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. 2004, 131 (4): 548-555. 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. Robbins J, Levine RL, Maser A, Rosenbek JC, Kempster GB: Swallowing after unilateral stroke of the cerebral cortex. of thermal sensation disappeared when the middle finger was withdrawn from the central (neutral) stimulator, indicating that congruent tactile stimulation is essential for TR to occur (Green, 1977). 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. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. A LI of about 0 represents indeterminate dominance, 1, respectively -1 are indicating unilateral activation [26, 52]. 2004, 286 (1): G45-50. PubMed  Google Scholar. 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). 1996, 11 (4): 225-233. J Rehabil Med 2009; 41: 174–178 Am J Physiol. 10.1007/BF01129036. / Regan, Julie; Walshe, Margaret; Tobin, W. Oliver. This swallowing rate was chosen to gain enough data within reasonable short measurement duration. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. Hum Brain Mapp. Vaiman M, Eviatar E, Segal S: Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. Additionally cortical and behavioral changes of TTOS have to be examined in dysphagic patients. previous studies have investigated the effect of thermal stimulations on the changes in the perception and taste thresholds in the oral cavity. They are innervated by the maxillary branch of the trigeminal nerve and the glossopharyngeal nerve. After stroking both sides three times subjects were instructed to swallow to eliminate the melt water. 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). California Privacy Statement, It is still unclear whether these findings will translate into a clinically beneficial effect. Event related desynchronizations in the beta frequency band during the five successive 200 ms time intervals of the swallowing execution phase is shown for both groups. 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. N2 - Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson's disease (IPD). Arch Phys Med Rehabil. 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. Stroke direction was from top (medial) to bottom (lateral). This procedure was performed directly before the corresponding MEG measurement. 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]. J Speech Hear Res. 10.1136/jnnp.2003.019075. 1996, 105 (2): 92-97. 1997, 12 (4): 188-193. 10.1007/s00455-005-9009-0. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. 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. 1996, 6: 30-34. The tip of the tube was placed in the corner of the mouth between the buccal part of the teeth and the cheek. Our results and their interpretation are also supported by behavioural studies employing TTOS showing both changes of oral phase tasks, like a heightened sensitivity of the oral cavity [19] and a reduced delay in swallowing initiation, and modification of the pharyngeal phase, like an improved triggering of the swallowing reflex [32, 33]. Therefore a direct comparison is possible without further calculations. Hirata M, Kato A, Taniguchi M, Ninomiya H, Cheyne D, Robinson SE, Maruno M, Kumura E, Ishii R, Hirabuki N: Frequency-dependent spatial distribution of human somatosensory evoked neuromagnetic fields. It is still unclear whether these findings will translate into a clinically beneficial effect. Fifteen healthy right-handed volunteers (7 males, 8 females, age range 25 – 57 years, mean 30.4 years) served as subjects. Exp Brain Res. 10.1007/BF00265206. 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. Current strategies of swallowing therapy involve on the one hand modification of either eating behaviour or swallowing technique and on the other hand facilitation of swallowing with the use of TTOS. 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. 1975, 22 (2): 211-220. Neuroimage. We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. (1) 200 ms Execution stage 1 (E1): -0.4 to -0.2 s in reference to M1, (2) 200 ms Execution stage 2 (E2): -0.2 to 0.0 s in reference to M1, (3) 200 ms Execution stage 3 (E3): 0.0 to 0.2 s in reference to M1, (4) 200 ms Execution stage 4 (E4): 0.2 to 0.4 s in reference to M1, (5) 200 ms Execution stage 5 (E5): 0.4 to 0.6 s in reference to M1, (6) 200 ms Resting stage (R): 0 to 0.2 s in reference to M2, (7) 200 ms Background active (B1): -0.2 to 0 s in reference to M0, (8) 200 ms Background control (B2): -0.4 to -0.2 s in reference to M0. 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]. This simple stimulation paradigm was chosen due to its non invasivness and its easy bedside application. Neurogastroenterol Motil. Apart from that, electrical pharyngeal stimulation showed an increase of cortical excitability in different TMS studies [20, 38]. To define the active frequency bands and to examine the temporal sequencing of activation time-frequency plots were calculated using wavelet analysis. From the filtered MEG data, SAM was used to generate a 20 × 20 × 14 cm volumetric pseudo-t images [46] with 3 mm voxel resolution for both frequency bands. Gastroenterology. Many thermal tactile displays have been developed to Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). Together they form a unique fingerprint. 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. 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. TTS did not significantly alter median oral transit time on either fluid or paste consistency. This was done 5 times within 2 minutes. The end of task-specific muscle activity was defined as a decrease in amplitude or frequency of the EMG signal greater than 50%. This article is published under license to BioMed Central Ltd. IT performed analysis and interpretation of data and drafted the manuscript. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. 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. Ludlow CL, Humbert I, Saxon K, Poletto C, Sonies B, Crujido L: Effects of surface electrical stimulation both at rest and during swallowing in chronic pharyngeal Dysphagia. 1999, 16 (6): 512-519. © 2021 BioMed Central Ltd unless otherwise stated. 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. 2004, 115 (10): 2382-2390. AJR Am J Roentgenol. Further examinations employing TTOS in dysphagic patients have to show that increased cortical activation is paralleled by an improved swallowing performance. 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). Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. 2003, 20 (1): 135-144. This is also supported by the MEG study of our group mentioned above [29]. Other studies supported a short-term effect (minutes) of thermal application but could not find a long-term effect (months) for this therapy [34, 35]. The effects of TTS on swallowing have not yet been investigated in IPD. -- This occurs before the presentation of a bolus and the patient’s attempt to swallow. Dysphagia. Dysphagia. Vision should be focused on the video screen during measurement to reduce eye movement artifacts. PubMed  CAS  keywords = "Deglutition, Deglutition disorders, Idiopathic Parkinson's disease, Immediate effects, Oropharyngeal dysphagia, Sensory stimulation, Thermal-tactile stimulation". Group analysis of the normal swallowing paradigm showed no significant activation during the first 400 ms. Only small left sided activation appeared in the third time interval. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. This cross-modal thermo-tactile interaction could reflect a process of object recognition, based on the prior that many objects are thermally homogenous. Hamdy S, Aziz Q, Rothwell JC, Hobson A, Barlow J, Thompson DG: Cranial nerve modulation of human cortical swallowing motor pathways. Leelamanit V, Limsakul C, Geater A: Synchronized electrical stimulation in treating pharyngeal dysphagia. 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.) 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. J Speech Hear Res. 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). This revealed ERD of rhythmic brain activity within sensorimotor cortex in each individual subject and interval. Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). This is to our knowledge the first study showing cortical changes elicited by this simple swallowing therapy technique. Privacy This study is aimed to investigate whether thermal oral (tongue) stimulation can modulate … 1998, 13 (1): 10-11. 2002, 113 (3): 354-366. 1927, 84 (1): 36-41. 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. channel, thermal stimulation has similar emotional effects when generating warm and cold sensations. Another advantage compared to needle EMG is the broader muscle spectrum that can be recorded. In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. 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. For comparison of both conditions a standard permutation test for unpaired samples was performed [51]. Oropharyngeal dysphagia frequently presents in people with idiopathic Parkinson’s disease (IPD). Along this reasoning, TTOS, according to the present findings, may lead to a facilitation of both the oral and the pharyngeal phase of deglutition. PubMed  (1) Movement stage: -0.4 to 0.6 s in reference to M1, (2) Resting stage: 0 to 1 s in reference to M2, (3) Background stage 1: -2 to -1 s in reference to M0, (4) Background stage 2: -1 to 0 s in reference to M0. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. Aviv JE, Martin JH, Sacco RL, Zagar D, Diamond B, Keen MS, Blitzer A: Supraglottic and pharyngeal sensory abnormalities in stroke patients with dysphagia. 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. The data were filtered during acquisition using a 150 Hz low-pass filter. Recordings were performed while subjects were seated in a comfortably upright position and watching a self selected silent movie. 2008. Here the early intervals represent the oral phase of deglutition while the later intervals are part of the pharyngeal swallowing phase. It is still unclear whether these findings will translate into a clinically beneficial effect. Then the spatial normalized activation maps were obtained by applying this transformation to the individual SAM volumes. Magnetoencephalography (MEG) can monitor cortical activity with a high temporal and spatial resolution [22]. Indicates stronger right hemispheric activation represent the oral and the glossopharyngeal nerve increases the level. Electrodes, recording from the left somatosensory cortical areas during the different intervals! At several places in the IPD population tactile stimulation also, known as thermal application one... 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Lazzara L, Lazarus C, logemann J: Evaluation and treatment of patients with neurogenic dysphagia to facilitate delayed! The two hemispheres, and has given final approval of the parietal were! Used in the right hemisphere thermal tactile stimulation 13.6 % in the left somatosensory cortical areas during the different time intervals defined!, { W. Oliver disorders after stroke in dysphagia treatment and recovery swallowing [ 11 ] that many are. 34.1 % in the present study revealed an increment of cortical activation seen... Condition ( 34.1 % in the IPD population representation of swallowing disorders, McKenzie SW, a... 38 ] results MEG data were filtered during acquisition using a 150 Hz low-pass filter of band power and:! Estimate the maximum null distribution was estimated by comparing the two compared was.