Sensors for Severe Speech Impairments. SENSORS (BASEL, SWITZERLAND) 2024; 24:4125. [PMID: 39000904 PMCID: PMC11244127 DOI: 10.3390/s24134125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 06/19/2024] [Accepted: 06/20/2024] [Indexed: 07/16/2024]
Abstract
This study aims to demonstrate the feasibility of using a new wireless electroencephalography (EEG)-electromyography (EMG) wearable approach to generate characteristic EEG-EMG mixed patterns with mouth movements in order to detect distinct movement patterns for severe speech impairments. This paper describes a method for detecting mouth movement based on a new signal processing technology suitable for sensor integration and machine learning applications. This paper examines the relationship between the mouth motion and the brainwave in an effort to develop nonverbal interfacing for people who have lost the ability to communicate, such as people with paralysis. A set of experiments were conducted to assess the efficacy of the proposed method for feature selection. It was determined that the classification of mouth movements was meaningful. EEG-EMG signals were also collected during silent mouthing of phonemes. A few-shot neural network was trained to classify the phonemes from the EEG-EMG signals, yielding classification accuracy of 95%. This technique in data collection and processing bioelectrical signals for phoneme recognition proves a promising avenue for future communication aids.
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Affiliation(s)
- Kee S Moon
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
| | - John S Kang
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Sung Q Lee
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Jeff Thompson
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
| | - Nicholas Satterlee
- Department of Mechanical Engineering, San Diego State University, San Diego, CA 92182, USA
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2
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Lai YJ, Li CY, Hung CH, Lin CY. Severity of tongue base collapse in various body positions in patients with obstructive sleep apnea: A trajectory analysis. J Formos Med Assoc 2024:S0929-6646(24)00086-X. [PMID: 38423924 DOI: 10.1016/j.jfma.2024.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 01/19/2024] [Accepted: 01/31/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Drug-induced sleep endoscopy (DISE) is used for evaluating upper airway anatomy and determining airway obstruction patterns. It is typically performed with the patient in the supine position. Airway collapse severity is influenced by body position and level of consciousness; the resultant dynamic changes may vary across patients. In this study, we evaluated the severity of upper airway collapse through awake endoscopy and DISE and identified factors affecting the pattern of airway collapse severity. METHODS This study included 66 patients with obstructive sleep apnea. The patients underwent type 1 polysomnography, tongue strength assessment, awake endoscopy in the sitting and supine positions, and DISE. Group-based trajectory modeling was performed to identify patients with different collapse severity patterns in different body positions and at different levels of consciousness. RESULTS Patient with similar severity trajectory were assigned to the same group. Two different severity trajectories (group 1 and group 2) were identified at the tongue base level. Tongue depression strength varied significantly between groups 1 and 2 (47.00 vs. 35.00 kPa; P = .047). During awake endoscopy, collapse severity was significantly higher in group 2 than in group 1. Group 1 had lower rapid eye movement/nonrapid eye movement apnea-hypopnea index ratios and higher tongue depression strength than did group 2. CONCLUSION In patients with obstructive sleep apnea, tongue strength may vary depending on body position. Our results should be interpreted with caution because of the limited sample size. Future studies should investigate the effect of oropharyngeal rehabilitation on tongue strength and collapse severity.
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Affiliation(s)
- Yi-Ju Lai
- Institute of Physical Education, Health and Leisure Studies, College of Management, National Cheng Kung University, Tainan, Taiwan; Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan; Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ching-Hsia Hung
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Cheng-Yu Lin
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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3
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Mialland A, Atallah I, Bonvilain A. Toward a robust swallowing detection for an implantable active artificial larynx: a survey. Med Biol Eng Comput 2023; 61:1299-1327. [PMID: 36792845 DOI: 10.1007/s11517-023-02772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 01/04/2023] [Indexed: 02/17/2023]
Abstract
Total laryngectomy consists in the removal of the larynx and is intended as a curative treatment for laryngeal cancer, but it leaves the patient with no possibility to breathe, talk, and swallow normally anymore. A tracheostomy is created to restore breathing through the throat, but the aero-digestive tracts are permanently separated and the air no longer passes through the nasal tracts, which allowed filtration, warming, humidification, olfaction, and acceleration of the air for better tissue oxygenation. As for phonation restoration, various techniques allow the patient to talk again. The main one consists of a tracheo-esophageal valve prosthesis that makes the air passes from the esophagus to the pharynx, and makes the air vibrate to allow speech through articulation. Finally, swallowing is possible through the original tract as it is now isolated from the trachea. Yet, many methods exist to detect and assess a swallowing, but none is intended as a definitive restoration technique of the natural airway, which would permanently close the tracheostomy and avoid its adverse effects. In addition, these methods are non-invasive and lack detection accuracy. The feasibility of an effective early detection of swallowing would allow to further develop an implantable active artificial larynx and therefore restore the aero-digestive tracts. A previous attempt has been made on an artificial larynx implanted in 2012, but no active detection was included and the system was completely mechanic. This led to residues in the airway because of the imperfect sealing of the mechanism. An active swallowing detection coupled with indwelling measurements would thus likely add a significant reliability on such a system as it would allow to actively close an artificial larynx. So, after a brief explanation of the swallowing mechanism, this survey intends to first provide a detailed consideration of the anatomical region involved in swallowing, with a detection perspective. Second, the swallowing mechanism following total laryngectomy surgery is detailed. Third, the current non-invasive swallowing detection technique and their limitations are discussed. Finally, the previous points are explored with regard to the inherent requirements for the feasibility of an effective swallowing detection for an artificial larynx. Graphical Abstract.
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Affiliation(s)
- Adrien Mialland
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France.
| | - Ihab Atallah
- Institute of Engineering and Management Univ. Grenoble Alpes, Otorhinolaryngology, CHU Grenoble Alpes, 38700, La Tronche, France
| | - Agnès Bonvilain
- Institute of Engineering and Management Univ. Grenoble Alpes, Univ. Grenoble Alpes, CNRS, Grenoble INP, Gipsa-lab, 38000, Grenoble, France
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4
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Shao M, Xing F, Carass A, Liang X, Zhuo J, Stone M, Woo J, Prince JL. Analysis of Tongue Muscle Strain During Speech From Multimodal Magnetic Resonance Imaging. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:513-526. [PMID: 36716389 PMCID: PMC10023187 DOI: 10.1044/2022_jslhr-22-00329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/23/2022] [Accepted: 10/26/2022] [Indexed: 06/18/2023]
Abstract
PURPOSE Muscle groups within the tongue in healthy and diseased populations show different behaviors during speech. Visualizing and quantifying strain patterns of these muscle groups during tongue motion can provide insights into tongue motor control and adaptive behaviors of a patient. METHOD We present a pipeline to estimate the strain along the muscle fiber directions in the deforming tongue during speech production. A deep convolutional network estimates the crossing muscle fiber directions in the tongue using diffusion-weighted magnetic resonance imaging (MRI) data acquired at rest. A phase-based registration algorithm is used to estimate motion of the tongue muscles from tagged MRI acquired during speech. After transforming both muscle fiber directions and motion fields into a common atlas space, strain tensors are computed and projected onto the muscle fiber directions, forming so-called strains in the line of actions (SLAs) throughout the tongue. SLAs are then averaged over individual muscles that have been manually labeled in the atlas space using high-resolution T2-weighted MRI. Data were acquired, and this pipeline was run on a cohort of eight healthy controls and two glossectomy patients. RESULTS The crossing muscle fibers reconstructed by the deep network show orthogonal patterns. The strain analysis results demonstrate consistency of muscle behaviors among some healthy controls during speech production. The patients show irregular muscle patterns, and their tongue muscles tend to show more extension than the healthy controls. CONCLUSIONS The study showed visual evidence of correlation between two muscle groups during speech production. Patients tend to have different strain patterns compared to the controls. Analysis of variations in muscle strains can potentially help develop treatment strategies in oral diseases. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21957011.
