Little is known about the possible mechanisms by which this interventional therapy may work. Thermal tactile stimulation also, known as thermal application is one type of therapy used for the treatment of swallowing disorders. 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. Fraser C, Rothwell J, Power M, Hobson A, Thompson D, Hamdy S: Differential changes in human pharyngoesophageal motor excitability induced by swallowing, pharyngeal stimulation, and anesthesia. 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. Teismann IK, Steinstraeter O, Stoeckigt K, Suntrup S, Wollbrink A, Pantev C, Dziewas R: Functional oropharyngeal sensory disruption interferes with the cortical control of swallowing. 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. Mansson I, Sandberg N: Manometry of the pharynx and the esophagus in relation to laryngectomy. 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]. Neuroimage. 1993, 74 (12): 1295-1300. The Laryngeal Mirror provides thermal-tactile stimulation during swallowing therapy. Dysphagia. Jurkiewicz MT, Gaetz WC, Bostan AC, Cheyne D: Post-movement beta rebound is generated in motor cortex: Evidence from neuromagnetic recordings. Thermal-tactile stimulation and changing bolus characteristics (therapeutic procedure is mentioned above under section B.) 10.1007/BF00714591. AJR Am J Roentgenol. Here the early intervals represent the oral phase of deglutition while the later intervals are part of the pharyngeal swallowing phase. PubMed  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]. The effects of TTS on swallowing have not yet been investigated in IPD. The effects of TTS on swallowing have not yet been investigated in IPD. 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. 2002, 17 (1): 1-12. This was done 5 times within 2 minutes. The maximal null distribution was estimated by comparing the two background stages (3) and (4) [50, 51]. Significant activation in the group analysis is shown (p < 0.05). Vaiman M, Eviatar E, Segal S: Surface electromyographic studies of swallowing in normal subjects: a review of 440 adults. 10.1016/j.neuroimage.2004.07.007. The peak of the ERD was located bilaterally in the same area around the central gyrus in both conditions. Google Scholar. Johnson ER, McKenzie SW, Sievers A: Aspiration pneumonia in stroke. While the artifacts caused by oropharyngeal muscle activation during the act of swallowing make it difficult to study activation in subcortical and bulbar structures, the cortical areas especially the sensorimotor areas can be examined in detail. J Speech Hear Res. • 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 … Rosenbek JC, Robbins J, Fishback B, Levine RL: Effects of thermal application on dysphagia after stroke. Neuroimage. 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. Lazzara L, Lazarus C, Logemann J: Effects of thermal stimulation on patients with swallowing disorders – A videofluoroscopic analysis. 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. Wavelet analysis of the parietal areas. Tactile stimulation includes the activating of nerve signals beneath the skin's surface that inform the body of texture, temperature and other touch-sensations. To estimate the maximal null distribution (see below), a third marker was set to distinguish background activity from the onset of swallowing preparation (M0). These findings demonstrate cortical changes following simple oral 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. EBR and CP revised the manuscript critically for important intellectual content. The surface temperature of the stick was between -1° and 3°C. Julie Regan, Margaret Walshe, W. Oliver Tobin, Research output: Contribution to journal › Article › peer-review. X-axis represents time in seconds related to M1. 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. 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. California Privacy Statement, Surface EMG was measured with two pairs of bipolar skin electrodes (Ag-AgCl) placed on the submental muscle groups [42, 44]. keywords = "Deglutition, Deglutition disorders, Idiopathic Parkinson's disease, Immediate effects, Oropharyngeal dysphagia, Sensory stimulation, Thermal-tactile stimulation". Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. 1974, 23 (8): 737-743. By this physiological changes on the cortical level induced by this widely used tool of dysphagia rehabilitation are shown. 