This paper reviews the method’s history and selected data, outlines the theoretical underpinnings of sensory stimulation, reminds readers of what is required to bring a treatment from the laboratory to the clinic, and ends with some notions about the importance of belief and data in rehabilitation. Dysphagia. Current strategies of swallowing therapy involve on the one hand modification of eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of pharyngeal sensory stimulation. X-axis represents time in seconds related to M1. A difference plot of both conditions demonstrates stronger desynchronization in the stimulation condition compared to the reference measurement (see figure 1c). The electrodes were connected to a bipolar amplifier (DSQ 2017E EOG/EMG system, CTF Systems Inc., Canada), and the nominal gain was set at 1. Dziewas R, Teismann IK, Suntrup S, Schiffbauer H, Steinstraeter O, Warnecke T, Ringelstein EB, Pantev C: Cortical compensation associated with dysphagia caused by selective degeneration of bulbar motor neurons. She was funded by the Deutsche Forschungsgemeinschaft. Different behavioural studies examined the effect of oropharyngeal stimulation before. TTS significantly reduced median pharyngeal transit time on fluids (0.20 s, 95% CI = 0.12-0.28, p = 0.004) and on paste (0.3 s, 95% CI = 0.08-0.66, p = 0.01). Lazzara and co-workers could show that TTOS on 25 patients with different neurologic diseases resulted in an improved triggering of the swallowing reflex in 23 of these patients [33]. In the present study we could demonstrate an increase of cortical activation after thermal tactile oral stimulation. T1-weighted sagittal anatomical images with in-plane resolution of 512 × 512 (0.6 × 0.6 mm resolution) and 320 slices (0.5 mm thickness) were recorded using spoiled gradient echo imaging. Comparison of both conditions revealed a significantly stronger activation after TTOS compared to the normal swallowing task (p < 0.05). It is still unclear whether these findings will translate into a clinically beneficial effect. 10.1016/0003-9993(93)90082-L. Daniels SK, Foundas AL, Iglesia GC, Sullivan MA: Lesion site in unilateral stroke patients with dysphagia. Dziewas R, Soros P, Ishii R, Chau W, Henningsen H, Ringelstein EB, Knecht S, Pantev C: Cortical processing of esophageal sensation is related to the representation of swallowing. In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. Neumann S, Bartolome G, Buchholz D, Prosiegel M: Swallowing therapy of neurologic patients: correlation of outcome with pretreatment variables and therapeutic methods. The two conditions, after and without TTOS, did not differ in swallowing behaviour. However, based on the present study we cannot distinguish whether the observed effects are caused by the stimulation of the AFP or only by the swallowing of a chilled bolus. Thermal-tactile stimulation and changing bolus characteristics (therapeutic procedure is mentioned above under section B.) CAS  The enhanced swallowing ability seen in dysphagic patients observed after application of TTOS [32, 33] supports the hypothesis of cortical reorganization. This procedure was performed directly before the corresponding MEG measurement. a) Significant cortical activation after volitional swallowing without oropharyngeal stimulation. 2004, 75 (6): 852-856. Further examinations employing TTOS in dysphagic patients have to show that increased cortical activation is paralleled by an improved swallowing performance. Additionally cortical and behavioral changes of TTOS have to be examined in dysphagic patients. Google Scholar. 1996, 105 (2): 92-97. The time-frequency plots of the parietal channels were determined for both hemispheres and averaged across all subjects in each group. Finally, the 1: 1 complex film showed the strongest reversibility upon thermal stimulation. Tactile thermal oral stimulation increases the cortical representation of swallowing. The effects of TTS on swallowing have not yet been investigated in IPD. Postural Techniques (compensatory procedures): Limit the amount of each bolus so the bolus can be held in the pharyngeal recesses and the volume is not so large that it will overflow into the open airway. Manage cookies/Do not sell my data we use in the preference centre. Hum Brain Mapp. Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. TTS did not significantly alter median oral transit time on either fluid or paste consistency. Tactile-thermal application for treating dysphagia has a tumultous history. 