Nakamori Masahiro, Ishikawa Ruoyi, Watanabe Tomoaki, Toko Megumi, Naito Hiroyuki, Takahashi Tamayo, Simizu Yoshitaka, Yamazaki Yu, Maruyama Hirofumi
Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Dental Anesthesiology, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.
Front Neurol. 2023 Aug 3;14:1212024. doi: 10.3389/fneur.2023.1212024. eCollection 2023.
Non-invasive, simple, and repetitive swallowing evaluation is required to prevent aspiration pneumonia in neurological care. We investigated the usefulness of swallowing sound evaluation in patients with amyotrophic lateral sclerosis (ALS) using our new electronic stethoscope artificial intelligence (AI) analysis tool.
We studied patients with ALS who provided written informed consent. We used an electronic stethoscope, placed a Bluetooth-enabled electronic stethoscope on the upper end of the sternum, performed a 3-mL water swallow three times, and remotely identified the intermittent sound components of the water flow caused at that time by AI, with the maximum value as the swallowing sound index. We examined the correlation between the swallowing sound index and patient background, including swallowing-related parameters.
We evaluated 24 patients with ALS (age 64.0 ± 11.8 years, 13 women, median duration of illness 17.5 months). The median ALS Functional Rating Scale-Revised (ALSFRS-R) score was 41 (minimum 18, maximum 47). In all cases, the mean swallowing sound index was 0.209 ± 0.088. A multivariate analysis showed that a decrease in the swallowing sound index was significantly associated with a low ALSFRS-R score, an ALSFRS-R bulbar symptom score, % vital capacity, tongue pressure, a Mann Assessment of Swallowing Ability (MASA) score, and a MASA pharyngeal phase-related score.
Swallowing sound evaluation using an electronic stethoscope AI analysis showed a correlation with existing indicators in swallowing evaluation in ALS and suggested its usefulness as a new method. This is expected to be a useful examination method in home and remote medical care.
在神经护理中，需要进行无创、简单且可重复的吞咽评估以预防吸入性肺炎。我们使用新的电子听诊器人工智能（AI）分析工具，研究了吞咽声音评估在肌萎缩侧索硬化症（ALS）患者中的实用性。
我们研究了签署书面知情同意书的ALS患者。我们使用电子听诊器，将具有蓝牙功能的电子听诊器置于胸骨上端，让患者分三次吞咽3毫升水，然后通过AI远程识别此时水流产生的间歇性声音成分，以最大值作为吞咽声音指数。我们检查了吞咽声音指数与患者背景（包括吞咽相关参数）之间的相关性。
我们评估了24例ALS患者（年龄64.0±11.8岁，女性13例，疾病中位持续时间17.5个月）。ALS功能评定量表修订版（ALSFRS-R）的中位评分为41分（最低18分，最高47分）。在所有病例中，平均吞咽声音指数为0.209±0.088。多因素分析显示，吞咽声音指数降低与低ALSFRS-R评分、ALSFRS-R延髓症状评分、肺活量百分比、舌压、吞咽能力曼恩评估（MASA）评分以及MASA咽期相关评分显著相关。
使用电子听诊器AI分析进行的吞咽声音评估显示与ALS吞咽评估中的现有指标相关，并表明其作为一种新方法的实用性。这有望成为家庭和远程医疗中的一种有用检查方法。