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Affiliation(s)
- Muhan Shao
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD
| | - Fangxu Xing
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Aaron Carass
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD
| | - Xiao Liang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore
| | - Jiachen Zhuo
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore
| | - Maureen Stone
- Department of Neural and Pain Sciences and Department of Orthodontics, University of Maryland School of Dentistry, Baltimore
| | - Jonghye Woo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Jerry L. Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD
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Cho H, Noh JS, Park J, Park C, Park ND, Ahn JY, Park JW, Choi YH, Chun SM. Decreased Maximal Tongue Protrusion Length May Predict the Presence of Dysphagia in Stroke Patients. Ann Rehabil Med 2022; 45:440-449. [PMID: 35000369 PMCID: PMC8743842 DOI: 10.5535/arm.21126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/13/2021] [Indexed: 01/22/2023] Open
Abstract
Objective To investigate the relationship between maximal tongue protrusion length (MTPL) and dysphagia in post-stroke patients. Methods Free tongue length (FTL) was measured using the quick tongue-tie assessment tool and MTPL was measured using a transparent plastic ruler in 47 post-stroke patients. The MTPL-to-FTL (RMF) ratio was calculated. Swallowing function in all patients was evaluated via videofluoroscopic swallowing study (VFSS), PenetrationAspiration Scale (PAS), Functional Oral Intake Scale (FOIS), and Videofluoroscopic Dysphagia Scale (VDS). Results The MTPL and RMF values were significantly higher in the non-aspirator group than in the aspirator group (MTPL, p=0.0049; RMF, p<0.001). MTPL and RMF showed significant correlations with PAS, FOIS and VDS scores. The cut-off value in RMF for the prediction of aspiration was 1.56, with a sensitivity of 84% and a specificity of 86%. Conclusion There is a relationship between MTPL and dysphagia in post-stroke patients. MTPL and RMF can be useful for detecting aspiration in post-stroke patients.
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Affiliation(s)
- Hyunchul Cho
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Jeong Se Noh
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Junwon Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Changwook Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - No Dam Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Jun Young Ahn
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ji Woong Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Yoon-Hee Choi
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Seong-Min Chun
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Seoul Hospital, Seoul, Korea
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Furlan RMMM, Santana GA, Motta AR, Casas EBDL. An instrument for tongue performance assessment in activities associated with digital games: content and construct validity. REVISTA CEFAC 2021. [DOI: 10.1590/1982-0216/20212359621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to analyze the content and construct validity of an instrument for tongue performance assessment in activities associated with digital games. Methods: to analyze content validity, ten speech-language pathologists answered a questionnaire in which each item of the instrument and the set of items were judged as to its representativeness. The content validity index and the modified Kappa statistics were calculated. To analyze construct validity, 20 participants, with age between 8 and 13 years, (10 children with weak tongues and 10 children with normal tongue strength) performed a game activity with the T-Station, involving 12 targets with 2 N of strength and 5 s of time for sustained contraction for each target. The performance was compared, for each item of the instrument, between groups. Results: most of the items obtained satisfactory score according to the speech-language pathologist’s evaluation. Children with reduced tongue force had a poorer performance than those with normal tongue force, with a statistically significant difference in three items of the instrument. Conclusion: the instrument proved to be valid as a method for evaluating performance in activities associated with the T-Station.
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7
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Gick B, Mayer C, Chiu C, Widing E, Roewer-Després F, Fels S, Stavness I. Quantal biomechanical effects in speech postures of the lips. J Neurophysiol 2020; 124:833-843. [PMID: 32727259 DOI: 10.1152/jn.00676.2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The unique biomechanical and functional constraints on human speech make it a promising area for research investigating modular control of movement. The present article illustrates how a modular control approach to speech can provide insights relevant to understanding both motor control and observed variation across languages. We specifically explore the robust typological finding that languages produce different degrees of labial constriction using distinct muscle groupings and concomitantly distinct lip postures. Research has suggested that these lip postures exploit biomechanical regions of nonlinearity between neural activation and movement, also known as quantal regions, to allow movement goals to be realized despite variable activation signals. We present two sets of computer simulations showing that these labial postures can be generated under the assumption of modular control and that the corresponding modules are biomechanically robust: first to variation in the activation levels of participating muscles, and second to interference from surrounding muscles. These results provide support for the hypothesis that biomechanical robustness is an important factor in selecting the muscle groupings used for speech movements and provide insight into the neurological control of speech movements and how biomechanical and functional constraints govern the emergence of speech motor modules. We anticipate that future experimental work guided by biomechanical simulation results will provide new insights into the neural organization of speech movements.NEW & NOTEWORTHY This article provides additional evidence that speech motor control is organized in a modular fashion and that biomechanics constrain the kinds of motor modules that may emerge. It also suggests that speech can be a fruitful domain for the study of modularity and that a better understanding of speech motor modules will be useful for speech research. Finally, it suggests that biomechanical modeling can serve as a useful complement to experimental work when studying modularity.
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Affiliation(s)
- Bryan Gick
- Department of Linguistics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Connor Mayer
- Department of Linguistics, University of California, Los Angeles, Los Angeles, California
| | - Chenhao Chiu
- Graduate Institute of Linguistics, National Taiwan University, Taipei, Taiwan
| | - Erik Widing
- Department of Computer Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Sidney Fels
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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8
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Luu BL, Saboisky JP, McBain RA, Trinder JA, White DP, Taylor JL, Gandevia SC, Butler JE. Genioglossus motor unit activity in supine and upright postures in obstructive sleep apnea. Sleep 2020; 43:5686881. [PMID: 31875918 DOI: 10.1093/sleep/zsz316] [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: 07/29/2019] [Revised: 10/03/2019] [Indexed: 11/14/2022] Open
Abstract
This study investigated whether a change in posture affected the activity of the upper-airway dilator muscle genioglossus in participants with and without obstructive sleep apnea (OSA). During wakefulness, a monopolar needle electrode was used to record single motor unit activity in genioglossus in supine and upright positions to alter the gravitational load that causes narrowing of the upper airway. Activity from 472 motor units was recorded during quiet breathing in 17 males, nine of whom had OSA. The mean number of motor units for each participant was 11.8 (SD 3.4) in the upright and 16.0 (SD 4.2) in the supine posture. For respiratory-modulated motor units, there were no significant differences in discharge frequencies between healthy controls and participants with OSA. Within each breath, genioglossus activity increased through the recruitment of phasic motor units and an increase in firing rate, with an overall increase of ~6 Hz (50%) across both postures and participant groups. However, the supine posture did not lead to compensatory increases in the peak discharge frequencies of inspiratory and expiratory motor units, despite the increase in gravitational load on the upper airway. Posture also had no significant effect on the discharge frequency of motor units that showed no respiratory modulation during quiet breathing. We postulate that, in wakefulness, any increase in genioglossus activity to compensate for the gravitational effects on the upper airway is achieved primarily through the recruitment of additional motor units in both healthy controls and participants with OSA.
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Affiliation(s)
- Billy L Luu
- Neuroscience Research Australia, Randwick, NSW, Australia
| | - Julian P Saboisky
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
| | - Rachel A McBain
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
| | | | - David P White
- Sleep Disorders Research Program, Division of Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Janet L Taylor
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia.,Edith Cowan University, Joondalup, WA, Australia
| | - Simon C Gandevia
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
| | - Jane E Butler
- Neuroscience Research Australia, Randwick, NSW, Australia.,University of New South Wales, Sydney, NSW, Australia
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Gomez AD, Stone ML, Woo J, Xing F, Prince JL. Analysis of fiber strain in the human tongue during speech. Comput Methods Biomech Biomed Engin 2020; 23:312-322. [PMID: 32031425 DOI: 10.1080/10255842.2020.1722808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This study investigates mechanical cooperation among tongue muscles. Five volunteers were imaged using tagged magnetic resonance imaging to quantify spatiotemporal kinematics while speaking. Waveforms of strain in the line of action of fibers (SLAF) were estimated by projecting strain tensors onto a model of fiber directionality. SLAF waveforms were temporally aligned to determine consistency across subjects and correlation across muscles. The cohort exhibited consistent patterns of SLAF, and muscular extension-contraction was correlated. Volume-preserving tongue movement in speech generation can be achieved through multiple paths, but the study reveals similarities in motion patterns and muscular action-despite anatomical (and other) dissimilarities.
