Blog Archives

Corrected High–Frame Rate Anchored Ultrasound With Software Alignment

Conclusions: CHAUSA produces high-FR, high-spatial-quality ultrasound images, which are head corrected to 1 mm. The method reveals tongue dorsum retraction during the posterior release of the alveolar click and tongue tip recoil following the anterior release of the alveolar click, both of which were previously undetectable. CHAUSA visualizes most of the tongue in studies of dynamic consonants with a major reduction in field problems, opening up important areas of speech research.

from the Journal of Speech, Language, and Hearing Research

The Relationship of Aspiration Status With Tongue and Handgrip Strength in Healthy Older Adults

Lower anterior and posterior isometric and swallowing tongue strength were dependent on aspiration status. Lower lingual strength in healthy adults may predispose them to aspiration. The correlation between tongue and handgrip strength is consistent with the hypothesis that impaired oropharyngeal strength reflects global age-related declines in muscle strength.

from the Journals of Gerontology Series A: Biological Sciences and Medical Sciences

Effects of Dining on Tongue Endurance and Swallowing-Related Outcomes

Conclusions: Young and old adults demonstrated reduced tongue strength and endurance after dining, but younger subjects showed greater declines in anterior tongue endurance, whereas older adults exhibited signs of swallowing difficulty.

from the Journal of Speech, Language, and Hearing Research

Comparison of Three Types of Tongue Pressure Measurement Devices

A new tongue pressure device consisting of a simple and safe disposable probe and manometer has been developed. This report describes a study that examined the validity of the new device, comparing it to a widely used tongue pressure manometer, the Iowa Oral Performance Instrument (IOPI), and to the stable adhered three air-filled bulbs manometry system. The first test compared maximum tongue pressure measured with the new device and the IOPI (13 male, 9 female, 25.0 years). The second test compared maximum tongue pressure and swallowing tongue pressure measured with the new device and the three-bulb device (13 male, 9 female, 31.0 years). Significant correlations of maximum tongue pressure were found between the new device and the IOPI in the first test (p < 0.05). In the second test, significant correlations of maximum tongue pressure were found between the new device at the anterior and middle sensors (p < 0.05) but not at the posterior sensor of the three-bulb device. Significant correlations of swallowing tongue pressure between the new device and the three-bulb device were found (p < 0.05). These findings demonstrate that the measurements by the new simple tongue pressure device are closely equivalent to those of the IOPI and three-bulb devices, demonstrating that the new device is capable of accurately measuring the pressure generated by the whole tongue.

from Dysphagia

B-mode and M-mode Ultrasonography of Tongue Movements during Swallowing

No qualitative differences could be established in B-mode imaging with the ultrasound method selected for this study. The parameters that could be measured on the M-mode images are not suitable for differentiating between visceral and somatic swallowing.

from the Journal of Orofacial Orthopedics

Tongue Pressure Modulation During Swallowing: Water Versus Nectar-Thick Liquids

Conclusion: Tongue-palate pressure amplitude modulation does not occur for nectar-thick swallows compared to thin liquid swallows. Modulation does, however, occur with respect to the tongue-palate contact surface area and pressure durations. The authors introduce the concept of pressure slope as a meaningful way to examine tongue-palate pressure application in swallowing.

from the Journal of Speech, Language, and Hearing Research

Premature infant swallowing: Patterns of tongue-soft palate coordination based upon videofluoroscopy

Coordination between movements of individual tongue points, and between soft palate elevation and tongue movements, were examined in 12 prematurely born infants referred from hospital NICUs for videofluoroscopic swallow study (VFSS) due to poor oral feeding and suspicion of aspiration. Detailed post-evaluation kinematic analysis was conducted by digitizing images of a lateral view of digitally superimposed points on the tongue and soft palate. The primary measure of coordination was continuous relative phase of the time series created by movements of points on the tongue and soft palate over successive frames. Three points on the tongue (anterior, medial, and posterior) were organized around a stable in-phase pattern, with a phase lag that implied an anterior to posterior direction of motion. Coordination between a tongue point and a point on the soft palate during lowering and elevation was close to anti-phase at initiation of the pharyngeal swallow. These findings suggest that anti-phase coordination between tongue and soft palate may reflect the process by which the tongue is timed to pump liquid by moving it into an enclosed space, compressing it, and allowing it to leave by a specific route through the pharynx.

from Infant Behavior and Development

Representation of the speech effectors in the human motor cortex: Somatotopy or overlap?

Somatotopy within the orofacial region of the human motor cortex has been a central concept in interpreting the results of neuroimaging and transcranial magnetic stimulation studies of normal and disordered speech. Yet, somatotopy has been challenged by studies showing overlap among the effectors within the homunculus. In order to address this dichotomy, we performed four voxel-based meta-analyses of 54 functional neuroimaging studies of non-speech tasks involving respiration, lip movement, tongue movement, and swallowing, respectively. While the centers of mass of the clusters supported the classic homuncular view of the motor cortex, there was significant variability in the locations of the activation-coordinates among studies, resulting in an overlapping arrangement. This “somatotopy with overlap” might reflect the intrinsic functional interconnectedness of the oral effectors for speech production.

