Characteristics of submental muscles function and hyoid bone movement in patients with dysphagia after stroke

Tang, Anli; Chen, Xuexian; Ma, Jan; Xu, Rui‐hua; Luo, Ziqiong; Chen, Jia‐Li; Zhang, Xuefei; Zhan, Hongrui; Wu, Weiliang

doi:10.1016/j.clinbiomech.2022.105772

Cited by 2 publications

(1 citation statement)

References 28 publications

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“…Improvement of the hyoid–larynx approximation was demonstrated when swallowing saliva, and clearance of saliva could decrease pharyngeal secretions and the risk of aspiration [41]. In stroke patients, multiple mechanisms such as impaired control of the pharyngeal and laryngeal muscles and decreased sensitivity of the oral cavity and pharynx, reduce the hyoid–larynx approximation and this event leads to problems in the upper esophageal sphincter closure, bolus passage through the pharyngeal segment, and airway protection [17,42]. In this study, the improvement of these values may lead to reduced PAS and FDS, which indicates the recovery of swallowing function.…”

Section: Discussionmentioning

confidence: 99%

The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial

Suh,

You,

Son

et al. 2024

International Journal of Rehabilitation Research

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Repetitive transcranial magnetic stimulation to the pharyngeal motor cortex has shown beneficial effects on poststroke dysphagia. Previous studies, however, using intermittent theta burst stimulation (iTBS) for dysphagia have targeted the suprahyoid motor cortex. This study aimed to investigate the effects of iTBS to the pharyngeal motor cortex in patients with poststroke dysphagia, using ultrasound and videofluoroscopic swallowing studies (VFSS). A randomized controlled trial was conducted on patients with dysphagia due to a first-time unilateral stroke. Patients who had signs and symptoms of dysphagia and showed aspiration or penetration on VFSS were included. Twenty-eight patients were randomly assigned to either real or sham iTBS groups, and each patient underwent five sessions of iTBS to the ipsilesional pharyngeal motor cortex. Each iTBS session was followed by conventional dysphagia treatment for 30 min. The hyoid–larynx approximation measured by ultrasound, penetration–aspiration scale (PAS) and functional dysphagia scale (FDS) assessed by VFSS were evaluated before and after completion of iTBS. There were no significant differences between the two groups in terms of demographic and clinical characteristics, including age and type of stroke. The hyoid–larynx approximation ratio increased in the real iTBS group and decreased in the sham iTBS group (median values of pre–post differences were 0.27 vs. −0.01, P < 0.001). The PAS and FDS showed greater improvements in the real iTBS group than in the sham iTBS group (median values of pre–post differences of the PAS were −2.50 vs. 0.00, P = 0.004; median values of pre–post differences of the FDS were −12.50 vs. −2.50, P < 0.001). No adverse effects were reported during or after iTBS sessions. Five-session iTBS to the pharyngeal motor cortex combined with conventional treatment led to a significant improvement in poststroke dysphagia in terms of hyoid–larynx approximation which is related to the suprahyoid muscle. Considering the short duration of one iTBS session, this can be an efficient and effective treatment tool for patients with this condition.

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Section: Discussionmentioning

confidence: 99%

The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial

Suh,

You,

Son

et al. 2024

International Journal of Rehabilitation Research

View full text Add to dashboard Cite

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Diagnostic value of a deep learning-based hyoid bone tracking model for aspiration in patients with post-stroke dysphagia

Ryu,

Kim,

Kim

et al. 2024

DIGITAL HEALTH

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Objective Hyoid bone movement is potentially related to aspiration risk in post-stroke dysphagia (PSD) patients but is difficult to assess quantitatively. This study aimed to measure the distance of hyoid bone movement more efficiently and accurately using a deep learning model and determine the clinical usefulness of the model in PSD patients. Methods This study included 85 patients with PSD within 6 months from onset. Patients were grouped into an aspiration group ( n = 35) and a non-aspiration group ( n = 50) according to the results of a videofluoroscopic swallowing study. Hyoid bone movement was tracked using a deep learning model constructed with the BiFPN-U-Net(T) architecture. The maximum distance of hyoid bone movement was measured horizontally ( Hmax), vertically ( Vmax), and diagonally ( Dmax). Results Compared with the non-aspiration group, the aspiration group showed significant decreases in hyoid bone movement in all directions. The area under the curve of Vmax was highest at 0.715 with a sensitivity of 0.680 and specificity of 0.743. The Vmax cutoff value for predicting aspiration risk was 1.61 cm. The success of oral feeding at the time of discharge was significantly more frequent when hyoid movement was equal to or larger than the cutoff value although no significant relationship was found between hyoid movement and other clinical characteristics. Conclusion Hyoid bone movement of PSD patients can be measured quantitatively and efficiently using a deep learning model. Deep learning model-based analysis of hyoid bone movement seems to be useful for predicting aspiration risk and the possibility of resuming oral feeding.

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Characteristics of submental muscles function and hyoid bone movement in patients with dysphagia after stroke

Cited by 2 publications

References 28 publications

The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial

The effect of real versus sham intermittent theta burst transcranial magnetic stimulation combined with conventional treatment on poststroke dysphagia: a randomized controlled trial

Diagnostic value of a deep learning-based hyoid bone tracking model for aspiration in patients with post-stroke dysphagia

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