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Affiliation(s)
- Arnold D Gomez
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Maureen L Stone
- Department of Neural and Pain Sciences, University of Maryland, Baltimore, MD, USA
| | - Jonghye Woo
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Fangxu Xing
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, USA
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Measurement and State-Dependent Modulation of Hypoglossal Motor Excitability and Responsivity In-Vivo. Sci Rep 2020; 10:550. [PMID: 31953471 PMCID: PMC6969049 DOI: 10.1038/s41598-019-57328-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 12/19/2019] [Indexed: 12/17/2022] Open
Abstract
Motoneurons are the final output pathway for the brain’s influence on behavior. Here we identify properties of hypoglossal motor output to the tongue musculature. Tongue motor control is critical to the pathogenesis of obstructive sleep apnea, a common and serious sleep-related breathing disorder. Studies were performed on mice expressing a light sensitive cation channel exclusively on cholinergic neurons (ChAT-ChR2(H134R)-EYFP). Discrete photostimulations under isoflurane-induced anesthesia from an optical probe positioned above the medullary surface and hypoglossal motor nucleus elicited discrete increases in tongue motor output, with the magnitude of responses dependent on stimulation power (P < 0.001, n = 7) and frequency (P = 0.002, n = 8, with responses to 10 Hz stimulation greater than for 15–25 Hz, P < 0.022). Stimulations during REM sleep elicited significantly reduced responses at powers 3–20 mW compared to non-rapid eye movement (non-REM) sleep and wakefulness (each P < 0.05, n = 7). Response thresholds were also greater in REM sleep (10 mW) compared to non-REM and waking (3 to 5 mW, P < 0.05), and the slopes of the regressions between input photostimulation powers and output motor responses were specifically reduced in REM sleep (P < 0.001). This study identifies that variations in photostimulation input produce tunable changes in hypoglossal motor output in-vivo and identifies REM sleep specific suppression of net motor excitability and responsivity.
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Maia AV, Furlan RMMM, Moraes KO, Amaral MS, Medeiros AMD, Motta AR. Tongue strength rehabilitation using biofeedback: a case report. Codas 2019; 31:e20180163. [PMID: 31664370 DOI: 10.1590/2317-1782/20182018163] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/10/2018] [Indexed: 11/22/2022] Open
Abstract
This research had the objective of reporting a clinical case in which the rehabilitation of tongue strength with biofeedback strategy was performed. This case report addresses a 20-year-old patient whose orofacial myofunctional evaluation revealed a severe decrease in the force of the anterior third of the tongue and changes in lingual mobility and coordination. The measurement of tongue pressure was performed using the Iowa Oral Performance Instrument (IOPI) during elevation, protrusion and lateralization, and it was verified a reduction in the values obtained in all measured directions, compared with normality patterns. We performed 11 sessions of therapy, with weekly frequency, using a biofeedback strategy that consisted of computer games controlled by the tongue. An instrument embedded in the oral cavity functioned as a joystick as the input method for specific digital games. The patient performed at home the isometric exercises of pressing the tip of the tongue against a spatula, exaggerated retraction of tongue, tongue tapering, and isotonic exercise of touching the commissures and lips alternately, daily. After eight sessions, in relation to the elevation pressure, there was an improvement of 28.6% for the apex and 7.1% for the dorsum. As for protrusion, there was an improvement of 123.5%. In the measurements of left and right lateralization, the values increased 53.8% and 7.4%, respectively. After twelve sessions, it was observed an improvement of 35.7%, 7.4%, 164%, 76.9% and 40.7% in relation to the initial evaluation, for apex elevation, dorsum elevation, protrusion, and lateralization to left and right, respectively. Despite the increase, values recommended in the literature as normal for sex and age were not reached after 12 therapy sessions.
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Affiliation(s)
- Aline Vargas Maia
- Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | | | | | - Mariana Souza Amaral
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
| | | | - Andréa Rodrigues Motta
- Departamento de Fonoaudiologia, Universidade Federal de Minas Gerais - UFMG - Belo Horizonte (MG), Brasil
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12
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Woo J, Prince JL, Stone M, Xing F, Gomez AD, Green JR, Hartnick CJ, Brady TJ, Reese TG, Wedeen VJ, El Fakhri G. A Sparse Non-Negative Matrix Factorization Framework for Identifying Functional Units of Tongue Behavior From MRI. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:730-740. [PMID: 30235120 PMCID: PMC6422735 DOI: 10.1109/tmi.2018.2870939] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Muscle coordination patterns of lingual behaviors are synergies generated by deforming local muscle groups in a variety of ways. Functional units are functional muscle groups of local structural elements within the tongue that compress, expand, and move in a cohesive and consistent manner. Identifying the functional units using tagged-magnetic resonance imaging (MRI) sheds light on the mechanisms of normal and pathological muscle coordination patterns, yielding improvement in surgical planning, treatment, or rehabilitation procedures. In this paper, to mine this information, we propose a matrix factorization and probabilistic graphical model framework to produce building blocks and their associated weighting map using motion quantities extracted from tagged-MRI. Our tagged-MRI imaging and accurate voxel-level tracking provide previously unavailable internal tongue motion patterns, thus revealing the inner workings of the tongue during speech or other lingual behaviors. We then employ spectral clustering on the weighting map to identify the cohesive regions defined by the tongue motion that may involve multiple or undocumented regions. To evaluate our method, we perform a series of experiments. We first use two-dimensional images and synthetic data to demonstrate the accuracy of our method. We then use three-dimensional synthetic and in vivo tongue motion data using protrusion and simple speech tasks to identify subject-specific and data-driven functional units of the tongue in localized regions.
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Affiliation(s)
- Jonghye Woo
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School
| | - Jerry L. Prince
- Department of Electrical and Computer Engineering at Johns Hopkins University
| | | | - Fangxu Xing
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School
| | - Arnold D. Gomez
- Department of Electrical and Computer Engineering at Johns Hopkins University
| | | | | | - Thomas J. Brady
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School
| | - Timothy G. Reese
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School
| | - Van J. Wedeen
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School
| | - Georges El Fakhri
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School
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Araújo TGD, Rodrigues TM, Furlan RMMM, Casas EBDL, Motta AR. Reproducibility assessment of an instrument for measuring the axial force of the tongue. Codas 2018; 30:e20170191. [PMID: 29972446 DOI: 10.1590/2317-1782/20182017191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 12/20/2017] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Evaluate the reproducibility of Forling, a portable instrument for measuring axial tongue force. METHODS Axial force of the tongue was measured in 49 individuals (30 women and 19 men) aged 18-25 years using the Forling portable instrument. Measurements were performed in three days at intervals of 7±2 days. On each day, three 7-second measurements were performed with one-minute intervals between them. The coefficient of variation, Wilcoxon paired test, and intraclass correlation coefficient were used in the statistical analysis of the data. Maximum and mean tongue force values were analyzed, and comparison between them was performed using three approaches: the mean of the three values; the mean of the two highest values; the highest value of each measurement. RESULTS In the analysis of mean tongue force, the coefficient of variation was considered desirable and the intraclass correlation coefficient was acceptable. Significant differences were observed regarding the maximum value between the second and third days, mean of the two highest values and mean of the three values between the first and second days and the second and third days. In the analysis of maximum tongue force, the coefficient of variation and the intraclass correlation coefficient were acceptable. Significant difference was found only in the comparison between the second and third days. CONCLUSION Good reproducibility of the data obtained with the use of the Forling portable instrument was observed.