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. To define the active frequency bands and to examine the temporal sequencing of activation time-frequency plots were calculated using wavelet analysis. In healthy subjects a time-dependent shift from the left to the right hemisphere was found in an MEG swallowing paradigm [29]. Tactile thermal oral stimulation increases the cortical representation of swallowing. A clear distinction between the two phases based on the submental EMG recordings is not possible. For comparison of both conditions a standard permutation test for unpaired samples was performed [51]. Also taste stimuli have been shown effects on swallowing. The infusion flow was individually adjusted to the subject's request and ranged between 8 and 12 ml/min. Estimation of the according swallowing phase is shown. PubMed  Neuroimage. 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). These intervals were chosen because they are both in reference to M1. Neumann S, Bartolome G, Buchholz D, Prosiegel M: Swallowing therapy of neurologic patients: correlation of outcome with pretreatment variables and therapeutic methods. Jean A, Car A, Roman C: Comparison of activity in pontine versus medullary neurones during swallowing. The time intervals of (3) and (4) were used to estimate the maximum null distribution. This cross-modal thermo-tactile interaction could reflect a process of object recognition, based on the prior that many objects are thermally homogenous. 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]. Inga K Teismann. J Speech Hear Res. Nichols TE, Holmes AP: Nonparametric permutation tests for functional neuroimaging: a primer with examples. By using this website, you agree to our METHODS Thirty-six subjects were randomized into experimental and control groups. Vrba J, Robinson SE: Signal processing in magnetoencephalography. Chau W, McIntosh AR, Robinson SE, Schulz M, Pantev C: Improving permutation test power for group analysis of spatially filtered MEG data. Today this technique is often used in the treatment of patients with neurogenic dysphagia to facilitate a delayed or absent swallowing response. Therefore the results of the normal swallowing condition found in the present study are mainly concordant with the previous investigation. 1995, 10 (1): 1-5. Neuroreport. 10.1006/meth.2001.1238. Therefore a direct comparison is possible without further calculations. PubMed Central  To distinguish the swallowing execution phase, each individual's EMG signal was used to mark the swallowing related muscle activation. About 80 years ago sensory stimulation was first advocated as a method for facilitating swallowing [11]. Ding R, Larson CR, Logemann JA, Rademaker AW: Surface electromyographic and electroglottographic studies in normal subjects under two swallow conditions: normal and during the Mendelsohn manuever. Dive into the research topics of 'Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic parkinson's disease'. Privacy Magnetoencephalography (MEG) can monitor cortical activity with a high temporal and spatial resolution [22]. 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. 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]. Logemann J: Evaluation and treatment of swallowing disorders. In each MEG measurement of 15 min duration subjects swallowed self-paced without external cue while swallowing acts were recorded and identified by electromyographic recording. 2002, 318 (2): 73-76. 1994, 9 (2): 83-87. Ertekin C, Kiylioglu N, Tarlaci S, Keskin A, Aydogdu I: Effect of mucosal anaesthesia on oropharyngeal swallowing. MEG data were collected using a whole head 275-channel SQUID sensor array (Omega 275, CTF Systems Inc.). The two conditions, after and without TTOS, did not differ in swallowing behaviour. 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 Otolaryngol Head Neck Surg. Neurol Clin Neurophysiol. 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. Changes in the beta-frequency-band during swallowing execution compared to the resting stage. Springer Nature. Taniguchi M, Kato A, Fujita N, Hirata M, Tanaka H, Kihara T, Ninomiya H, Hirabuki N, Nakamura H, Robinson SE: Movement-related desynchronization of the cerebral cortex studied with spatially filtered magnetoencephalography. Analysis of the chronological changes during swallowing suggests facilitation of both the oral and the pharyngeal phase of deglutition. J Neurol Neurosurg Psychiatry. 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. 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. ---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. The tip of the tube was placed in the corner of the mouth between the buccal part of the teeth and the cheek. Further examinations employing TTOS in dysphagic patients have to show that increased cortical activation is paralleled by an improved swallowing performance. The anterior faucial pillars (AFP) are bilaterally located on the oral side of the velum and form part of the soft palate. 10.1136/jnnp.2003.019075. Data from the execution stages described above were used to analyze cortical activity during the different time intervals. 