from Brain and Language

Botulinum toxin in the treatment of lingual movement disorders

Lingual movement disorders are a rare but serious manifestation of neurologic disease, which have the potential to cause significant morbidity. Traditionally, these disorders were treated with pharmacotherapy achieving only limited results. Several case series have demonstrated the effectiveness of Botulinum toxin injection for the management of focal lingual movement disorders; however, apprehension persists regarding intralingual injections due to the risk of dysphagia. Here, we report seven patients with lingual movement disorders treated with intralingual BotoxTM (Allergan product) injections via a novel superior approach into the genioglossus over a period of 3 to 72 months. All patients experienced a marked improvement in their abnormal tongue movements with no substantial bleeding or dysphagia. Lingual Botulinum toxin injection should be considered a safe and viable treatment option for a variety of disorders affecting the tongue. © 2009 Movement Disorder Society

from Movement Disorders

Tongue Movements During Water Swallowing in Healthy Young and Older Adults

Purpose: The purpose of this study was to explore the nature and extent of variability in tongue movement during healthy swallowing as a function of aging and gender. In addition, changes were quantified in healthy tongue movements in response to specific differences in the nature of the swallowing task (discrete vs. sequential swallows).

Method: Electromagnetic midsagittal articulography (EMMA) was used to study the swallowing-related movements of markers located in midline on the anterior (blade), middle (body), and posterior (dorsum) tongue in a sample of 34 healthy adults in 2 age groups (under vs. over 50 years of age). Participants performed a series of reiterated water swallows, in either a discrete or a sequential manner.

Results: This study shows that age-related changes in tongue movements during swallowing are restricted to the domain of movement duration. The authors confirm that different tongue regions can be selectively modulated during swallowing tasks and that both functional and anatomical constraints influence the manner in which tongue movement modulation occurs. Sequential swallowing, in comparison to discrete swallowing, elicits simplification or down-scaling of several kinematic parameters.

Conclusion: The data illustrate task-specific stereotyped patterns of tongue movement in swallowing, which are robust to the effects of healthy aging in all aspects other than movement duration.

from the Journal of Speech, Language, and Hearing Research

Swallowing after right hemisphere stroke: oral versus pharyngeal deficits

Although previous studies have attempted to identify distinct patterns of dysphagia following unilateral hemispheric stroke, the relationships between lesion sites and swallowing dysfunction remain unclear. In particular, swallowing deficits resulting from right hemisphere stroke remain poorly understood. The present study employed a case report design to examine the oral and pharyngeal phase deficits in swallowing following right hemisphere stroke. Lateral-view videofl uoroscopic images were obtained from six subjects following right hemisphere stroke as they performed swallowing trials with various bolus consistencies (i.e., thin liquid, thick liquid, and paste). Each swallow was evaluated on 17 oral phase, and 17 pharyngeal phase physiologic swallowing parameters. Results indicated that, whereas all patients exhibited both oral and pharyngeal phase swallowing defi cits, the majority of patients showed relatively greater oral phase than pharyngeal phase impairment. In addition, patterns of swallowing defi cits were highly variable across individuals, particularly for the pharyngeal phase. These fi ndings suggest that oral phase swallowing impairment can be a prominent feature of right hemisphere stroke. Thus, swallowing assessment in patients with right hemisphere stroke should emphasize both oral and pharyngeal phases. Instrumental techniques can provide valuable insights into swallow pathophysiology in this population.

from the Canadian Journal of Speech-Language Pathology and Audiology

Differences in Tongue Strength Across Age and Gender: Is There a Diminished Strength Reserve?

from Dysphagia

Abstract Maximum tongue strength was investigated and compared to mean swallowing pressure elicited by the anterior tongue to calculate the percentage of maximum tongue strength used during swallowing in 96 participants with normal swallowing, divided into three 20-year age groups. The purposes of this investigation were to investigate normal swallowing physiology and to determine whether tongue strength reserves diminished according to age or gender. The results of the study yielded significant maximum tongue strength differences between the youngest and oldest and middle and oldest age groups; the oldest group had the weakest tongues. Mean swallowing pressure did not differ based on age, but women were found to have significantly higher pressures than men. The percentage of maximum tongue strength used during swallowing did not vary as a function of age, but women used a significantly higher percentage of tongue strength to swallow than men. Based on the results, it appears that a diminishing strength reserve does not exist based on age, but it does exist based on gender. Specifically, it appears that women have a reduced tongue strength reserve compared to men. Clinical implications are discussed.

Quantitative Contributions of the Muscles of the Tongue, Floor-of-Mouth, Jaw, and Velum to Tongue-to-Palate Pressure Generation

from the Journal of Speech, Language, and Hearing Research

Purpose: The purpose of this investigation was to evaluate the relationship between tongue-to-palate pressure and the electromyography (EMG) measured from the mylohyoid, anterior belly of the digastric, geniohyoid, medial pterygoid, velum, genioglossus, and intrinsic tongue muscles.

Methods: Seven healthy adults performed tongue-to-palate pressure tasks at known percentages of their maximum pressure while intramuscular EMG was recorded from the muscles stated above. Multiple regression analysis was performed.

Results: Predictors of pressure included the posterior fibers of the genioglossus, mylohyoid, anterior belly of digastric, medial pterygoid, and intrinsic tongue.

Conclusions: Increasing tongue-to-palate pressure coincides with increased muscle activity. Activation of the floor-of-mouth, tongue, and jaw closing muscles increased tongue-to-palate pressure. These findings support the use of a tongue-press exercise to strengthen floor-of-mouth muscles, tongue, and jaw-closing muscles.