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Luu BL, Muceli S, Saboisky JP, Farina D, Héroux ME, Bilston LE, Gandevia SC, Butler JE. Motor unit territories in human genioglossus estimated with multichannel intramuscular electrodes. J Appl Physiol (1985) 2018; 124:664-671. [DOI: 10.1152/japplphysiol.00889.2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The discharge patterns of genioglossus motor units during breathing have been well-characterized in previous studies, but their localization and territories are not known. In this study, we used two newly developed intramuscular multichannel electrodes to estimate the territories of genioglossus motor units in the anterior and posterior regions of the muscle. Seven healthy men participated. Each electrode contained fifteen bipolar channels, separated by 1 mm, and was inserted percutaneously below the chin, perpendicular to the skin, to a depth of 36 mm. Single motor unit activity was recorded with subjects awake, supine, and breathing quietly through a nasal mask for 180 s. Motor unit territories were estimated from the spike-triggered averages of the electromyographic signal from each channel. A total of 30 motor units were identified: 22 expiratory tonic, 1 expiratory phasic, 2 tonic, 3 inspiratory tonic, and 2 inspiratory phasic. Motor units appeared to be clustered based on unit type, with peak activities for expiratory units predominantly located in the anterior and superficial fibers of genioglossus and inspiratory units in the posterior region. Of these motor unit types, expiratory tonic units had the largest estimated territory, a mean 11.3 mm (SD 1.9). Estimated territories of inspiratory motor units ranged from 3 to 6 mm. In accordance with the distribution of motor unit types, the estimated territory of genioglossus motor units varied along the sagittal plane, decreasing from anterior to posterior. Our findings suggest that genioglossus motor units have large territories relative to the cross-sectional size of the muscle. NEW & NOTEWORTHY In this study, we used a new multichannel intramuscular electrode to address a fundamental property of human genioglossus motor units. We describe the territory of genioglossus motor units in the anterior and posterior regions of the muscle and show a decrease in territory size from anterior to posterior and that expiratory-related motor units have larger estimated territories than inspiratory-related motor units.
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Affiliation(s)
- Billy L. Luu
- Neuroscience Research Australia, Randwick, and University of New South Wales, Sydney, Australia
| | - Silvia Muceli
- Neurorehabilitation Systems Research Group, Clinic for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Julian P. Saboisky
- Neuroscience Research Australia, Randwick, and University of New South Wales, Sydney, Australia
| | - Dario Farina
- Neurorehabilitation Systems Research Group, Clinic for Trauma Surgery, Orthopaedics and Plastic Surgery, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Martin E. Héroux
- Neuroscience Research Australia, Randwick, and University of New South Wales, Sydney, Australia
| | - Lynne E. Bilston
- Neuroscience Research Australia, Randwick, and University of New South Wales, Sydney, Australia
| | - Simon C. Gandevia
- Neuroscience Research Australia, Randwick, and University of New South Wales, Sydney, Australia
| | - Jane E. Butler
- Neuroscience Research Australia, Randwick, and University of New South Wales, Sydney, Australia
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15
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Cullins MJ, Krekeler BN, Connor NP. Differential impact of tongue exercise on intrinsic lingual muscles. Laryngoscope 2017; 128:2245-2251. [PMID: 29243257 DOI: 10.1002/lary.27044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/18/2017] [Accepted: 11/09/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Aging is associated with muscle fiber hypotrophy and decreased percentages of rapidly contracting myosin heavy chain (MyHC) type IIb muscle fibers. Tongue exercise programs used to treat dysphagia target age-related decline in tongue muscle function, but the impact of exercise on the intrinsic tongue muscles is unknown. We hypothesized that exercise would induce muscle fiber hypertrophy and increase the percentage of MyHC IIa fibers in the intrinsic tongue. STUDY DESIGN Animal model. METHODS Eight old and eight young-adult rats underwent 8 weeks of tongue exercise training, and 8 animals of each age group served as controls. Longitudinal, transverse, and verticalis muscle samples from the anterior, middle, and posterior regions of the tongue were sectioned and stained to determine muscle fiber diameter and MyHC composition. RESULTS MyHC fiber type distribution was altered by exercise, and the effects differed by muscle and region of the tongue. In the exercise groups, as compared to the control groups, the anterior transverse and middle superior longitudinal muscles had significantly reduced percentages of MyHC IIx positive fibers and higher percentages of rapidly contracting fatigable MyHC IIb positive muscle fibers, whereas the middle transverse and posterior longitudinal muscles had increased percentages of the less rapidly contracting and more fatigue-resistant MyHC IIa fibers. The impact of exercise did not differ with age, as there was no significant interaction between age and exercise. Tongue exercise had no significant effect on muscle fiber diameter. CONCLUSIONS The impact of exercise varied among the tongue muscles, which may indicate different functional contributions to the tongue exercise task. LEVEL OF EVIDENCE NA Laryngoscope, 128:2245-2251, 2018.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
| | - Brittany N Krekeler
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
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Woo J, Xing F, Stone M, Green J, Reese TG, Brady TJ, Wedeen VJ, Prince JL, El Fakhri G. Speech Map: A Statistical Multimodal Atlas of 4D Tongue Motion During Speech from Tagged and Cine MR Images. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING-IMAGING AND VISUALIZATION 2017; 7:361-373. [PMID: 31328049 DOI: 10.1080/21681163.2017.1382393] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Quantitative measurement of functional and anatomical traits of 4D tongue motion in the course of speech or other lingual behaviors remains a major challenge in scientific research and clinical applications. Here, we introduce a statistical multimodal atlas of 4D tongue motion using healthy subjects, which enables a combined quantitative characterization of tongue motion in a reference anatomical configuration. This atlas framework, termed Speech Map, combines cine- and tagged-MRI in order to provide both the anatomic reference and motion information during speech. Our approach involves a series of steps including (1) construction of a common reference anatomical configuration from cine-MRI, (2) motion estimation from tagged-MRI, (3) transformation of the motion estimations to the reference anatomical configuration, and (4) computation of motion quantities such as Lagrangian strain. Using this framework, the anatomic configuration of the tongue appears motionless, while the motion fields and associated strain measurements change over the time course of speech. In addition, to form a succinct representation of the high-dimensional and complex motion fields, principal component analysis is carried out to characterize the central tendencies and variations of motion fields of our speech tasks. Our proposed method provides a platform to quantitatively and objectively explain the differences and variability of tongue motion by illuminating internal motion and strain that have so far been intractable. The findings are used to understand how tongue function for speech is limited by abnormal internal motion and strain in glossectomy patients.