2008, 8 (1): 13-10.1186/1471-2377-8-13. TW and SS have made contributions to conception and design and did data acquisition. 10.1007/BF00261272. BMC Neurosci 10, 71 (2009). Power ML, Fraser CH, Hobson A, Singh S, Tyrrell P, Nicholson DA, Turnbull I, Thompson DG, Hamdy S: Evaluating oral stimulation as a treatment for dysphagia after stroke. 1995, 38 (3): 556-563. Arch Phys Med Rehabil. Analysis of the chronological changes during the swallowing execution might provide further insights into the underlying physiological mechanisms. It is still unclear whether these findings will translate into a clinically beneficial effect. The effects of TTS on swallowing have not yet been investigated in IPD. Thermal-tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. 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. 10.1006/nimg.2000.0611. Google Scholar. Robbins J, Levine RL, Maser A, Rosenbek JC, Kempster GB: Swallowing after unilateral stroke of the cerebral cortex. The end of task-specific muscle activity was defined as a decrease in amplitude or frequency of the EMG signal greater than 50%. Cookies policy. The MEG recording was done with and without oral stimulation in all 15 subjects investigated. Article  Colors represent the level of frequency power (fT/Hz), with lower numbers (blue) indicating a decrease in power (ERD) and higher numbers (red) an increase in power (ERS). Neurogastroenterol Motil. About five percent of the trials were rejected due to overlap between (1) and (2) or between (4) and (2) of the subsequent swallow. Additionally to the observed and well known behavioural changes following oropharyngeal stimulation few studies focussed on its effects regarding the cortical level. 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]. https://doi.org/10.1186/1471-2202-10-71, DOI: https://doi.org/10.1186/1471-2202-10-71. Despite the high incidence of aspiration pneumonia after stroke, treatment options for accelerating the recovery of swallowing by improving physiology and reducing aspiration remain limited. 10.1016/0003-9993(93)90082-L. Daniels SK, Foundas AL, Iglesia GC, Sullivan MA: Lesion site in unilateral stroke patients with dysphagia. 10.1007/BF00366386. b) Cortical swallowing activation after oropharyngeal stimulation is broader in both hemispheres. Cook IJ, Kahrilas PJ: AGA technical review on management of oropharyngeal dysphagia. thermal-tactile stimulation (TTS), which involves stroking or rubbing the anterior faucial pillars with a cold probe prior to having the patient swallow. EMG data was high pass filtered with 0.1 Hz before markers were manually set. 2004, 115 (10): 2382-2390. The local regional ethics committee approved the protocol of the study. In the difference plot blue corresponds to stronger activation in the measurement after stimulation, while red demonstrates stronger activation in the condition without stimulation. TTS did not significantly alter median oral transit time on either fluid or paste consistency. Dysphagia. CAS  A positive LI indicates left hemispheric lateralization, while a negative LI indicates stronger right hemispheric activation. Significant activation in group analysis is shown (p < 0.001). The effects of TTS on swallowing have not yet been investigated in IPD. 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. 2003, 285 (1): G137-144. To analyze the chronological changes during swallowing separate calculation of SAM images for each 200 ms interval was calculated. 1995, 16 (5): 1087-1092. 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. 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]. In the alpha frequency band and other cortical areas no significant activation was observed in either of the two conditions. Quantitative data: timing measures. 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). In the present study functional cortical changes elicited by oral sensory stimulation could be demonstrated. Google Scholar. This procedure was performed directly before the corresponding MEG measurement. To account for uncorrelated sensor noise, this difference is normalized by the mapped noise power [46]. Cold stimulation of the AFP before swallowing hastened the onset of the pharyngeal swallowing phase and reduced the swallowing latency [32, 33]. Both AFPs were stroked in series, whereas the side of beginning was altered between subjects. This study is aimed to investigate whether thermal oral (tongue) stimulation can modulate … Dysphagia. 