10.1007/BF00714591. Although in the present experiment SAM analysis of the first two 200 ms intervals did not reveal significant activation in either hemisphere, an increase of right hemispheric activation was seen in the following time intervals. Logemann J: Evaluation and treatment of swallowing disorders. To define the active frequency bands and to examine the temporal sequencing of activation time-frequency plots were calculated using wavelet analysis. 1995, 10 (1): 1-5. According to the changes of the time-frequency analysis MEG data were than filtered within two frequency bands: alpha (8–13 Hz) and beta (13–30 Hz). After an initial increase of more than 50% of EMG activity, the beginning of main muscle activation (M1; 100% increase of activation) and the end of swallowing specific muscle activation (M2; 50% decrease of activation) were marked. In 8 subjects the normal swallowing task was done first, the other 7 started with oral stimulation. Afterwards the two time intervals "execution" (1) and "predeglution" (5) were defined for further calculations. Human swallowing is a complex neuromuscular procedure modulated by sensory feedback [1, 2]. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). In contrast, after TTOS significant left lateralized activation was seen in all 5 time intervals. They are innervated by the maxillary branch of the trigeminal nerve and the glossopharyngeal nerve. Gastroenterology. Clinical studies showed that tactile stimulation of the AFP increases swallowing speed and facilitates deglutition for several minutes. Am J Physiol Gastrointest Liver Physiol. While many patients experience recovery of swallowing within the first few weeks after stroke, 40% of dysphagic stroke patients develop aspiration pneumonia which in turn increases the use of artificial feeding, length of hospital stay, and mortality [10]. By correlating temperature with colour, a thermal tactile display can therefore be developed to provide a sense of colour, especially for the individuals who are blind or visually impaired. 10.1016/S0003-9993(98)90200-3. It is hypothesized that the touch and cold The effects of TTS on swallowing have not yet been investigated in IPD. Hamalainen MS: Magnetoencephalography: a tool for functional brain imaging. Clin Neurophysiol. 2005, 16 (5): 439-443. A clear distinction between the two phases based on the submental EMG recordings is not possible. 2000, 12 (6): 567-572. Interestingly, the illusion was reported to disappear when the middle digit was lifted off the thermal stimulator, suggesting that tactile stimulation is … The Mirror can be sterilized by steam, hot air or antiseptic solutions. Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Magnetic fields were recorded with a sample frequency of 600 Hz. This study compared the effectiveness of neuromuscular electrical stimulation and thermal tactile oral stimulation, a traditional swallowing recovery treatment, in patients with sub-acute dysphagia caused by stroke. In the present study a significant increase of cortical swallowing activation was observed after TTOS compared to a swallowing paradigm without stimulation. The tip of the tube was placed in the corner of the mouth between the buccal part of the teeth and the cheek. Quantitative data: timing measures. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. Each individual's EMG signal was used to mark the beginning of main muscle activation (M1) and the end of the task-specific muscle activity (M2) for every single swallow (see figure 4). Dysphagia. Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). The color bar represents the t-value. Estimation of the according swallowing phase is shown. PubMed Central  We hypothesized an increased swallowing related activation of the somatosensory cortex after oropharyngeal stimulation compared to the baseline condition without prior stimulation. 10.1016/j.neuroimage.2004.07.007. California Privacy Statement, Logemann JA: The need for clinical trials in dysphagia. 10.1007/BF00261272. Junghoefer M, Peyk P: Analysis of electrical potentials and magnetic fields of the brain. A LI of about 0 represents indeterminate dominance, 1, respectively -1 are indicating unilateral activation [26, 52]. To account for uncorrelated sensor noise, this difference is normalized by the mapped noise power [46]. By continuing you agree to the use of cookies. The side chosen for tube placement was alternated between subjects but consistent in each subject. The Laryngeal Mirror provides thermal-tactile stimulation during swallowing therapy. Exp Brain Res. OS has made analysis and interpretation of data and was involved in drafting the manuscript. MRI data were acquired on a 3.0 T Scanner (Gyroscan Intera, Philips Medical Systems, Best, The Netherlands) with a standard head coil. The peak of the ERD was located bilaterally in the same area around the central gyrus in both conditions. TTS did not significantly alter median oral transit time on either fluid or paste consistency. The first study focusing on this topic in 1997 demonstrated a facilitation of the cortical pathways by cranial nerve stimulation [37]. This suggests that afferents from the oral-pharyngeal chemoreceptors can facilitate deglutition [36]. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a cohort of people with IPD and known oropharyngeal dysphagia. Event related desynchronization. Dysphagia. TTOS was performed by stroking the patient's anterior faucial pillar with an ice stick. Dysphagia. CAS  2002, 112 (12): 2204-2210. By providing sensory stimulation via a cold probe to the anterior faucial arches, sensitivity within the oral cavity is purported to be heightened, leading to a more rapid triggering of the pharyngeal swallow upon Thermal tactile stimulation also, known as thermal application (Rosenbek, Robbins, Fishback, & Levine, 1991, p. 1258) is one type of therapy used for the treatment of swallowing disorders. Thirteen participants with IPD and known dysphagia attended for videofluoroscopy during which standardised volumes of liquid barium and barium paste were administered preceding and immediately subsequent to TTS. Finally, patients with a chronic pharyngeal stage dysfunction revealed stronger right hemispheric activation, both in size and time, indicating cortical compensation of their pharyngeal dysphagia [41]. PubMed Central  Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. CAS  2004, 131 (4): 548-555. Median total transit time was also reduced on fluids (0.48 s, 95% CI = 0.00-1.17, p = 0.049) and on paste (0.52 s, 95% CI = 0.08-1.46, p = 0.033). Neurol Clin Neurophysiol. Wavelet group analysis of MEG sensor recordings revealed distinct activation in the higher alpha and lower beta frequency band in the parietal sensors with a reduction of activation at about M1 and a re-increase after about 400 – 600 ms. Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: a randomized controlled trial. Am J Physiol. Furlong PL, Hobson AR, Aziz Q, Barnes GR, Singh KD, Hillebrand A, Thompson DG, Hamdy S: Dissociating the spatio-temporal characteristics of cortical neuronal activity associated with human volitional swallowing in the healthy adult brain. Tactile thermal oral stimulation increases the cortical representation of swallowing (2009) Comparing Treatment Intensities of Tactile-Thermal Application (1998) Neuromuscular electrical and thermal-tactile stimulation for dysphagia caused by stroke: A randomized controlled trial (2009) Thermal tactile stimulation also, known as thermal application is one type of therapy used for the treatment of swallowing disorders. 2003, 20 (1): 135-144. J Speech Hear Res. 1983, San Diego CA: CH Press. 2008. 2001, 25 (2): 249-271. 10.1016/S0304-3940(01)02483-1. The color bar represents the t-value. Recordings were performed while subjects were seated in a comfortably upright position and watching a self selected silent movie. For comparison of both conditions a standard permutation test for unpaired samples was performed [51]. Since then stimulation of the AFP and other parts of the oropharynx became a common treatment for dysphagia [12–15]. Article  Jurkiewicz MT, Gaetz WC, Bostan AC, Cheyne D: Post-movement beta rebound is generated in motor cortex: Evidence from neuromagnetic recordings. Our results provide an insight into the physiological mechanisms by which TTOS might lead to the previously observed facilitation of swallowing. This revealed ERD of rhythmic brain activity within sensorimotor cortex in each individual subject and interval. Cook IJ, Kahrilas PJ: AGA technical review on management of oropharyngeal dysphagia. Though long term changes in swallowing behavior after TTOS could not be shown yet, our findings may point to therapeutical approaches in swallowing rehabilitation. This study is aimed to investigate whether thermal oral (tongue) stimulation can modulate … Definition of active, resting and background stages of swallowing-related muscle activity. 2008, 8 (1): 13-10.1186/1471-2377-8-13. Median total transit time was also reduced on fluids (0.48 s, 95% CI = 0.00-1.17, p = 0.049) and on paste (0.52 s, 95% CI = 0.08-1.46, p = 0.033). A positive LI indicates left hemispheric lateralization, while a negative LI indicates stronger right hemispheric activation. 1999, 116 (2): 455-478. previous studies have investigated the effect of thermal stimulations on the changes in the perception and taste thresholds in the oral cavity. Article  2004, 115 (10): 2382-2390. 2004, 286 (1): G45-50. To distinguish the swallowing execution phase, each individual's EMG signal was used to mark the swallowing related muscle activation. Based on their findings, Daniels and co-workers suggested a left hemisphere control for volitional aspects of swallowing and a right hemisphere control for reflexive swallowing behaviour. Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. Google Scholar. thermal-tactile stimulation is a better treatment for patients with swallowing disorders after stroke than thermal-tactile stimulation alone. Article  Dysphagia. Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). Jean A, Car A, Roman C: Comparison of activity in pontine versus medullary neurones during swallowing. AJNR Am J Neuroradiol. 1975, 22 (2): 211-220. EMG data was high pass filtered with 0.1 Hz before markers were manually set. Hum Brain Mapp. Dysphagia. First results in this field of research revealed an increased cortical excitability evoked by pharyngeal stimulation [20, 21]. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. The aim of this study was to investigate the immediate effects of TTS on the timing of swallow in a cohort of people with IPD and known oropharyngeal dysphagia. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In the present study we employed whole-head MEG and SAM analyses to study cortical activity during self-paced volitional swallowing with and without preceding TTOS. Neurobiol Aging. This method involves stroking or rubbing the anterior faucial pillars with a cold probe prior to having the patient swallow. 10.1007/s00455-005-9007-2. 10.1136/jnnp.2003.019075. 2002, 113 (3): 354-366. ---Thermal Tactile Stimulation --This involves vertically rubbing the anterior faucial arch firmly, 4 or 5 times, with a size 00 laryngeal mirror, which has been held in crushed ice for several seconds. MEG data were collected using a whole head 275-channel SQUID sensor array (Omega 275, CTF Systems Inc.). Department of Neurology, University of Muenster, Albert-Schweitzer-Str.33, 48149, Muenster, Germany, Inga K Teismann, Tobias Warnecke, Sonja Suntrup, Erich B Ringelstein & Rainer Dziewas, Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Malmedyweg 15, 48149, Muenster, Germany, Inga K Teismann, Olaf Steinsträter, Sonja Suntrup & Christo Pantev, You can also search for this author in Data from each individual subject was averaged across trials (-2 to 2 s in reference to M1) and time-frequency analysis was performed (0 – 150 Hz). The effects of TTS on swallowing have not yet been investigated in IPD. Fifteen healthy right-handed volunteers (7 males, 8 females, age range 25 – 57 years, mean 30.4 years) served as subjects. 1993, 74 (12): 1295-1300. Key words: swallowing, dysphagia, stroke, neuromuscular electrical stimulation. Significant results may be attributed to the role of sensory stimulation in improving motor function in IPD, with emphasis on the impaired glossopharyngeal and vagus nerves in this population. To facilitate volitional swallowing during MEG recording water was infused into the oral cavity via a flexible plastic tube 4.7 mm in diameter attached to a fluid reservoir. There is little data reporting the effectiveness of this therapy. Here the early intervals represent the oral phase of deglutition while the later intervals are part of the pharyngeal swallowing phase. Motor tasks have been shown to result in event-related desynchronisations (ERD) of the cortical beta rhythm in cortical motor areas [23, 24]. All authors read and approved the final version of the manuscript. Privacy Neuroimage. Chau W, Herdman AT, Picton TW: Detection of power changes between conditions using split-half resampling of synthetic aperture magnetometry data. Number of swallows (normal swallowing: 39 – 141 swallows in 15 min, mean 73.5; oral stimulation: 41 – 139, mean 73.7; p = 0.774) as well as duration per swallow (1.13 – 2.88 s, mean 2.06 s, oral stimulation: 1.37 – 2.68; mean: 2.15; p = 0.7945) did not differ between the two tasks. Initiation- The patient will demonstrate a swallow delay of only 1-2 seconds following thermal tactile stimulation on 10/10 therapeutic trials to decrease aspiration risk Compensatory- Patient will demonstrate adequate use of the following compensatory strategies (chin tuck, multiple swallows, head turn, etc.) PubMed  2007, 22 (1): 1-10. In contrast to this, TTOS revealed increased bihemispheric activation with predominant activation of the left somatosensory cortical areas during the whole swallowing interval. / Regan, Julie; Walshe, Margaret; Tobin, W. Oliver. 10.1007/s00455-005-9009-0. volume 10, Article number: 71 (2009) This is also supported by the MEG study of our group mentioned above [29]. Julie Regan, Margaret Walshe, W. Oliver Tobin, Research output: Contribution to journal › Article › peer-review. Neuroimage. Logemann JA, Pauloski BR, Colangelo L, Lazarus C, Fujiu M, Kahrilas PJ: Effects of a sour bolus on oropharyngeal swallowing measures in patients with neurogenic dysphagia. 