Neural Network Pattern Recognition of Lingual–Palatal Pressure for Automated Detection of Swallow

Abstract

We describe a novel device and method for real-time measurement of lingual-palatal pressure and automatic identification of the oral transfer phase of deglutition. Clinical measurement of the oral transport phase of swallowing is a complicated process requiring either placement of obstructive sensors or sitting within a fluoroscope or articulograph for recording. Existing detection algorithms distinguish oral events with EMG, sound, and pressure signals from the head and neck, but are imprecise and frequently result in false detection. We placed seven pressure sensors on a molded mouthpiece fitting over the upper teeth and hard palate and recorded pressure during a variety of swallow and non-swallow activities. Pressure measures and swallow times from 12 healthy and 7 Parkinson's subjects provided training data for a time-delay artificial neural network to categorize the recordings as swallow or non-swallow events. User-specific neural networks properly categorized 96 % of swallow and non-swallow events, while a generalized population-trained network was able to properly categorize 93 % of swallow and non-swallow events across all recordings. Lingual-palatal pressure signals are sufficient to selectively and specifically recognize the initiation of swallowing in healthy and dysphagic patients.

Prediction of Larynx Function Using Multichannel Surface EMG Classification

“…5), missed swallow rate is 24.9 ± 6.9 % (control) and 36.9 ± 6.1 % (TL). A model tailored to a specific participant may improve performance, reducing missed swallow rate [14], [39].…”

“…Swallow detection has also been investigated with alternative methods to sEMG. Using tongue pressure on the hard palate, and a time-delayed ANN, to classify swallow events, Hadley et al [14] achieved a TPR of 90 %, and a PPV of 80 %. These studies demonstrate the feasibility of detecting swallow events.…”

“…The late oral phase ranges from 308 ± 32 ms to 900 ± 300 ms, and the pharyngeal phase from 648 ± 194 ms to 1500 ± 450 ms [11], [22], [23]. Thus, a maximum delay of 500 ms may be reliable, conservative, and safe [14] .…”

The effects of different frequencies of repetitive transcranial magnetic stimulation (rTMS) on intracranial neurotransmitters in patients with swallowing disorders after cerebral infarction

“…At present, the anterior lateral part of the motor cortex and the motor cortex of the central sulcus are considered to be the cortical central control regions for swallowing [21]; therefore, we used which as the body surface projection area when encephalofluctuograph performing. rTMS penetrates the skull to directly act on the cerebral cortex, stimulating the local cortical neurons to directly or indirectly promote remodeling of the swallowing cortex center [22]. rTMS modulates cortical excitability by focally stimulating the cortical region [23].…”

Oro-Pharyngeal Dysphagia in Parkinson’s Disease and Related Movement Disorders

“…As a result, difficulties in the initiation of swallow, piecemeal swallow and premature falling of the food can occur. Reduced tongue pressure and abnormal patterns of tongue-palatal pressure also contribute to difficulties with bolus management (Supplementary Videos 1-3 in the online-only Data Supplement) [37,38]. It can cause severe residue in the oral cavity and may be involved in problems of oral hygiene or medication intake.…”