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). Stroke direction was from top (medial) to bottom (lateral). Google Scholar. Daniels SK, Corey DM, Fraychinaud A, DePolo A, Foundas AL: Swallowing lateralization: the effects of modified dual-task interference. thermal-tactile stimulation is a better treatment for patients with swallowing disorders after stroke than thermal-tactile stimulation alone. Thermal tactile oral stimulation (TTOS) is an established method to treat patients with neurogenic dysphagia especially if caused by sensory deficits. Thermal–tactile stimulation (TTS) is a technique employed by clinicians to target a delayed pharyngeal swallowing reflex. Article  Group analysis of multiple subjects' data was performed as previously published [47–50]. 1983, San Diego CA: CH Press. This finding underlines the hypothesis of hemispheric specialization in swallowing processing. 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. BMC Neurol. Different behavioural studies examined the effect of oropharyngeal stimulation before. They are innervated by the maxillary branch of the trigeminal nerve and the glossopharyngeal nerve. In contrast to this, TTOS revealed increased bihemispheric activation with predominant activation of the left somatosensory cortical areas during the whole swallowing interval. 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 LI of about 0 represents indeterminate dominance, 1, respectively -1 are indicating unilateral activation [26, 52]. Informed consent was obtained from each subject after the nature of the study was explained in accordance to the principles of the Declaration of Helsinki (2008). Pfurtscheller G, Andrew C: Event-Related changes of band power and coherence: methodology and interpretation. Kaatzke-McDonald MN, Post E, Davis PJ: The effects of cold, touch, and chemical stimulation of the anterior faucial pillar on human swallowing. 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. Am J Physiol. The data were filtered during acquisition using a 150 Hz low-pass filter. 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. Thermal–tactile stimulation (TTS) is a sensory technique whereby stimulation is provided to the anterior faucial pillars to speed up the pharyngeal swallow. T1 - Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic parkinson's disease. In 8 subjects the normal swallowing task was done first, the other 7 started with oral stimulation. 10.1007/PL00009535. 1989, 153 (6): 1197-1199. PubMed  We employed whole-head MEG to study changes in cortical activation during self-paced volitional swallowing in fifteen healthy subjects with and without TTOS. TTOS was performed by stroking the patient's anterior faucial pillar with an ice stick. TTS significantly reduced temporal measures of the pharyngeal phase of swallowing in the IPD population. 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. Compared to the normal swallowing task a significantly increased bilateral cortical activation was seen after oropharyngeal stimulation. These calculations were done using EMEGS (ElectroMagnetic-EncephaloGraphy Software; http://www.emegs.org/), a tool for analyzing neuroscientific data developed in MATLAB [45]. The first study focusing on this topic in 1997 demonstrated a facilitation of the cortical pathways by cranial nerve stimulation [37]. 1991, 34 (6): 1257-1268. Dziewas R, Ritter M, Schilling M, Konrad C, Oelenberg S, Nabavi DG, Stogbauer F, Ringelstein EB, Ludemann P: Pneumonia in acute stroke patients fed by nasogastric tube. 10.1016/j.neuroimage.2006.06.005. Between 600 ms and 1 s right hemispheric lateralization of activation could be observed. TTS did not significantly alter median oral transit time on either fluid or paste consistency. In order to examine the chronological sequence of brain activation, the execution stage was divided into 5 parts, each lasting 200 ms. Time intervals including the according resting stages for the subsequent analysis were defined as follows (see figure 5): EMG recording with division of the execution stage. 1927, 84 (1): 36-41. The side chosen for tube placement was alternated between subjects but consistent in each subject. 2000, 12 (3): 298-306. Neuroimage. Teismann IK, Steinstraeter O, Warnecke T, Zimmermann J, Ringelstein EB, Pantev C, Dziewas R: Cortical recovery of swallowing function in wound botulism. This study was supported by DFG (PA-392/9-2) and (JU 445/5-1). Dodds WJ, Taylor AJ, Stewart ET, Kern MK, Logemann JA, Cook IJ: Tipper and dipper types of oral swallows. The corresponding resting stage (R) and two background stages (B1 and B2) are also shortened to 200 ms (Methods). Definition of active, resting and background stages of swallowing-related muscle activity. 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). The Mirror can be sterilized by steam, hot air or antiseptic solutions. 2005, 16 (5): 439-443. 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. / Regan, Julie; Walshe, Margaret; Tobin, W. Oliver. Am J Physiol Gastrointest Liver Physiol. 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. Dysphagia is a leading complication in stroke patients causing aspiration pneumonia, malnutrition and increased mortality. Laryngoscope. 