A comparison between swallowing sounds and vibrations in patients with dysphagia

The cervical auscultation refers to the observation and analysis of sounds or vibrations captured during swallowing using either a stethoscope or acoustic/vibratory detectors. Microphones and accelerometers have recently become two common sensors used in modern cervical auscultation methods. There are open questions about whether swallowing signals recorded by these two sensors provide unique or complementary information about swallowing function; or whether they present interchangeable information. This study aims to compare of swallowing signals recorded by a microphone and a tri-axial accelerometer from 72 patients (mean age 63.94 ± 12.58 years, 42 male, 30 female), who had videofluoroscopic examination. The participants swallowed one or more boluses of thickened liquids of different consistencies, including thin liquids, nectar-thick liquids, and pudding. A comfortable self-selected volume from a cup or a controlled volume by the examiner from a 5 ml spoon was given to the participants. A broad feature set was extracted in time, information-theoretic, and frequency domains from each of 881 swallows presented in this study. The swallowing sounds exhibited significantly higher frequency content and kurtosis values than the swallowing vibrations. In addition, the Lempel-Ziv complexity was lower for swallowing sounds than those for swallowing vibrations. To conclude, information provided by microphones and accelerometers about swallowing function are unique and these two transducers are not interchangeable. Consequently, the selection of transducer would be a vital step in future studies.

[1]  Tom Chau,et al.  Understanding the statistical persistence of dual-axis swallowing accelerometry signals , 2010, Comput. Biol. Medicine.

[2]  Koji Takahashi,et al.  Methodology for detecting swallowing sounds , 2004, Dysphagia.

[3]  C. Wolfe,et al.  Long-term outcome after stroke: does dysphagia matter? , 2006, Age and ageing.

[4]  Tom Chau,et al.  Vocalization removal for improved automatic segmentation of dual-axis swallowing accelerometry signals. , 2010, Medical engineering & physics.

[5]  Tom Chau,et al.  Automatic discrimination between safe and unsafe swallowing using a reputation-based classifier , 2011, Biomedical engineering online.

[6]  Sergio Cerutti,et al.  Entropy, entropy rate, and pattern classification as tools to typify complexity in short heart period variability series , 2001, IEEE Transactions on Biomedical Engineering.

[7]  J. Christie,et al.  Express Your LOV: An Engineered Flavoprotein as a Reporter for Protein Expression and Purification , 2012, PloS one.

[8]  I. Gewolb,et al.  Variability of Swallow-associated Sounds in Adults and Infants , 2009, Dysphagia.

[9]  E. Ferlin,et al.  Assessment of Swallowing Sounds by Digital Cervical Auscultation in Children , 2008, The Annals of otology, rhinology, and laryngology.

[10]  Subashan Perera,et al.  Anatomical Directional Dissimilarities in Tri-axial Swallowing Accelerometry Signals , 2017, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[11]  S. Hamlet,et al.  Stethoscope acoustics and cervical auscultation of swallowing , 2004, Dysphagia.

[12]  Yong Man Ro,et al.  Mass type-specific sparse representation for mass classification in computer-aided detection on mammograms , 2013, Biomedical engineering online.

[13]  Tom Chau,et al.  The effects of head movement on dual-axis cervical accelerometry signals , 2010, BMC Research Notes.

[14]  Roberto Hornero,et al.  Interpretation of the Lempel-Ziv Complexity Measure in the Context of Biomedical Signal Analysis , 2006, IEEE Transactions on Biomedical Engineering.

[15]  Tom Chau,et al.  A Method for Removal of Low Frequency Components Associated with Head Movements from Dual-Axis Swallowing Accelerometry Signals , 2012, PloS one.

[16]  Tom Chau,et al.  Classification of healthy and abnormal swallows based on accelerometry and nasal airflow signals , 2011, Artif. Intell. Medicine.

[17]  Damijan Miklavčič,et al.  Web-based tool for visualization of electric field distribution in deep-seated body structures and planning of electroporation-based treatments , 2015, Biomedical engineering online.

[18]  A. Yadollahi,et al.  Feature selection for swallowing sounds classification , 2007, 2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[19]  Tom Chau,et al.  Segmentation of Dual-Axis Swallowing Accelerometry Signals in Healthy Subjects With Analysis of Anthropometric Effects on Duration of Swallowing Activities , 2009, IEEE Transactions on Biomedical Engineering.

[20]  M. Reding,et al.  Aspiration and relative risk of medical complications following stroke. , 1994, Archives of neurology.

[21]  Catriona M. Steele,et al.  The Influence of Food Texture and Liquid Consistency Modification on Swallowing Physiology and Function: A Systematic Review , 2014, Dysphagia.

[22]  O. Ekberg,et al.  Videomanometric Analysis of Supraglottic Swallow, Effortful Swallow, and Chin Tuck in Healthy Volunteers , 1999, Dysphagia.

[23]  T. Chau,et al.  A procedure for denoising dual-axis swallowing accelerometry signals , 2010, Physiological measurement.

[24]  L. T. DeCarlo.  On the meaning and use of kurtosis. , 1997 .

[25]  Koji Takahashi,et al.  Symmetry and reproducibility of swallowing sounds , 2004, Dysphagia.

[26]  Z. Moussavi,et al.  Automated Extraction of Swallowing Sounds Using a Wavelet-Based Filter , 2006, 2006 International Conference of the IEEE Engineering in Medicine and Biology Society.