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Affiliation(s)
- Jonghye Woo
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Fangxu Xing
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Maureen Stone
- Department of Neural and Pain Sciences, University of Maryland Dental School, Baltimore, MD 21201, USA
| | - Jordan Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA 02129, USA
| | - Timothy G Reese
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Thomas J Brady
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Van J Wedeen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02129, USA
| | - Jerry L Prince
- Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Georges El Fakhri
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
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17
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Cullins MJ, Connor NP. Alterations of intrinsic tongue muscle properties with aging. Muscle Nerve 2017; 56:E119-E125. [PMID: 28181263 DOI: 10.1002/mus.25605] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Age-related decline in the intrinsic lingual musculature could contribute to swallowing disorders, yet the effects of age on these muscles is unknown. We hypothesized there is reduced muscle fiber size and shifts to slower myosin heavy chain (MyHC) fiber types with age. METHODS Intrinsic lingual muscles were sampled from 8 young adult (9 months) and 8 old (32 months) Fischer 344/Brown Norway rats. Fiber size and MyHC were determined by fluorescent immunohistochemistry. RESULTS Age was associated with a reduced number of rapidly contracting muscle fibers, and more slowly contracting fibers. Decreased fiber size was found only in the transverse and verticalis muscles. DISCUSSION Shifts in muscle composition from faster to slower MyHC fiber types may contribute to age-related changes in swallowing duration. Decreasing muscle fiber size in the protrusive transverse and verticalis muscles may contribute to reductions in maximum isometric tongue pressure found with age. Differences among regions and muscles may be associated with different functional demands. Muscle Nerve 56: E119-E125, 2017.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, 1300 University Avenue, Madison, Wisconsin, 53706, USA
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, 1300 University Avenue, Madison, Wisconsin, 53706, USA
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18
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Motta AR, Las Casas EBD, César CC, Bommarito S, Chiari BM. Caracterização da força da língua por meio de medidas objetivas. REVISTA CEFAC 2017. [DOI: 10.1590/1982-021620171919116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: analisar a força axial da língua e parâmetros relacionados por meio do FORLING. Método: foram analisados os dados de 92 participantes, entre homens e mulheres, com média de 23,3±7,7 anos. Resultados: no parâmetro força média da língua, identificaram-se valores médios de 13,0 N, já para a força máxima observou-se valor médio de 18,3 N. A força média e a máxima da língua apresentaram correlação positiva e associação altamente significante (p<0,001). A energia acumulada pela língua indicou valores de 131,1 N/s. O tempo médio gasto para que se alcance a força máxima da língua foi de 3,8 segundos, indicando um efeito do treinamento ao se comparar a 1ª à 3ª medida, com redução dos valores (p<0,001). Conclusão: o instrumento demonstrou ser capaz de mensurar parâmetros importantes para o fonoaudiólogo, indicando ser uma promissora ferramenta complementar à avaliação clínica fonoaudiológica.
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Abstract
AbstractMore than 35 years ago, Meltzoff and Moore (1977) published their famous article, “Imitation of facial and manual gestures by human neonates.” Their central conclusion, that neonates can imitate, was and continues to be controversial. Here, we focus on an often-neglected aspect of this debate, namely, neonatal spontaneous behaviors themselves. We present a case study of a paradigmatic orofacial “gesture,” namely tongue protrusion and retraction (TP/R). Against the background of new research on mammalian aerodigestive development, we ask: How does the human aerodigestive system develop, and what role does TP/R play in the neonate's emerging system of aerodigestion? We show that mammalian aerodigestion develops in two phases: (1) from the onset of isolated orofacial movementsin uteroto the postnatal mastery of suckling at 4 months after birth; and (2) thereafter, from preparation to the mastery of mastication and deglutition of solid foods. Like other orofacial stereotypies, TP/R emerges in the first phase and vanishes prior to the second. Based upon recent advances in activity-driven early neural development, we suggest a sequence of three developmental events in which TP/R might participate: the acquisition of tongue control, the integration of the central pattern generator (CPG) for TP/R with other aerodigestive CPGs, and the formation of connections within the cortical maps of S1 and M1. If correct, orofacial stereotypies are crucial to the maturation of aerodigestion in the neonatal period but also unlikely to co-occur with imitative behavior.
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20
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Rezende BA, Furlan RMMM, Casas EBDL, Motta AR. Relationship between clinical and instrumental assessment of the tongue in healthy young adults. Codas 2015. [DOI: 10.1590/2317-1782/20152014155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
PURPOSE: To verify the association of tongue clinical evaluation aspects with quantitative evaluation of tongue force. METHODS: A cross-sectional study was conducted with 48 healthy adults, 13 men and 35 women (ages 20-44 years; mean - M=24.8 years; standard deviation - SD=5.3 years). By clinical evaluation, the following aspects were checked: tongue force, alternate movements, snap, suction and vibration of the tongue. The evaluator also checked if the floor of the mouth elevated during tasks of tongue elevation and sucking tongue on palate and the occurrence of lingual tremor. Quantitative evaluation was accomplished using the FORLING instrument. It is composed of a piston/cylinder assembly attached to a mouthguard and to a drive shaft. The force applied by the tongue to the drive shaft is hydraulically transmitted to a pressure sensor. Mann-Whitney's test was used to verify whether there were differences in average and maximum forces according to the characteristics assessed. The test was performed at a 5% level of significance. RESULTS: The aspects with the most frequent alteration were sucking tongue on palate and tongue vibration. Tremor had a higher occurrence during tongue movements. Elevation of the floor of the mouth in sucking tongue on palate was the only aspect associated with quantitative evaluation. CONCLUSION: The association between elevation of the floor of the mouth during sucking tongue on palate and quantitative evaluation can provide insight into the higher participation of the suprahyoid muscles in some participants in both tasks.
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21
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Shumway KR, Porfirio DJ, Bailey EF. Phonation-related rate coding and recruitment in the genioglossus muscle. Exp Brain Res 2015; 233:2133-40. [PMID: 25899868 DOI: 10.1007/s00221-015-4284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/10/2015] [Indexed: 11/26/2022]
Abstract
Motor unit recruitment was assessed in two muscles with similar muscle fiber-type compositions and that participate in skilled movements: the tongue muscle, genioglossus (GG), and the hand muscle, first dorsal interosseous (FDI). Our primary objectives were to determine in the framework of a voluntary movement whether muscle force is regulated in tongue as it is in limb, i.e., via processes of rate coding and recruitment. Recruitment in the two muscles was assessed within each subject in the context of ramp force (FDI) and in the tongue (GG) during vowel production and specifically, in the context of ramp increases in loudness, and subsequently expressed relative to the maximal. The principle findings of the study are that the general rules of recruitment and rate coding hold true for both GG and FDI, and second, that average firing rates, firing rates at recruitment and peak firing rates in GG are significantly higher than for FDI (P < 0.001) despite tasks performed across comparable force ranges (~2-40 % of max). The higher firing rates observed in the tongue within the context of phonation may be a function of that muscle's dual role as (prime) mover and hydrostatic support element.
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Affiliation(s)
- K R Shumway
- Department of Physiology, College of Medicine, The University of Arizona, Tucson, AZ, 85721-0093, USA
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22
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Vranish JR, Bailey EF. A comprehensive assessment of genioglossus electromyographic activity in healthy adults. J Neurophysiol 2015; 113:2692-9. [PMID: 25695653 DOI: 10.1152/jn.00975.2014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 02/12/2015] [Indexed: 12/23/2022] Open
Abstract
The genioglossus (GG) is an extrinsic muscle of the human tongue that plays a critical role in preserving airway patency. In the last quarter century, >50 studies have reported on respiratory-related GG electromyographic (EMG) activity in human subjects. Remarkably, of the studies performed, none have duplicated subject body position, electrode recording locations, and/or breathing task(s), making interpretation and integration of the results across studies extremely challenging. In addition, more recent research assessing lingual anatomy and muscle contractile properties has identified regional differences in muscle fiber type and myosin heavy chain expression, giving rise to the possibility that the anterior and posterior regions of the muscle fulfill distinct functions. Here, we assessed EMG activity in anterior and posterior regions of the GG, across upright and supine, in rest breathing and in volitionally modulated breathing tasks. We tested the hypotheses that GG EMG is greater in the posterior region and in supine, except when breathing is subject to volitional modulation. Our results show differences in the magnitude of EMG (%regional maximum) between anterior and posterior muscle regions (7.95 ± 0.57 vs. 11.10 ± 0.99, respectively; P < 0.001), and between upright and supine (8.63 ± 0.73 vs. 10.42 ± 0.90, respectively; P = 0.008). Although the nature of a task affects the magnitude of EMG (P < 0.001), the effect is similar for anterior and posterior muscle regions and across upright and supine (P > 0.2).
