Fang Gang, Zhuang Ren, Wang Chaolan, Zhou Mengye, Zhang Yi
Department of Rehabilitation, No. 1 Hospital of Changzhou and Third Affiliated Hospital of Soochow University, 185 Juqian Street, Tianning District, Changzhou, Jiangsu, China.
Changzhou De'an Hospital, 11 Taoyuan Road, Tianning District, Changzhou, Jiangsu, China.
Dysphagia. 2025 May 4. doi: 10.1007/s00455-025-10830-6.
Swallowing disorder or dysphagia is one of the common functional disorders in stroke survivors, and its early screening is important for reducing patient dependence, pneumonia incidence, mortality, and shortening the hospital stay. However, the commonly used methods to examine dysphagia, which include Toronto bedside swallowing screening test, volume viscosity swallowing test, and swallowing angiography screening/examination, are all invasive with the risk of aspiration. Here we have undertaken a detailed voice analysis on stroke patients with dysphagia by monitoring a series of acoustic parameters including maximum volume, maximum pitch, glottal noise excitation ratio, fundamental frequency perturbation, amplitude perturbation (Shimmer), maximum pronunciation time, irregularity, breath sound, overall severity, and voice disorder severity index. We show that all these acoustic parameters change significantly for the stroke patients with dysphagia compared with the healthy group as well as stroke group with no dysphagia, and the changes are correlated with the severity of pharyngeal residue especially for Shimmer and overall severity of the voice. Our findings suggest that voice analysis, which is quick and non-invasive, may give an important initial indication on the severity of dysphagia and cross-validate results from swallowing tests that clinicians may further pursue for a thorough diagnosis of dysphagia.
吞咽障碍或吞咽困难是中风幸存者常见的功能障碍之一，其早期筛查对于减少患者依赖、降低肺炎发病率、死亡率以及缩短住院时间至关重要。然而，常用的吞咽困难检查方法，包括多伦多床边吞咽筛查试验、容积黏度吞咽试验以及吞咽血管造影筛查/检查，均具有侵入性且存在误吸风险。在此，我们通过监测一系列声学参数，包括最大音量、最大音调、声门噪声激励比、基频微扰、幅度微扰（闪烁）、最大发音时间、不规则度、呼吸音、整体严重程度以及嗓音障碍严重指数，对患有吞咽困难的中风患者进行了详细的嗓音分析。我们发现，与健康组以及无吞咽困难的中风组相比，所有这些声学参数在患有吞咽困难的中风患者中均有显著变化，并且这些变化与咽部残留的严重程度相关，尤其是闪烁和嗓音的整体严重程度。我们的研究结果表明，快速且非侵入性的嗓音分析可能为吞咽困难的严重程度提供重要的初步指示，并对吞咽测试结果进行交叉验证，临床医生可进一步采用这些结果以进行吞咽困难的全面诊断。