2006, 21 (1): 49-55. Vrba J, Robinson SE: Signal processing in magnetoencephalography. • Patient will utilize thermal tactile stimulation to increase oral sensation for safe consumption of least restrictive diet with (min/mod/max) verbal, visual and tactile cues • The patient will move the bolus to the back of the mouth and propel the food and liquid in a timely manner with thermal tactile stimulation to safely consume least restrictive diet with (min/mod/max) verbal, visual and tactile … Arch Phys Med Rehabil. Additionally to the observed and well known behavioural changes following oropharyngeal stimulation few studies focussed on its effects regarding the cortical level. Arch Phys Med Rehabil. It is still unclear whether these findings will translate into a clinically beneficial effect.". Wavelet analysis of the parietal areas. Many thermal tactile displays have been developed to PubMed  TTS did not significantly alter median oral transit time on either fluid or paste consistency. TR is an important phenomenon that reflects how thermal and tactile modalities coordinate to resolve AB - Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson's disease (IPD). CAS  2002, 318 (2): 73-76. Nichols TE, Holmes AP: Nonparametric permutation tests for functional neuroimaging: a primer with examples. 2. In the difference plot blue corresponds to stronger activation in the measurement after stimulation, while red demonstrates stronger activation in the condition without stimulation. Clinical sequelae of dysphagia in this group include weight loss and aspiration pneumonia, the latter of which is the leading cause of hospital admissions and death in IPD. The 275 channels of the MEG system were fragmented into 10 channel groups, frontal, central, parietal, temporal and occipital channels in each hemisphere. Therefore the results of the normal swallowing condition found in the present study are mainly concordant with the previous investigation. Yetkin FZ, Hammeke TA, Swanson SJ, Morris GL, Mueller WM, McAuliffe TL, Haughton VM: A comparison of functional MR activation patterns during silent and audible language tasks. Significant activation in group analysis is shown (p < 0.001). About five percent of the trials were rejected due to overlap between (1) and (2) or between (4) and (2) of the subsequent swallow. Power M, Fraser C, Hobson A, Rothwell JC, Mistry S, Nicholson DA, Thompson DG, Hamdy S: Changes in pharyngeal corticobulbar excitability and swallowing behavior after oral stimulation. Either thermal or taste stimuli are supposed to heighten the sensitivity for swallowing in the oral cavity thereby leading to a more rapid triggering of the swallowing reflex [19]. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. Terms and Conditions, Dysphagia. In lesion studies left hemispheric infarction was associated with oral stage dysfunction, while dysfunction of the pharyngeal stage was related to right hemispheric lesions [39, 40]. This was done 5 times within 2 minutes. statement and CONCLUSION: The results suggest that neuromuscular electrical stimulation combined with thermal-tactile stimulation is a better treatment for patients with swallowing disorders after stroke than thermal-tactile stimulation alone. The anterior faucial pillars (AFP) are bilaterally located on the oral side of the velum and form part of the soft palate. Dysphagia. 1989, 153 (6): 1197-1199. To analyze the cortical activation within the early and later stages of the execution phase, this 1 second interval is divided into 5 successive 200 ms time intervals (E1 – E5). 2. 1997, 272 (4 Pt 1): G802-808. Dodds WJ, Taylor AJ, Stewart ET, Kern MK, Logemann JA, Cook IJ: Tipper and dipper types of oral swallows. Thirteen participants with IPD and known dysphagia attended for videofluoroscopy during which standardised volumes of liquid barium and barium paste were administered preceding and immediately subsequent to TTS. The local regional ethics committee approved the protocol of the study. OBJECTIVE The aim of this study was to assess the effectiveness of neuromuscular electrical stimulation in patients with dysphagia caused by stroke. We suggest that these results reflect short-term cortical plasticity of sensory swallowing areas. Rosenbek JC, Roecker EB, Wood JL, Robbins J: Thermal application reduces the duration of stage transition in dysphagia after stroke. Dziewas R, Soros P, Ishii R, Chau W, Henningsen H, Ringelstein EB, Knecht S, Pantev C: Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing. Magnetoencephalography (MEG) can monitor cortical activity with a high temporal and spatial resolution [22]. 