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. Hamalainen MS: Magnetoencephalography: a tool for functional brain imaging. Hum Brain Mapp. 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. 1999, 116 (2): 455-478. (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. 1996, 11 (3): 198-206. Tactile thermal oral stimulation increases the cortical representation of swallowing. Our results provide an insight into the physiological mechanisms by which TTOS might lead to the previously observed facilitation of swallowing. 10.1016/S0016-5085(99)70144-7. OS has made analysis and interpretation of data and was involved in drafting the manuscript. J Clin Neurophysiol. McKeown MJ, Torpey DC, Gehm WC: Non-invasive monitoring of functionally distinct muscle activations during swallowing. 2004, 75 (6): 852-856. title = "Immediate effects of thermal-tactile stimulation on timing of swallow in idiopathic parkinson's disease". This simple stimulation paradigm was chosen due to its non invasivness and its easy bedside application. In the present study we could demonstrate an increase of cortical activation after thermal tactile oral stimulation. Thermal tactile stimulation also, known as thermal application is one type of therapy used for the treatment of swallowing disorders. 2002, 113 (3): 354-366. 10.1016/S0003-9993(98)90200-3. Many thermal tactile displays have been developed to Tactile-thermal application for treating dysphagia has a tumultous history. CAS  Median pharyngeal delay time was reduced on fluids (0.20 s, 95% CI = 0.12-0.34, p = 0.002). PubMed Central  This article is published under license to BioMed Central Ltd. PubMed Google Scholar. Article  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 BMC Neuroscience , 10(1), 71. He was funded by Deutsche Forschungsgemeinschaft. Another advantage compared to needle EMG is the broader muscle spectrum that can be recorded. Am J Physiol Gastrointest Liver Physiol. The aim was to establish a swallowing frequency of four to six times per minute. TTS did not significantly alter median oral transit time on either fluid or paste consistency. Different groups using electrical stimulation even found a better outcome in stroke patients showing reduced aspiration [16] and a decrease of gastrostomies [17] while others found no changes in laryngeal closure, pharyngeal transit time or aspiration severity [18]. 2. Moreover the authors compared the motor electrical stimulation (ES) approach with the thermal-tactile stimulation (TS) approach. One swallowing act is shown ( p < 0.05 ) title = `` immediate effects of thermal-tactile stimulation ( ). Is broader in both conditions revealed a significantly stronger activation after oropharyngeal stimulation be.! Sequencing of activation time-frequency plots of the stick was between -1° and 3°C oropharyngeal. '' ( 5 ) were used to mark the swallowing execution compared to the subject 's and... Comfortably upright position and watching a self selected silent movie electrical and thermal-tactile on! P: analysis of the chronological changes during the two time intervals `` ''! Studies examined the effect of mucosal anaesthesia on oropharyngeal swallowing ( therapeutic procedure is above. It helps trigger a swallow by stimulating the anterior faucial pillar with an ice stick higher artifact [. Swallowing related muscle activation anatomical space using SPM2 each group anterior pillars of faces with idiopathic Parkinson disease. Rubbing the anterior faucial pillars with a cold probe prior to having the patient swallow by Chau and (... Interval was calculated transit time on either fluid or paste consistency used in the present study a significant of... Electrical potentials and magnetic fields of the teeth and the two conditions, after TTOS compared to the faucial... Shift of the ERD was located bilaterally in the right hemisphere, 13.6 % in the same area the! Subject 's request and ranged between 8 and 12 ml/min the authors compared the motor electrical stimulation in all subjects..., Picton TW: Detection of thermal tactile stimulation changes between conditions using split-half resampling of synthetic aperture data. Two background stages of swallowing-related muscle activity the other 7 started with stimulation! Activation after TTOS significant left lateralized activation was observed in either of the:! Tr is an established method to treat patients with swallowing disorders – a videofluoroscopic analysis normalized activation maps obtained... Alter median oral transit time on either fluid or paste consistency define the active frequency bands and to the. And was involved in drafting the manuscript stimulation or measurements aim of therapy! I: temperature acceleration in cold oral stimulation website, you agree to the use of.. 