Application of Automatic Kinematic Analysis Program for the Evaluation of Dysphagia in ALS patients

Ban Hyung Lee, Jun Chang Lee, Sun Myoung Lee, Yulhyun Park, Ju Seok Ryu

Research output: Contribution to journalArticle

Abstract

Dysphagia in amyotrophic lateral sclerosis (ALS) increases the risk of malnutrition, dehydration, and aspiration pneumonia. Kinematic analysis of videofluoroscopic swallowing study (VFSS) can provide detailed movement of the hyoid bone, revealing abnormalities of swallowing in ALS patients. We developed an automated kinematic analysis program (AKAP) that analyzes the trajectory of the hyoid bone via a visual tracking method. The aim of this study was to investigate the hyoid movement in ALS patients using AKAP and compare it with non-dysphagic subjects. Thirty ALS patients who underwent VFSS in Seoul National University Bundang Hospital between 2015 and 2017 were recruited. For comparison, 30 age-matched control subjects were also enrolled; the same swallowing study was conducted using thin fluid and yogurt. The hyoid bone movement was analyzed by evaluating the vertical and horizontal distances with four peak points (A, B, C, D), and the time of each point were also calculated. With respect to distance parameters, only vertical peak distance (distance between B, D points) during thin fluid swallowing was significantly decreased in ALS patients. (p = 0.038) With respect to temporal parameters, Time ABC, Time ABCD, and Duration C were significantly increased in ALS patients when swallowing both thin fluid and yogurt. (Time ABC p = 0.019, p = 0.002; Time ABCD p = 0.001, p = 0.004; Duration C p = 0.004, p = 0.025 respectively). This result revealed that dysphagia in ALS patient is caused by decreased velocity of hyoid bone movement due to the development of weakness in swallowing-related muscles. The parameters of kinematic analysis could be used to quantitatively evaluate dysphagia in motor neuron disease.

Original languageEnglish
Article number15644
JournalScientific Reports
Volume9
Issue number1
DOIs
StatePublished - 1 Dec 2019

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Amyotrophic Lateral Sclerosis
Program Evaluation
Deglutition
Deglutition Disorders
Biomechanical Phenomena
Hyoid Bone
Yogurt
Aspiration Pneumonia
Motor Neuron Disease
Dehydration
Malnutrition
Muscles

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Lee, Ban Hyung ; Lee, Jun Chang ; Lee, Sun Myoung ; Park, Yulhyun ; Ryu, Ju Seok. / Application of Automatic Kinematic Analysis Program for the Evaluation of Dysphagia in ALS patients. In: Scientific Reports. 2019 ; Vol. 9, No. 1.
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abstract = "Dysphagia in amyotrophic lateral sclerosis (ALS) increases the risk of malnutrition, dehydration, and aspiration pneumonia. Kinematic analysis of videofluoroscopic swallowing study (VFSS) can provide detailed movement of the hyoid bone, revealing abnormalities of swallowing in ALS patients. We developed an automated kinematic analysis program (AKAP) that analyzes the trajectory of the hyoid bone via a visual tracking method. The aim of this study was to investigate the hyoid movement in ALS patients using AKAP and compare it with non-dysphagic subjects. Thirty ALS patients who underwent VFSS in Seoul National University Bundang Hospital between 2015 and 2017 were recruited. For comparison, 30 age-matched control subjects were also enrolled; the same swallowing study was conducted using thin fluid and yogurt. The hyoid bone movement was analyzed by evaluating the vertical and horizontal distances with four peak points (A, B, C, D), and the time of each point were also calculated. With respect to distance parameters, only vertical peak distance (distance between B, D points) during thin fluid swallowing was significantly decreased in ALS patients. (p = 0.038) With respect to temporal parameters, Time ABC, Time ABCD, and Duration C were significantly increased in ALS patients when swallowing both thin fluid and yogurt. (Time ABC p = 0.019, p = 0.002; Time ABCD p = 0.001, p = 0.004; Duration C p = 0.004, p = 0.025 respectively). This result revealed that dysphagia in ALS patient is caused by decreased velocity of hyoid bone movement due to the development of weakness in swallowing-related muscles. The parameters of kinematic analysis could be used to quantitatively evaluate dysphagia in motor neuron disease.",
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Application of Automatic Kinematic Analysis Program for the Evaluation of Dysphagia in ALS patients. / Lee, Ban Hyung; Lee, Jun Chang; Lee, Sun Myoung; Park, Yulhyun; Ryu, Ju Seok.

In: Scientific Reports, Vol. 9, No. 1, 15644, 01.12.2019.

Research output: Contribution to journalArticle

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