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Affiliation(s)
- Jennifer R Vranish
- Department of Physiology, College of Medicine, University of Arizona, Tucson, Arizona
| | - E Fiona Bailey
- Department of Physiology, College of Medicine, University of Arizona, Tucson, Arizona
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23
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Effects of tongue position and lung volume on voluntary maximal tongue protrusion force in humans. Respir Physiol Neurobiol 2015; 206:61-6. [DOI: 10.1016/j.resp.2014.11.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 11/19/2014] [Accepted: 11/28/2014] [Indexed: 11/23/2022]
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24
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Jacobi I, van Rossum MA, van der Molen L, Hilgers FJM, van den Brekel MWM. Acoustic analysis of changes in articulation proficiency in patients with advanced head and neck cancer treated with chemoradiotherapy. Ann Otol Rhinol Laryngol 2014; 122:754-62. [PMID: 24592578 DOI: 10.1177/000348941312201205] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Our aim was to characterize articulation proficiency and differences between tumor sites before and after chemoradiotherapy for advanced head and neck cancer with the help of acoustic measures. Our further goal was to improve objective speech measures and gain insight into muscle functioning before and after treatment. METHODS In 34 patients with laryngeal or hypopharyngeal, nasal or nasopharyngeal, or oral or oropharyngeal cancer, we acoustically analyzed nasality, vowel space, precision, and strength of articulation in 12 speech sounds (/a/, /i/, /u/, /p/, /s/, /z/, /1/, /t/, /tj/, /k/, /x/, /r/) before treatment and 10 weeks and 1 year after treatment. Outcomes were compared between assessment points and between tumor sites. RESULTS Nasality in nonlaryngeal sites was significantly reduced by treatment. Most affected in articulation were the oral or oropharyngeal cancer sites, followed by the nasal or nasopharyngeal sites. One year after treatment, vowel space had not recovered and consonant articulation had weakened. Laryngeal sites were less affected in articulation by tumor or treatment. CONCLUSIONS Analyses of articulatory-acoustic features are a useful instrument for assessing articulation and speech quality objectively. Assessment of a number of sounds representing various articulation manners, places, and tongue shapes revealed patterns of speech deterioration after chemoradiotherapy. The results suggest that patients' speech could benefit from articulation exercises to address changes in muscle coordination and/or sensitivity and to counteract side effects and "underexercise" atrophy.
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Affiliation(s)
- Irene Jacobi
- Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute
| | - Maya A van Rossum
- Department of Ear, Nose, Throat, University Medical Center Leiden, Leiden, The Netherlands
| | | | - Frans J M Hilgers
- Academic Medical Center, Institute of Phonetic Sciences, Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam
| | - Michiel W M van den Brekel
- Academic Medical Center, Institute of Phonetic Sciences, Amsterdam Center for Language and Communication, University of Amsterdam, Amsterdam
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25
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Trinder J, Jordan AS, Nicholas CL. Discharge properties of upper airway motor units during wakefulness and sleep. PROGRESS IN BRAIN RESEARCH 2014; 212:59-75. [DOI: 10.1016/b978-0-444-63488-7.00004-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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26
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Affiliation(s)
- Bryan Gick
- Department of Linguistics, University of British Columbia Vancouver, BC, Canada ; Haskins Laboratories New Haven, CT, USA
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan Saskatoon, SK, Canada
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27
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Horner RL. Neural control of the upper airway: integrative physiological mechanisms and relevance for sleep disordered breathing. Compr Physiol 2013; 2:479-535. [PMID: 23728986 DOI: 10.1002/cphy.c110023] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The various neural mechanisms affecting the control of the upper airway muscles are discussed in this review, with particular emphasis on structure-function relationships and integrative physiological motor-control processes. Particular foci of attention include the respiratory function of the upper airway muscles, and the various reflex mechanisms underlying their control, specifically the reflex responses to changes in airway pressure, reflexes from pulmonary receptors, chemoreceptor and baroreceptor reflexes, and postural effects on upper airway motor control. This article also addresses the determinants of upper airway collapsibility and the influence of neural drive to the upper airway muscles, and the influence of common drugs such as ethanol, sedative hypnotics, and opioids on upper airway motor control. In addition to an examination of these basic physiological mechanisms, consideration is given throughout this review as to how these mechanisms relate to integrative function in the intact normal upper airway in wakefulness and sleep, and how they may be involved in the pathogenesis of clinical problems such obstructive sleep apnea hypopnea.
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28
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Fregosi RF, Ludlow CL. Activation of upper airway muscles during breathing and swallowing. J Appl Physiol (1985) 2013; 116:291-301. [PMID: 24092695 DOI: 10.1152/japplphysiol.00670.2013] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The upper airway is a complex muscular tube that is used by the respiratory and digestive systems. The upper airway is invested with several small and anatomically peculiar muscles. The muscle fiber orientations and their nervous innervation are both extremely complex, and how the activity of the muscles is initiated and adjusted during complex behaviors is poorly understood. The bulk of the evidence suggests that the entire assembly of tongue and laryngeal muscles operate together but differently during breathing and swallowing, like a ballet rather than a solo performance. Here we review the functional anatomy of the tongue and laryngeal muscles, and their neural innervation. We also consider how muscular activity is altered as respiratory drive changes, and briefly address upper airway muscle control during swallowing.
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Affiliation(s)
- Ralph F Fregosi
- Department of Physiology, University of Arizona, Tucson, Arizona
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29
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Furlan RMMM, Motta AR, Valentim AF, Barroso MFS, Costa CG, Las Casas EB. Protrusive tongue strength in people with severely weak tongues. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2013; 15:503-510. [PMID: 23336828 DOI: 10.3109/17549507.2012.752863] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of the study was to quantify tongue protrusion force and compare its characteristics between participants with severely weak tongues and those with normal lingual strength. The sample consisted of 11 participants with severe lingual strength deficits and 11 age- and sex-matched participants with normal lingual strength. Tongue force was evaluated quantitatively using the Forling instrument, and the average force, maximum force, average force application rate, and area under the graphic curve were analysed. These parameters were compared between the groups. In the participants with severely weak tongues, the average and the maximum forces in N (Newton) were 2.03 ± 1.17 and 3.56 ± 1.77, respectively. The average force application rate in N/s (Newton per second) was 1.25 and the area under the graphic curve in Ns (Newton times second) was 18.6. The values of the participants with normal lingual strength were, respectively, 13.27 ± 6.15 N, 18.91 ± 7.95 N, 10.46 N/s, and 108.08 Ns. All parameters analysed differed significantly between the groups. The data collected could aid speech-language pathologists in diagnosing problems related to tongue force.
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30
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Walls CE, Laine CM, Kidder IJ, Bailey EF. Human hypoglossal motor unit activities in exercise. J Physiol 2013; 591:3579-90. [PMID: 23690561 DOI: 10.1113/jphysiol.2013.252452] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
The genioglossus (GG) muscle is considered the principal protruder muscle of the tongue that dilates and stiffens the pharyngeal airway. We recorded whole muscle and single motor unit (MU) activities in healthy adults performing progressive intensity exercise on a cycle ergometer. Tungsten microelectrodes were inserted percutaneously into the GG of 11 subjects (20-40 years) to record electromyographic (EMG) activities and pulmonary ventilation (VI) at rest and at workload increments up to 300 W. Increases in respiratory drive were associated with increases in VI, mean inspiratory flow (Vt/Ti) and tonic and phasic components of the GG EMG activity. In contrast, individual MUs typically showed expiration-related decreases in firing as exercise intensity increased. We suggest the decrease in MU activity may occur secondary to afferent feedback from lungs/chest wall and that compensation for more negative inspiratory airway pressures generated during heavy exercise occurs primarily via recruitment of previously silent MUs.
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Affiliation(s)
- Clinton E Walls
- Department of Physiology, College of Medicine, The University of Arizona, Tucson, AZ 85721-0093, USA
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Almeida LDD, Furlan RMMM, Las Casas EBD, Motta AR. Influence of height, weight and body mass index in the axial tongue force. ACTA ACUST UNITED AC 2013; 24:381-5. [PMID: 23306690 DOI: 10.1590/s2179-64912012000400015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 08/13/2012] [Indexed: 11/22/2022]
Abstract
PURPOSE To analyze the influence of weight, height and body mass index in the axial tongue force. METHODS Medical records with data from 44 subjects aged between 20 and 37 years, 11 (25%) males and 33 (75%) female, were analyzed. The investigated information were weight, height, result of clinical evaluation for tongue force (lingual tonus) and instrumental assessment of axial tongue force, which was accomplished by using the FORLING. Data was statistically analyzed. RESULTS No differences were observed between the force values regarding the variables body mass index classification and clinical classification of tongue force. Body mass index and weight had positive correlation with mean tongue force. There was a strong positive correlation between the variables mean force, maximum force and highest maximum force. CONCLUSION Although body mass index and weight correlated positively with the mean axial tongue force, there was no association between body mass index classification and the axial tongue forces.
