Lee Woo Hyung, Lim Min Hyuk, Nam Hyung Seok, Kim Yoon Jae, Seo Han Gil, Bang Moon Suk, Seong Min Yong, Oh Byung-Mo, Kim Sungwan
Department of Biomedical Engineering, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
J Electromyogr Kinesiol. 2019 Aug;47:57-64. doi: 10.1016/j.jelekin.2019.05.011. Epub 2019 May 16.
This study aimed to investigate spatiotemporal characteristics of the hyoid bone during swallowing in patients with Parkinson's disease (PD) and dysphagia. Spatiotemporal data of the hyoid bone was obtained from videofluoroscopic images of 69 subjects (23 patients with PD, 23 age- and sex-matched healthy elderly controls, and 23 healthy young controls). Normalized profiles of displacement/velocity were analyzed during different periods (percentile) of swallowing using functional regression analysis, and the maximal values were compared between the groups. Maximal horizontal displacement and velocity were significantly decreased during the initial backward (P = 0.006 and P < 0.001, respectively) and forward (P = 0.008 and P < 0.001, respectively) motions in PD patients compared to elderly controls. Maximal vertical velocity was significantly lower in PD patients than in elderly controls (P = 0.001). No significant difference was observed in maximal displacement and velocity in both horizontal and vertical planes between the healthy elderly and young controls, although horizontal displacement was significantly decreased during the forward motion (51st-57th percentiles) in the elderly controls. In conclusion, reduced horizontal displacement and velocity of the hyoid bone during the forward motion would be due to combined effects of disease and aging, whereas those over the initial backward motion may be considered specific to patients with PD.
本研究旨在调查帕金森病(PD)伴吞咽困难患者吞咽过程中舌骨的时空特征。舌骨的时空数据取自69名受试者的视频荧光图像(23例PD患者、23例年龄和性别匹配的健康老年对照者以及23例健康年轻对照者)。使用功能回归分析在吞咽的不同阶段(百分位数)分析位移/速度的标准化曲线,并比较各组之间的最大值。与老年对照者相比,PD患者在初始向后(分别为P = 0.006和P < 0.001)和向前(分别为P = 0.008和P < 0.001)运动期间的最大水平位移和速度显著降低。PD患者的最大垂直速度显著低于老年对照者(P = 0.001)。尽管老年对照者在向前运动(第51 - 57百分位数)期间水平位移显著降低,但健康老年对照者和年轻对照者在水平和垂直平面上的最大位移和速度均未观察到显著差异。总之,向前运动期间舌骨水平位移和速度降低是疾病和衰老共同作用的结果,而初始向后运动期间的降低可能是PD患者特有的。