Seo Han Gil, Oh Byung-Mo, Leigh Ja-Ho, Han Tai Ryoon
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 110-744, Republic of Korea.
Dysphagia. 2014 Oct;29(5):591-602. doi: 10.1007/s00455-014-9550-9. Epub 2014 Jul 8.
Although coordination and timing of swallowing have often been investigated by using discrete timing events such as the onset, peak, and duration of specific motions, the sequence and duration of swallowing events cannot represent the coordination of the swallowing mechanism quantitatively. This study aimed to apply a cross-correlation analysis of the motions of the hyolaryngeal structures during swallowing as an objective method for measuring the coordination and timing of the motions. Forty healthy subjects swallowed 2 and 5 ml of diluted barium solution (35 %) and 5 ml of curd yogurt under videofluoroscopy. Hyolaryngeal motions in videofluoroscopic images were digitized using the motion analysis system. The time series of the horizontal and vertical hyoid motion, the laryngeal elevation, and the angle of the epiglottic tilt were analyzed using cross-correlation at each 1/60-s time lag. The results showed high and consistent cross-correlations between hyolaryngeal motions during swallowing in most of the subjects regardless of age and bolus type. The horizontal hyoid motion and laryngeal elevation were more strongly correlated with the epiglottic tilt than the vertical hyoid motion, which might suggest the mechanism of the epiglottic tilt during swallowing. The bolus volume and viscosity affected the correlation coefficients and time lags between the hyolaryngeal motions, particularly those related to the epiglottic tilt. The results suggest that cross-correlation analysis may be used for measuring the coordination and timing of swallowing. Further studies using cross-correlation analysis of additional physiological factors related to swallowing or pathological conditions are warranted.
尽管吞咽的协调性和时间安排常常通过使用离散的时间事件来研究，比如特定动作的起始、峰值和持续时间，但吞咽事件的顺序和持续时间并不能定量地反映吞咽机制的协调性。本研究旨在应用吞咽过程中舌骨下咽结构运动的互相关分析，作为一种测量运动协调性和时间安排的客观方法。40名健康受试者在透视荧光检查下吞咽2毫升和5毫升稀释钡剂溶液（35%）以及5毫升凝乳状酸奶。使用运动分析系统将透视荧光检查图像中的舌骨下咽运动数字化。在每1/60秒的时间滞后，使用互相关分析舌骨水平和垂直运动、喉部抬高以及会厌倾斜角度的时间序列。结果显示，无论年龄和团块类型如何，大多数受试者在吞咽过程中舌骨下咽运动之间都存在高度且一致的互相关。与舌骨垂直运动相比，舌骨水平运动和喉部抬高与会厌倾斜的相关性更强，这可能提示了吞咽过程中会厌倾斜机制。团块体积和黏度影响了舌骨下咽运动之间的相关系数和时间滞后，尤其是那些与会厌倾斜相关的运动。结果表明，互相关分析可用于测量吞咽的协调性和时间安排。有必要进一步开展研究，对与吞咽或病理状况相关的其他生理因素进行互相关分析。