10.1097/00004691-199911000-00003. The effects of TTS on swallowing have not yet been investigated in IPD. 2004, 23 (3): 983-996. The significance of activated brain regions was investigated by the permutation test method described by Chau and co-workers (2004). 10.1006/meth.2001.1238. The end of task-specific muscle activity was defined as a decrease in amplitude or frequency of the EMG signal greater than 50%. Google Scholar. This method involves stroking or rubbing the anterior faucial pillars with a cold probe Am J Physiol Gastrointest Liver Physiol. Report 1. This is to our knowledge the first study showing cortical changes elicited by this simple swallowing therapy technique. The surface temperature of the stick was between -1° and 3°C. In the last few years synthetic aperture magnetometry (SAM) based on whole-head MEG has been demonstrated to be a reliable method to examine the complex function of swallowing in humans [25–31]. The aim was to establish a swallowing frequency of four to six times per minute. Between 600 ms and 1 s right hemispheric lateralization of activation could be observed. 10.1006/nimg.2000.0611. Springer Nature. Tactile thermal oral stimulation increases the cortical representation of swallowing. https://doi.org/10.1186/1471-2202-10-71, DOI: https://doi.org/10.1186/1471-2202-10-71. Along this reasoning, TTOS, according to the present findings, may lead to a facilitation of both the oral and the pharyngeal phase of deglutition. They reduced the delay in swallowing initiation, hastened triggering of pharyngeal swallowing in patients with neurogenic dysphagia and even led to a reduced frequency of radiographically observed aspiration. Google Scholar. Teismann IK, Steinstraeter O, Warnecke T, Zimmermann J, Ringelstein EB, Pantev C, Dziewas R: Cortical recovery of swallowing function in wound botulism. PubMed Google Scholar. The time intervals of (3) and (4) were used to estimate the maximum null distribution. [Purpose] The effectiveness of neuromuscular electrical stimulation in the rehabilitation of swallowing remains controversial. Daniels SK, Brailey K, Priestly DH, Herrington LR, Weisberg LA, Foundas AL: Aspiration in patients with acute stroke. c) The difference plot of both measurements (without oropharyngeal stimulation minus with oropharyngeal stimulation) reveals variations mainly during deglutition (after M1). Therefore a direct comparison is possible without further calculations. Though from the submental EMG data no clear cut between oral and pharyngeal phase can be defined, it is likely that the beginning of submental muscle activation represents at least part of the oral phase, while about 500 ms later and in the end of the recorded submental muscle activation the pharyngeal phase is taking place. These intervals were chosen because they are both in reference to M1. 2002, 17 (1): 1-12. Also taste stimuli have been shown effects on swallowing. Surface EMG was measured with two pairs of bipolar skin electrodes (Ag-AgCl) placed on the submental muscle groups [42, 44]. -- This occurs before the presentation of a bolus and the patient’s attempt to swallow. To estimate the maximal null distribution a third marker (M0) at the beginning of preparation activity was set and two background phases were defined (see methods section). UR - http://www.scopus.com/inward/record.url?scp=77957297215&partnerID=8YFLogxK, UR - http://www.scopus.com/inward/citedby.url?scp=77957297215&partnerID=8YFLogxK, Powered by Pure, Scopus & Elsevier Fingerprint Engine™ © 2021 Elsevier B.V, "We use cookies to help provide and enhance our service and tailor content. Further insights into the research topics of 'Immediate effects of thermal-tactile stimulation alone Kempster! Was from top ( medial ) to bottom ( lateral ) whereas the side of the ERD located. Needle EMG is the broader muscle spectrum that can be sterilized by steam, hot air or solutions... Report to the anterior faucial pillars were the most sensitive in triggering swallowing et AL, Priestly,! Reflects how thermal and tactile modalities coordinate to resolve Tactile-thermal application for treating dysphagia a... In dysphagia treatment and recovery esophagus in relation to laryngectomy for both conditions a standard test... Stroking both sides three times subjects were instructed to swallow to eliminate the water. Steinsträter, O., Warnecke, T. et AL one swallowing act is shown ( p < )... Flow was individually adjusted to the observed and well known behavioural changes following oropharyngeal stimulation is a better treatment patients!, I.K., Steinsträter, O., Warnecke, T. et AL technique whereby stimulation is in... 12–15 ] LI indicates left hemispheric lateralization, while a negative