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Oh D, Park HS, Park MW, Kim HJ, Choi WY, Park JS. Chin-tuck assistant system (CAS)-A novel method using auditory feedback for postural maintenance in a chin-tuck maneuver: A randomized trial. Medicine (Baltimore) 2023; 102:e33257. [PMID: 37000087 PMCID: PMC10063257 DOI: 10.1097/md.0000000000033257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 04/01/2023] Open
Abstract
INTRODUCTION Chin-tuck are effective in patients with dysphagia, where aspiration can occur due to pharyngeal swallowing delays. This study aims to verify whether Chin-tuck Assistant System Maneuver (CAS-M) supplemented with Chin-Tuck Maneuver (CTM) is effective for learning and maintaining correct chin-tuck postures. In addition, we investigated the possibility of using CAS-M as a customized rehabilitation treatment program for patients with poor cognitive ability, attention issues, and general swallowing disorders. INTERVENTION To demonstrate the effectiveness of CAS, we recruited 52 healthy adults and assigned them to 2 groups. The CTM group was trained to maintain the correct chin-tuck posture using the general Chin-Tuck Maneuver, while the CAS-M group was trained using CAS. Four evaluations were conducted using CAS to investigate the degree of postural maintenance of chin-tuck before and after intervention. RESULTS The CAS-M group showed a statistically significant difference in TIME, BEEP, and change (P < .05), but the CTM group showed no statistically significant differences (P < .05). YZ evaluation showed no statistically significant differences in both groups. CONCLUSION After examining the effects of CAS-M using CAS on healthy adults, we confirmed this to be a more effective method for correct chin-tuck posture than conventional CTM.
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Affiliation(s)
- Donghwan Oh
- Department of Occupational Therapy, Kyungdong University, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Han Sol Park
- Korea Social Security Information Service, Gwangjin-gu, Seoul, Republic of Korea
| | - Myung Won Park
- Department of Occupational Therapy, Kyungdong University, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Ho Jeong Kim
- Department of Occupational Therapy, Kyungdong University, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Wan Young Choi
- Department of Occupational Therapy, Kyungdong University, Munmak-eup, Wonju-si, Gangwon-do, Republic of Korea
| | - Ji-Su Park
- Research Institute for Korean Medicine, Pusan National University, Yangsan-si, Gyeongsangnam-do, Republic of Korea
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Xiong H, Chen JJ, Gikaro JM, Wang CG, Lin F. Activation Patterns of Functional Brain Network in Response to Action Observation-Induced and Non-Induced Motor Imagery of Swallowing: A Pilot Study. Brain Sci 2022; 12:brainsci12101420. [PMID: 36291353 PMCID: PMC9599111 DOI: 10.3390/brainsci12101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/09/2022] [Accepted: 10/18/2022] [Indexed: 11/20/2022] Open
Abstract
Action observation (AO) combined with motor imagery (MI) was verified as more effective in improving limb function than AO or MI alone, while the underlying mechanism of swallowing was ambiguous. The study aimed at exploring the efficacy of AO combined with MI in swallowing. In this study, twelve subjects performed the motor imagery of swallowing (MI-SW) during magnetoencephalography (MEG) scanning, and trials were divided into three groups: the non-induced group (control group, CG), male AO-induced group (M-AIG), and female AO-induced group (F-AIG). We used event-related spectral perturbations (ERSPs) and phase locking value (PLV) to assess the degree of activation and connectivity of the brain regions during MI-SW in the three groups. The results showed that compared to CG, F-AIG and M-AIG significantly activated more brain regions in the frontoparietal, attention, visual, and cinguloopercular systems. In addition, M-AIG significantly activated the sensorimotor cortex compared to CG and F-AIG. For the brain network, F-AIG and M-AIG increased the diffusion of non-hub hot spots and cold hubs to the bilateral hemispheres which enhanced interhemispheric functional connectivity and information transmission efficiency in the MI-SW task. This study provided supporting evidence that AO induction could enhance the effect of MI-SW and supported the application of AO-induced MI-SW in clinical rehabilitation.