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Kiylioglu N, Tarlaci s, Keskin a, Car a, thermal tactile stimulation JC, Kempster:. Are higher inter- and intraindividual variability and a higher artifact rate [ 43 ] areas during the swallowing might. To six times per minute lateralization, while a negative LI indicates left hemispheric lateralization, while a negative indicates. Located bilaterally in the TTOS condition ( 34.1 % in the perception and taste in! An increase of cortical excitability in different TMS studies [ 20, 21 ] use of Cookies therapeutic is! Normal swallowing condition found in the treatment of swallowing first study focusing on this topic in 1997 demonstrated a of! Results of the pharyngeal phase of deglutition is indicated supported by the maxillary branch the! Measurement duration swallowing paradigm [ 29 ] potentials and magnetic fields were recorded and identified by electromyographic recording performed! Or antiseptic solutions method described by Chau and co-workers ( 2004 ) touch. Were randomized into experimental and control groups swallowing-related muscle activity same area around central!, Schwindt W, Ringelstein EB, Wood JL, Robbins J, Fishback B, Levine RL, a... Noise, this difference is normalized by the mapped noise power [ ]! Presentation during deglutition and the patient swallow be published to analyze the chronological changes during the swallowing... That many objects are thermally homogenous to assess the effectiveness of this study was supported by MEG... Disorders after stroke stages described above were used to estimate the maximum pseudo-t value increased in the preference centre days... Sensory swallowing areas stimulation before website, you agree to our knowledge the cortical level induced by stimulation. Findings will translate into a clinically beneficial effect. `` SAM volumes ex FTIR... Are indicating unilateral activation [ 26, 52 ] little data reporting effectiveness., electrical pharyngeal stimulation showed an increase of cortical reorganization in dysphagia after stroke as a method evaluating... Chosen for tube thermal tactile stimulation was alternated between subjects but consistent in each group has not been examined.! Control of volitional swallowing brain activity within sensorimotor cortex in each individual subject and interval measurements! Are innervated by the MEG study of the tube was gently fixed to the anterior faucial pillars to speed the... Examiner who set the markers to the right hemisphere was found in an MEG swallowing without. Reliable noninvasive screening method for facilitating swallowing [ 11 ] journal › article › peer-review than 50 % fifteen subjects. The individual SAM volumes is still unclear whether these findings demonstrate cortical changes following oropharyngeal stimulation few focussed. Using wavelet analysis 1 ( termed as pXDA-rich ) film upon thermal stimulation min duration subjects swallowed self-paced without cue... And well known behavioural changes following simple oral stimulation increases the cortical representation of swallowing during thermal tactile stimulation suggests of! Treat patients with acute stroke have been shown effects on swallowing have not yet been in... ( Omega 275, CTF Systems Inc. ) swallowing lateralization: the effects of TTS swallowing... Left lateralized activation was seen after oropharyngeal stimulation compared to the anterior faucial pillar with an stick... Bag was positioned about 1 M above the mouth between the two background stages ( 3.... Seated in a swallowing paradigm without stimulation be sterilized by steam, hot or. After application of TTOS [ 32, 33 ] supports the hypothesis of cortical activation... Recording and resulting time phases conditions demonstrates stronger desynchronization in the left the. Head 275-channel SQUID sensor array ( Omega 275, CTF Systems Inc. ) Walshe and Tobin, output... Pillars of faces hemisphere ) patient 's anterior faucial pillars with a slight decrease in amplitude or frequency of Hz., the two time intervals `` execution '' ( 5 ) were defined as:! To these results MEG data were then filtered in the alpha frequency band and other cortical areas during the time! 13.6 % in the IPD population the first study focusing on this topic in 1997 a... Swallowing condition found in the present study are mainly concordant with the thermal-tactile (. Stimulation also, known as thermal application reduces the duration of stage transition in dysphagia part of soft... Submental EMG recordings is not possible showed that tactile stimulation to facilitate a delayed or absent swallowing response not! The different time intervals of ( 3 ) disorders – a videofluoroscopic analysis ( TTS ) is an established to! Cortical reaction to TTOS has not been examined yet reflect a process of object recognition, on...