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Affiliation(s)
- Letícia Duarte de Almeida
- Undergraduate Program in Speech-Language Pathology and Audiology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Tawadros PB, Cordato D, Cathers I, Burne JA. An electromyographic study of parkinsonian swallowing and its response to levodopa. Mov Disord 2012; 27:1811-5. [DOI: 10.1002/mds.25262] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2012] [Revised: 09/05/2012] [Accepted: 09/27/2012] [Indexed: 11/06/2022] Open
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Furlan RMMM, Valentim AF, Motta AR, Barroso MFS, Costa CGD, Las Casas EBD. Métodos quantitativos para avaliação da força de língua. REVISTA CEFAC 2012. [DOI: 10.1590/s1516-18462012005000099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Por muitos anos, pesquisadores têm procurado métodos para quantificar a força da língua e muitos instrumentos foram construídos para este fim. O objetivo deste trabalho é apresentar uma revisão crítica da literatura sobre instrumentos para quantificar a força de língua. Os 30 aparelhos encontrados foram agrupados em quatro diferentes categorias: bocal contendo sensores (n=9), sensores fixados nos dentes, palato ou em placas palatais (n=8), bulbos preenchidos com fluidos e conectados a sensores de pressão (n=7) e outras tecnologias (n=8). Esses instrumentos podem, potencialmente, auxiliar o fonoaudiólogo na avaliação miofuncional orofacial, fazendo com que o diagnóstico de força da língua seja mais preciso. Alguns aparelhos apresentam desvantagens, tais como não serem sensíveis a pequenas mudanças de força, dificuldades na reprodutibilidade do posicionamento e outros pontos específicos. A grande variação de valores de força/pressão máxima e média encontrados relaciona-se à grande diversidade dos métodos, que empregam diferentes tecnologias.
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Stavness I, Lloyd JE, Fels S. Automatic prediction of tongue muscle activations using a finite element model. J Biomech 2012; 45:2841-8. [PMID: 23021611 DOI: 10.1016/j.jbiomech.2012.08.031] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Revised: 08/20/2012] [Accepted: 08/22/2012] [Indexed: 11/29/2022]
Abstract
Computational modeling has improved our understanding of how muscle forces are coordinated to generate movement in musculoskeletal systems. Muscular-hydrostat systems, such as the human tongue, involve very different biomechanics than musculoskeletal systems, and modeling efforts to date have been limited by the high computational complexity of representing continuum-mechanics. In this study, we developed a computationally efficient tracking-based algorithm for prediction of muscle activations during dynamic 3D finite element simulations. The formulation uses a local quadratic-programming problem at each simulation time-step to find a set of muscle activations that generated target deformations and movements in finite element muscular-hydrostat models. We applied the technique to a 3D finite element tongue model for protrusive and bending movements. Predicted muscle activations were consistent with experimental recordings of tongue strain and electromyography. Upward tongue bending was achieved by recruitment of the superior longitudinal sheath muscle, which is consistent with muscular-hydrostat theory. Lateral tongue bending, however, required recruitment of contralateral transverse and vertical muscles in addition to the ipsilateral margins of the superior longitudinal muscle, which is a new proposition for tongue muscle coordination. Our simulation framework provides a new computational tool for systematic analysis of muscle forces in continuum-mechanics models that is complementary to experimental data and shows promise for eliciting a deeper understanding of human tongue function.
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Affiliation(s)
- Ian Stavness
- Department of Bioengineering, Clark Center, Room S221, Stanford University, Mail Code 5448, 318 Campus Drive, Stanford, CA 94305, USA.
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Lee KZ, Fuller DD, Hwang JC. Pulmonary C-fiber activation attenuates respiratory-related tongue movements. J Appl Physiol (1985) 2012; 113:1369-76. [PMID: 22936725 DOI: 10.1152/japplphysiol.00031.2012] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The functional impact of pulmonary C-fiber activation on upper airway biomechanics has not been evaluated. Here, we tested the hypothesis that pulmonary C-fiber activation alters the respiratory-related control of tongue movements. The force produced by tongue movements was quantified in spontaneously breathing, anesthetized adult rats before and after stimulation of pulmonary C fibers via intrajugular delivery of capsaicin (0.625 and 1.25 μg/kg). Brief occlusion of the trachea was used to increase the respiratory drive to the tongue muscles, and hypoglossal (XII) nerve branches were selectively sectioned to denervate the protrusive and retrusive tongue musculature. Tracheal occlusion triggered inspiratory-related tongue retrusion in rats with XII nerves intact or following section of the medial XII nerve branch, which innervates the genioglossus muscle. Inspiratory-related tongue protrusion was only observed after section of the lateral XII branch, which innervates the primary tongue retrusor muscles. The tension produced by inspiratory-related tongue movement was significantly attenuated by capsaicin, but tongue movements remained retrusive, unless the medial XII branch was sectioned. Capsaicin also significantly delayed the onset of tongue movements such that tongue forces could not be detected until after onset of the inspiratory diaphragm activity. We conclude that altered neural drive to the tongue muscles following pulmonary C-fiber activation has a functionally significant effect on tongue movements. The diminished tongue force and delay in the onset of tongue movements following pulmonary C-fiber activation are potentially unfavorable for upper airway patency.
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Affiliation(s)
- Kun-Ze Lee
- Department of Biological Sciences, College of Science, National Sun Yat-sen University, Kaohsiung, Taiwan.
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Motta AR, César CC, Bommarito S, Chiari BM. Axial force of the tongue in different age groups. ACTA ACUST UNITED AC 2012; 23:201-5. [PMID: 22012153 DOI: 10.1590/s2179-64912011000300004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 07/11/2011] [Indexed: 11/22/2022]
Abstract
PURPOSE To analyze the maximum axial force, the mean axial force, the amount of energy accumulated by the tongue, and the time taken to reach the maximum axial force, in different age ranges. METHODS The records of 92 individuals - students, staff and visitors at an university -, 29 (32.6%) men and 63 (67.4%) women, with ages between 14 and 53 years old, were analyzed. Subjects were divided into four age groups: 14 to 18 years, 19 to 23 years, 24 to 28 years, and 29 to 53 years. Each subject underwent clinical and instrumental assessment of the tongue. Instrumental assessment used FORLING. Data were statistically analyzed. RESULTS Regarding the maximum force, the mean force and the tongue's accumulated energy, no differences were observed between groups. Regarding the time taken to reach the maximum force, the greatest values were obtained at the age range from 14 to 18 years (4.5 s), and the shortest values, at the age range from 19 to 23 years (3.1 s), with significant difference between the groups (p=0.001). CONCLUSION Only the time taken to reach the tongue's maximum force is influenced by age range, indicating that teenagers are not able to reach the maximum lingual force as fast as young adults.