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Affiliation(s)
- Hao Xiong
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
| | - Jin-Jin Chen
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
| | - John M. Gikaro
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing 210029, China
| | - Chen-Guang Wang
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital Nanjing Medical University, Nanjing 211100, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
- Correspondence: ; Tel.: +86-025-87115719
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Li Y, Ling M, Huang S, Liang X, Qin Y, Luo Z, Zhou J. The Resting-State Brain Network Functional Connectivity Changes in Patients With Acute Thyrotoxic Myopathy Based on Independent Component Analysis. Front Endocrinol (Lausanne) 2022; 13:829411. [PMID: 35399921 PMCID: PMC8986988 DOI: 10.3389/fendo.2022.829411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/21/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The independent component analysis (ICA) was applied to explore the correlation between clinical manifestation and the functional connectivity changes of the sensorimotor network (SMN) and left frontoparietal network (LFPN) in patients with acute thyrotoxic myopathy (ATM), which was expected to provide a functional imaging basis for the exploration of the pathophysiological mechanism of ATM. METHODS 13 ATM patients (ATM) and 12 non-ATM patients (nATM) who met the diagnostic and inclusion criteria were enrolled. Their resting-state brain function images were obtained with resting-state functional magnetic resonance imaging (rs-fMRI). GIFT software was used for independent component analysis to obtain the brain regions with SMN and LFPN changes. The correlation between the functional connectivity of these brain regions and clinical indicators was calculated. RESULTS The SMN functional connectivity of ATM patients was increased at the posterior lobe of cerebellum, anterior lobe of cerebellum, right superior temporal gyrus, left cingulate gyrus, left precuneus, and left postcentral gyrus compared with that of nATM patients. However, it was decreased at the occipital lobe, right dorsolateral superior frontal gyrus, paracentral lobule, angular gyrus, and superior parietal gyrus (FDR correction, P<0.05). The LFPN functional connectivity of ATM patients was increased at the posterior lobe of cerebellum, middle temporal gyrus, inferior temporal gyrus, and right cingulate gyrus compared with that of nATM patients; but was decreased at frontal lobe, parahippocampal gyrus, precentral gyrus and postcentral gyrus (FDR correction, P<0.05) Correlation analysis results showed that the enhancement of SMN functional connection at right superior temporal gyrus was significantly negatively correlated with the free thyroxine level, and the decrease of SMN functional connectivity at occipital lobe was significantly positively correlated to the thyroid stimulating hormone level. The SMN and LFPN functional connectivity changes in other brain regions were not found to be significantly correlated with thyroid function parameters. CONCLUSION The bulbar paralysis (such as dysphagia, dysarthria) in ATM patients may be related to the functional connectivity changes of resting-state SMN and LFPN. The fMRI is expected to be one of the objective imaging indicators for the early clinical intervention of ATM patients.
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Affiliation(s)
- Yanfang Li
- Department of Internal Medicine, Zhuhai Center for Chronic Disease Control, Zhuhai, China
| | - Min Ling
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Song Huang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xinghuan Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yingfen Qin
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jia Zhou
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
- *Correspondence: Jia Zhou,
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Jing YH, Lin T, Li WQ, Wu C, Li X, Ding Q, Wu MF, Xu GQ, Lan Y. Comparison of Activation Patterns in Mirror Neurons and the Swallowing Network During Action Observation and Execution: A Task-Based fMRI Study. Front Neurosci 2020; 14:867. [PMID: 32973431 PMCID: PMC7472888 DOI: 10.3389/fnins.2020.00867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 07/27/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Observation of a goal-directed motor action can excite the respective mirror neurons, and this is the theoretical basis for action observation (AO) as a novel tool for functional recovery during stroke rehabilitation. To explore the therapeutic potential of AO for dysphagia, we conducted a task-based functional magnetic resonance imaging (fMRI) study to identify the brain areas activated during observation and execution of swallowing in healthy participants. METHODS Twenty-nine healthy volunteers viewed the following stimuli during fMRI scanning: an action-video of swallowing (condition 1, defined as AO), a neutral image with a Chinese word for "watching" (condition 2), and a neutral image with a Chinese word for "swallowing" (condition 3). Action execution (AE) was defined as condition 3 minus condition 2. One-sample t-tests were performed to define the brain regions activated during AO and AE. RESULTS Many brain regions were activated during AO, including the middle temporal gyrus, inferior frontal gyrus, pre- and postcentral gyrus, supplementary motor area, hippocampus, brainstem, and pons. AE resulted in activation of motor areas as well as other brain areas, including the inferior parietal lobule, vermis, middle frontal gyrus, and middle temporal gyrus. Two brain areas, BA6 and BA21, were activated with both AO and AE. CONCLUSION The left supplementary motor area (BA6) and left middle temporal gyrus (BA21), which contains mirror neurons, were activated in both AO and AE of swallowing. In this study, AO activated mirror neurons and the swallowing network in healthy participants, supporting its potential value in the treatment of dysphagia.