[27]  Giuseppe Baselli,et al.  Measuring regularity by means of a corrected conditional entropy in sympathetic outflow , 1998, Biological Cybernetics.

[28]  O. Ekberg,et al.  Supraglottic Swallow, Effortful Swallow, and Chin Tuck Did Not Alter Hypopharyngeal Intrabolus Pressure in Patients with Pharyngeal Dysfunction , 2002, Dysphagia.

[29]  B. Murdoch,et al.  Acoustic Signature of the Normal Swallow: Characterization by Age, Gender, and Bolus Volume , 2002, The Annals of otology, rhinology, and laryngology.

[30]  Bruce E. Murdoch,et al.  Detection of Swallowing Sounds: Methodology Revisited , 2001, Dysphagia.

[31]  J. Stierwalt,et al.  An Acoustic Profile of Normal Swallowing , 2005, Dysphagia.

[32]  Tom Chau,et al.  Classification of Penetration--Aspiration Versus Healthy Swallows Using Dual-Axis Swallowing Accelerometry Signals in Dysphagic Subjects , 2013, IEEE Transactions on Biomedical Engineering.

[33]  H. Brenman,et al.  Mouthing activities in the human neonatal sucking act. , 1969, Archives of oral biology.

[34]  Tom Chau,et al.  Effects of liquid stimuli on dual-axis swallowing accelerometry signals in a healthy population , 2010, Biomedical engineering online.

[35]  Bruce E. Murdoch,et al.  The Physiologic Cause of Swallowing Sounds: Answers from Heart Sounds and Vocal Tract Acoustics , 1998, Dysphagia.

[36]  R. H. Mills,et al.  Using cervical auscultation in the clinical dysphagia examination in long-term care , 2004, Dysphagia.

[37]  J. Heinz,et al.  Cervical Auscultation Of Suckle Feeding In Newborn Infants , 1990, Developmental medicine and child neurology.

[38]  Ervin Sejdic,et al.  Dysphagia Screening: Contributions of Cervical Auscultation Signals and Modern Signal-Processing Techniques , 2015, IEEE Transactions on Human-Machine Systems.

[39]  Joshua M. Dudik,et al.  The effects of increased fluid viscosity on swallowing sounds in healthy adults , 2013, Biomedical engineering online.

[40]  Richard D. Wilson,et al.  A Cost‐Effectiveness Analysis of Screening Methods for Dysphagia After Stroke , 2012, PM & R : the journal of injury, function, and rehabilitation.

[41]  N. P. Reddy,et al.  Measurements of acceleration during videofluorographic evaluation of dysphagic patients. , 2000, Medical engineering & physics.

[42]  T Chau,et al.  Hyolaryngeal excursion as the physiological source of swallowing accelerometry signals , 2010, Physiological measurement.

[43]  Tom Chau,et al.  Noninvasive Detection of Thin-Liquid Aspiration Using Dual-Axis Swallowing Accelerometry , 2012, Dysphagia.

[44]  Joshua M. Dudik,et al.  A comparative analysis of DBSCAN, K-means, and quadratic variation algorithms for automatic identification of swallows from swallowing accelerometry signals , 2015, Comput. Biol. Medicine.

[45]  Tom Chau,et al.  Swallow segmentation with artificial neural networks and multi-sensor fusion. , 2009, Medical engineering & physics.

[46]  Maurizio Ranieri,et al.  Acoustic analysis of swallowing sounds: a new technique for assessing dysphagia. , 2009, Journal of rehabilitation medicine.

[47]  I. Aydogdu,et al.  The effect of head and neck positions on oropharyngeal swallowing: a clinical and electrophysiologic study. , 2001, Archives of physical medicine and rehabilitation.

[48]  Jing Hu,et al.  Analysis of Biomedical Signals by the Lempel-Ziv Complexity: the Effect of Finite Data Size , 2006, IEEE Transactions on Biomedical Engineering.

[49]  Joshua M. Dudik,et al.  A comparative analysis of swallowing accelerometry and sounds during saliva swallows , 2015, Biomedical engineering online.

[50]  Dana Christine Bech-Hansen Zoratto,et al.  Hyolaryngeal Excursion as the Physiological Source of Accelerometry Signals during Swallowing , 2010 .

[51]  Edward Sazonov,et al.  Swallowing detection by sonic and subsonic frequencies: A comparison , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[52]  Tom Chau,et al.  Baseline Characteristics of Dual-Axis Cervical Accelerometry Signals , 2010, Annals of Biomedical Engineering.

[53]  Edward Sazonov,et al.  Non-invasive monitoring of chewing and swallowing for objective quantification of ingestive behavior. , 2008, Physiological measurement.

[54]  T Chau,et al.  Time and time–frequency characterization of dual-axis swallowing accelerometry signals , 2008, Physiological measurement.

[55]  Tom Chau,et al.  An Online Swallow Detection Algorithm Based on the Quadratic Variation of Dual-Axis Accelerometry , 2010, IEEE Transactions on Signal Processing.

[56]  W J Logan,et al.  Sonic correlates of human deglutition. , 1967, Journal of applied physiology.

[57]  Suzanne Kieffer,et al.  Feature extraction and selection for objective gait analysis and fall risk assessment by accelerometry , 2011, Biomedical engineering online.