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Johnson AN, Huo X, Ghovanloo M, Shinohara M. Dual-task motor performance with a tongue-operated assistive technology compared with hand operations. J Neuroeng Rehabil 2012; 9:1. [PMID: 22244362 PMCID: PMC3287148 DOI: 10.1186/1743-0003-9-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 01/13/2012] [Indexed: 01/09/2023] Open
Abstract
Background To provide an alternative motor modality for control, navigation, and communication in individuals suffering from impairment or disability in hand functions, a Tongue Drive System (TDS) has been developed that allows for real time tracking of tongue motion in an unobtrusive, wireless, and wearable device that utilizes the magnetic field generated by a miniature disk shaped magnetic tracer attached to the tip of the tongue. The purpose of the study was to compare the influence of a concurrent motor or cognitive task on various aspects of simple movement control between hand and tongue using the TDS technology. Methods Thirteen young able-bodied adults performed rapid and slow goal-directed movements of hand and tongue (with TDS) with and without a concurrent motor (hand or tongue) or cognitive (arithmetic and memory) task. Changes in reaction time, completion time, speed, correctness, accuracy, variability of displacement, and variability of time due to the addition of a concurrent task were compared between hand and tongue. Results The influence of an additional concurrent task on motor performance was similar between the hand and tongue for slow movement in controlling their displacement. In rapid movement with a concurrent motor task, most aspects of motor performance were degraded in hand, while tongue speed during rapid continuous task was maintained. With a concurrent cognitive task, most aspects of motor performance were degraded in tongue, while hand accuracy during the rapid discrete task and hand speed during the rapid continuous task were maintained. Conclusion Rapid goal-directed hand and tongue movements were more consistently susceptible to interference from concurrent motor and cognitive tasks, respectively, compared with the other movement.
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Affiliation(s)
- Ashley N Johnson
- School of Applied Physiology, Georgia Institute of Technology, Atlanta, GA, USA
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Fregosi RF. Respiratory related control of hypoglossal motoneurons--knowing what we do not know. Respir Physiol Neurobiol 2011; 179:43-7. [PMID: 21741499 DOI: 10.1016/j.resp.2011.06.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 06/24/2011] [Accepted: 06/26/2011] [Indexed: 10/18/2022]
Abstract
Because tongue position and stiffness help insure that the pharyngeal airspace is sufficiently open during breathing, the respiration-related behavior of the tongue muscles has been studied in detail, particularly during the last two decades. Although eight different muscles act upon the mammal tongue, we know very little about the respiration-related control of the majority of these, and almost nothing about how they work together as a complex electro-mechanical system. Other significant gaps include how hypoglossal motoneuron axons find their appropriate muscle target during development, whether the biophysical properties of hypoglossal motoneurons driving different muscles are the same, and how afferent information from cardiorespiratory reflex systems is transmitted from major brainstem integrating centers to the hypoglossal motoneuron pool. This brief review outlines some of these issues, with the hope that this will spur research in the field, ultimately leading to an improved understanding of the respiration-related control of the mammalian tongue musculature.
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Affiliation(s)
- Ralph F Fregosi
- Department of Physiology, College of Medicine and Department of Neuroscience, College of Science, The University of Arizona, Tucson, AZ 85721-0093, United States.
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Bailey EF. Activities of human genioglossus motor units. Respir Physiol Neurobiol 2011; 179:14-22. [PMID: 21558022 DOI: 10.1016/j.resp.2011.04.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 04/14/2011] [Accepted: 04/17/2011] [Indexed: 01/13/2023]
Abstract
Upper airway muscles play an important role in regulating airway lumen and in increasing the ability of the pharynx to remain patent in the face of subatmospheric intraluminal pressures produced during inspiration. Due to the considerable technical challenges associated with recording from muscles of the upper airway, much of the experimental work conducted in human subjects has centered on recording respiratory-related activities of the extrinsic tongue protudor muscle, the genioglossus (GG). The GG is one of eight muscles that invest the human tongue (Abd-El-Malek, 1939). All eight muscles are innervated by the hypoglossal nerve (cranial nerve XII) the cell bodies of which are located in the hypoglossal motor nucleus (HMN) of the caudal medulla. Much of the earlier work on the respiratory-related activity of XII motoneurons was based on recordings obtained from single motor axons dissected from the whole XII nerve or from whole muscle GG EMG recordings. Detailed information regarding respiratory-related GG motor unit activities was lacking until as recently as 2006. This paper examines key findings that have emerged from the last decade of work conducted in human subjects. Wherever appropriate, these results are compared with results obtained from in vitro and in vivo studies conducted in non-human mammals. The review is written with the objective of facilitating some discussion and some new thoughts regarding future research directions. The material is framed around four topics: (a) motor unit type, (b) rate coding and recruitment, (c) motor unit activity patterns, and (d) a compartment based view of pharyngeal airway control.
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Affiliation(s)
- E Fiona Bailey
- Department of Physiology, College of Medicine, The University of Arizona, Tucson, AZ 85721-0093, USA.
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BOUDREAU SA, HENNINGS K, SVENSSON P, SESSLE BJ, ARENDT-NIELSEN L. The effects of training time, sensory loss and pain on human motor learning. J Oral Rehabil 2010; 37:704-18. [DOI: 10.1111/j.1365-2842.2010.02103.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Richardson PA, Bailey EF. Tonically discharging genioglossus motor units show no evidence of rate coding with hypercapnia. J Neurophysiol 2010; 103:1315-21. [PMID: 20053847 DOI: 10.1152/jn.00686.2009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The genioglossus (GG) is considered the principle protrudor muscle of the human tongue. Unlike most skeletal muscles, GG electromyographic (EMG) activities are robustly preserved in sleep and thus may fulfill a critical role in preserving airway patency. Previous studies in human subjects also confirm that the GG EMG increases in response to chemoreceptor and mechanoreceptor stimulation. This increase occurs secondary to the recruitment of previously inactive motor units (MUs) and/or an increase in firing rate of already active MUs. Which strategy the nervous system uses when the synaptic drive onto GG motoneurons increases is not known. Here we report on GG whole muscle and tonic MU activities under conditions that mimic sleep, i.e., mild-moderate elevations in CO(2) (3% inspired CO(2) or the addition of a 1.0 l dead space) and elevated airway resistance. Based on previous work in rat, we hypothesized that mild hypercapnia would increase the firing rates of tonic MUs and that these effects would be further potentiated by a modest increase in airway resistance. Fine wire and tungsten microelectrodes were inserted into the GG to record whole muscle and single MU activities in 21 subjects (13 women, 8 men; 20-55 yr). Either 3% inspired CO(2) or added dead space resulted in a 200-300% increase in the amplitude of both tonic and phasic components of the whole muscle GG EMG and a doubling of minute ventilation. Despite these changes, recordings obtained from a total of 84 tonically discharging GG single MUs provide no evidence of a change in firing rate under any of the conditions. On this basis we conclude that in healthy adults, the increase in the tonic component of the whole muscle GG EMG secondary to mild hypercapnia is due almost exclusively to the recruitment of previously inactive MUs.
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Affiliation(s)
- Patrick A Richardson
- Dept. of Physiology, College of Medicine, The University of Arizona, Tucson, AZ 85721-0093, USA
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Saboisky JP, Chamberlin NL, Malhotra A. Potential therapeutic targets in obstructive sleep apnoea. Expert Opin Ther Targets 2009; 13:795-809. [PMID: 19530985 DOI: 10.1517/14728220903005608] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Obstructive sleep apnoea (OSA) is a disease of ever-increasing importance due to its association with multiple impairments and rising prevalence in an increasingly susceptible demographic. The syndrome is linked with loud snoring, disrupted sleep and observed apnoeas. Serious co-morbidities associated with OSA appear to be reversed by continuous positive airway pressure (CPAP) treatment; however, CPAP is variably tolerated leaving many patients untreated and emphasising the need for alternative treatments. Virtually all OSA patients have airways that are anatomically vulnerable to collapse, but numerous pathophysiological factors underlie when and how OSA is manifested. This review describes how the complexity of OSA requires multiple treatment approaches that are individually targeted. This approach may take the form of more specific diagnoses in terms of the mechanisms underlying OSA as well as rational pharmacological treatment directed toward such disparate ends as arousal threshold and ventilatory control/chemosensitivity, and mechanical treatment in the form of surgery and augmentation of lung volumes.
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Affiliation(s)
- Julian P Saboisky
- Brigham and Women's Hospital, Harvard Medical School, Division of Sleep Medicine, 221 Longwood Avenue, Boston, Massachusetts 02115, USA.
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