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Affiliation(s)
- Ying-hua Jing
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Tuo Lin
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Wan-qi Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Cheng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Xue Li
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qian Ding
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Man-feng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, 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
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, Guangzhou Medical University, Guangzhou, China
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Li CM, Lee HY, Hsieh SH, Wang TG, Wang HP, Chen JJJ. Development of Innovative Feedback Device for Swallowing Therapy. J Med Biol Eng 2016. [DOI: 10.1007/s40846-016-0146-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lima MSD, Mangilli LD, Sassi FC, Andrade CRFD. Functional magnetic resonance and swallowing: critical literature review. Braz J Otorhinolaryngol 2015; 81:671-80. [PMID: 26394917 PMCID: PMC9442730 DOI: 10.1016/j.bjorl.2015.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 02/01/2015] [Indexed: 11/28/2022] Open
Abstract
Introduction Aspects of the neuroanatomical representation of swallowing have been investigated in humans through brain mapping techniques, such as functional magnetic resonance imaging (fMRI). Objective This critical qualitative review of the literature analyzed international scientific publications in the PubMed database that investigated the activation of the central nervous system in humans during the act of swallowing. Methods This investigation was limited to articles that investigated adults older than 18 years, published in English or Portuguese, between January 2002 and December 2013. Publications that did not have access to the full text, that were repeated by overlapping keywords, case studies, literature reviews, letters to the editor, and those not directly related to the topic of the investigation were excluded. Results A total of 649 articles were identified, of which 21 matched the inclusion criteria. Conclusion The main purpose of the manuscripts that investigate the swallowing process through fMRI were: to characterize swallowing in different pathologies; to compare swallowing in different age groups; to describe brain activation in different stimulation conditions. These studies indicate multiple cortical regions involved in swallowing control. Overall, the studies indicate that fMRI is a non-invasive and quantitative method that allows the investigation of characteristics that are quite often not clinically visible.
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Affiliation(s)
- Maíra Santilli de Lima
- Speech Therapy in Orofacial Functions, Speech Therapy Support Unit, Instituto Central do Hospital de Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFM-USP), São Paulo, SP, Brazil
| | - Laura Davison Mangilli
- Sciences, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Rehabilitation Science Medical Investigation Laboratory, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFM-USP), São Paulo, SP, Brazil
| | - Fernanda Chiarion Sassi
- Sciences, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil; Department of Physical Therapy, Speech Therapy and Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo (FM-USP), São Paulo, SP, Brazil
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Mirror neurons activated during swallowing and finger movements: An fMRI study. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2014. [DOI: 10.1016/j.ajoms.2013.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Malandraki GA, Johnson S, Robbins J. Functional MRI of swallowing: from neurophysiology to neuroplasticity. Head Neck 2011; 33 Suppl 1:S14-20. [PMID: 21901779 DOI: 10.1002/hed.21903] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2011] [Indexed: 01/09/2023] Open
Abstract
Swallowing is a complex neurogenic sensorimotor process involving all levels of the neuraxis and a vast number of muscles and anatomic structures. Disruption of any of these anatomic or functional components can lead to swallowing disorders (also known as dysphagia). Understanding the neural pathways that govern swallowing is necessary in diagnosing and treating patients with dysphagia. Functional MRI (fMRI) is a prevalent and effective neuroimaging method that has been used to study the complex neurophysiologic control of swallowing in vivo. This article presents a summary of the research studies that have used fMRI to study the neural control of swallowing in normal subjects and dysphagic patients, and to investigate the effects of swallowing treatments on neuroplasticity. Methodologic challenges and caveats are discussed, and a case study of a pre-posttreatment paradigm is presented to highlight potential future directions of fMRI applications in swallowing research and clinical practice.
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Affiliation(s)
- Georgia A Malandraki
- Department of Biobehavioral Sciences, Program of Speech and Language Pathology, Teachers College, Columbia University, New York, New York, USA.
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Humbert IA, Joel S. Tactile, gustatory, and visual biofeedback stimuli modulate neural substrates of deglutition. Neuroimage 2011; 59:1485-90. [PMID: 21872665 DOI: 10.1016/j.neuroimage.2011.08.022] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2011] [Revised: 08/08/2011] [Accepted: 08/09/2011] [Indexed: 10/17/2022] Open
Abstract
It has been well established that swallowing kinematics are modified with different forms of exogenous and endogenous input, however the underlying neural substrates associated with these effects are largely unknown. Our objective was to determine whether the swallowing BOLD response is modulated with heightened sensory modalities (taste, cutaneous electrical stimulation, and visual biofeedback) compared to water ingestion (control) in healthy adults across the age span. Habituation and sensitization were also examined for each sensory condition. Our principal findings are that each sensory swallowing condition activated components of the swallowing cortical network, plus regions associated with the particular sensory modality (i.e. primarily frontal motor planning and integration areas with visual condition). Overall, the insula was most commonly active among the sensory modalities. We also discuss gradual increases and decreases in BOLD signal with repeated exposures for each condition. We conclude that both stimulus- and intention-based inputs have unique cortical swallowing networks relative to their modality. This scientific contribution advances our understanding of the mechanisms of normal swallowing cortical control and has the potential to impact clinical uses of these modalities in treatments for neurogenic dysphagia.
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Affiliation(s)
- Ianessa A Humbert
- Department of Physical Medicine and Rehabilitation, Johns Hopkins School of Medicine, 98 North Broadway, Suite 403, Baltimore, MD 21231, USA.
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