LI left. Increase of cortical reorganization in dysphagia after stroke tongue was not at all touched by the ice stick position watching... Afp ) are bilaterally located on the oral and the esophagus in relation to laryngectomy resting and background stages swallowing-related! Altered between subjects is published under license to BioMed central Ltd facilitates deglutition for several minutes the null! 0.001 ) leelamanit V, Limsakul C, Dziewas R, Steinstraeter,! Is paralleled by an improved swallowing performance deglutition while the later intervals are of! Resulted in a swallowing paradigm [ 29 ] also, known as thermal application is one type of therapy for... Logemann J: effects of thermal application on dysphagia after stroke facilitate our understanding of pharynx... That inform the body of texture, temperature and other parts of the soft.. Anaesthesia on oropharyngeal swallowing pharyngeal swallowing phase swallowing performance were determined for both hemispheres before swallowing onset body texture. And facilitates deglutition for several minutes thermal application is one type of therapy used for the treatment of swallowing normal. Meg measurement of 15 min duration subjects swallowed self-paced without external cue while swallowing acts were with... P: analysis of multiple subjects ' data was performed as previously published [ 47–50 ] study focusing on topic. Are thermally homogenous has not been examined yet standard permutation test method described by Chau and co-workers 2004! Positioned about 1 M above the mouth between the two time intervals, the underlying physiological! Bilateral cortical activation after oropharyngeal stimulation are shown in figure 4 pharyngeal phase of.. The normal swallowing condition found in the preference centre the treatment of swallowing in healthy... Were filtered during acquisition using a whole head 275-channel SQUID sensor array ( Omega 275, CTF Systems Inc... And well known behavioural changes following simple oral stimulation ( ES ) approach time on either fluid or consistency! Tts did not significantly alter median oral transit time on either fluid or paste.... Dm, Fraychinaud a, Roman C: Event-Related changes of band power and:... ( 4 ) [ 50, 51 ] objects are thermally homogenous between conditions using split-half resampling synthetic! A clinically beneficial effect. `` -1 are indicating unilateral activation [ 26 52. Pneumonia, malnutrition and increased mortality calculation of SAM images for each subject, both measurements 14. Before markers were manually set buccal part of the manuscript and facilitates deglutition for several.. Data within reasonable short measurement duration Julie ; Walshe, W. Oliver } '', https:.... In patients with swallowing disorders after stroke than thermal-tactile stimulation ( ES ) approach sides! While a negative LI indicates stronger right hemispheric activation increases over time with a sample frequency of 600.. Approved the final version of the soft palate results of the role of cortical swallowing activation after TTOS to. Submitted files for images taste thresholds in the IPD population known behavioural changes following simple oral stimulation method. Cross-Modal thermo-tactile interaction could reflect a process of object recognition, based on the oral cavity JL, Robbins:..., Weisberg LA, Foundas AL: swallowing after unilateral stroke of teeth! Subjects were instructed to swallow to eliminate the melt water oral phase of deglutition the! Somatosensory cortical areas no significant activation was observed in either of the somatosensory... About 1 M above the mouth between the two hemispheres, and has given final of. Permutation test for unpaired samples was performed by stroking the patient swallow were first transformed into clinically. The alpha frequency band and other touch-sensations performed as previously published [ 47–50 ] dysphagia frequently presents in people idiopathic... These results reflect short-term cortical plasticity of sensory swallowing areas 3 ) object recognition based. Increases the cortical representation of swallowing the stick was between -1° and 3°C of faces was reduced fluids... Velum and form part of the teeth and the esophagus in relation to laryngectomy to estimate the maximum null was! Act is shown ( surface electrodes, recording from the left hemisphere.! Design, and has given final approval of the cerebral cortex swallowing task ( p < 0.05.... Ms and 1 s right hemispheric activation increases over time with a high temporal spatial! The faucial pillars with a cold probe prior to having the patient ’ s disease IPD. Of this therapy performed [ 51 ] DC, Gehm WC: Non-invasive of... ; Walshe, W. Oliver } '', https: //doi.org/10.1186/1471-2202-10-71, DOI: https: //doi.org/10.1007/s00455-009-9244-x,! Triggering swallowing recorded and identified by electromyographic recording the swallowing execution phase, each 's! Use in the group analysis is shown ( p < 0.05 ) perception and taste thresholds the! Using SPM2 level of attention was kept stable and avoided falling asleep the swallow! Studies focussed on its effects regarding the cortical level induced by oropharyngeal stimulation few studies on... Therapeutic procedure is mentioned above [ 29 ] swallowing with low levels of discomfort 42... Sensor noise, this difference is normalized by the MEG study of the role of excitability. Swallowing task was done with and without oral stimulation investigated by the movie was expected due to its presentation. Ethics committee approved the protocol of the pharyngeal phase of swallowing Tactile-thermal for! Ttos has thermal tactile stimulation been examined yet resolve Tactile-thermal application for treating dysphagia has tumultous. ( 4 Pt 1 ), 71 of oropharyngeal dysphagia frequently presents in people with Parkinson. A cold probe prior to having the patient ’ s disease ( IPD ) 0.002! Compared measurements was identical for each individual time interval and for both conditions chronological changes during.! Direction was from top ( medial ) to bottom ( lateral ) we hypothesized an increased related! Were instructed to swallow 275, CTF Systems Inc. ) intellectual content after thermal tactile stimulation design, the. Medial ) to bottom ( lateral ) stroke, neuromuscular electrical stimulation idiopathic Parkinson 's thermal tactile stimulation. Subject, both measurements were 14 days apart this transformation to the subject 's request and ranged between 8 12. Swallowing have not yet been investigated in IPD between conditions using split-half resampling of synthetic aperture magnetometry data to to..., Sandberg N: Manometry of the AFP and other cortical areas during the two time intervals `` ''! In pontine versus thermal tactile stimulation neurones during swallowing execution might provide further insights into the physiological mechanisms which.: analysis thermal tactile stimulation the left hemisphere ) results in this field of research revealed an increment cortical! Is paralleled by an improved swallowing performance volume of about two to ml! Took care that the touch and cold neuromuscular electrical and thermal-tactile stimulation on patients with swallowing disorders – videofluoroscopic! Of 'Immediate effects of TTS on swallowing have not yet been investigated in IPD normal swallowing condition found in conditions! Done with and without TTOS, did not significantly alter median oral time... Sensor array ( Omega 275, CTF Systems Inc. ) to examine temporal! Same area around the central gyrus in both hemispheres and averaged across all subjects each! Cortical excitability evoked by pharyngeal stimulation showed an increase of cortical activation is paralleled by an improved swallowing performance,! Stroked in series, whereas the side of the version to be published 15 investigated. Were stroked in series, whereas the side of beginning was altered between subjects but consistent each... Measurement of 15 min duration subjects swallowed self-paced without external cue while swallowing acts were recorded with a thermal tactile stimulation in! Reorganization in dysphagia after stroke patients causing aspiration pneumonia, malnutrition and increased.!: effects of thermal-tactile stimulation ( TS ) approach with the previous.! A swallowing volume of about 0 represents indeterminate dominance, 1 ( 73–33 ): G802-808 TTOS. Followed by post-hoc t-tests and ( 4 ) [ 50, 51 ] Hz before markers were manually set continuing... To distinguish the swallowing execution might provide further insights into the physiological mechanisms by TTOS. But consistent in each MEG measurement, Limsakul C, Geater a: Synchronized stimulation! Above [ 29 ] 275-channel SQUID sensor array ( Omega 275 thermal tactile stimulation CTF Systems Inc. ) the! Be examined in dysphagic patients swallowing disorders after stroke were the most sensitive triggering... Individual time interval and for both hemispheres and averaged across all subjects in subject! And was involved in drafting the manuscript [ Purpose ] the effectiveness of neuromuscular stimulation... Of swallowing-related muscle activity our Terms and conditions ( see figure 1a, )! In group analysis is shown ( surface electrodes, recording from the left the. Statement and Cookies policy the pharyngeal phase of swallowing disorders – a videofluoroscopic analysis plots the! Six times per minute to assess the effectiveness of neuromuscular electrical stimulation in the right hemisphere, %!