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A Preliminary Investigation of Whether HRCA Signals Can Differentiate Between Swallows from Healthy People and Swallows from People with Neurodegenerative Diseases

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Abstract

High-resolution cervical auscultation (HRCA) is an emerging method for non-invasively assessing swallowing by using acoustic signals from a contact microphone, vibratory signals from an accelerometer, and advanced signal processing and machine learning techniques. HRCA has differentiated between safe and unsafe swallows, predicted components of the Modified Barium Swallow Impairment Profile, and predicted kinematic events of swallowing such as hyoid bone displacement, laryngeal vestibular closure, and upper esophageal sphincter opening with a high degree of accuracy. However, HRCA has not been used to characterize swallow function in specific patient populations. This study investigated the ability of HRCA to differentiate between swallows from healthy people and people with neurodegenerative diseases. We hypothesized that HRCA would differentiate between swallows from healthy people and people with neurodegenerative diseases with a high degree of accuracy. We analyzed 170 swallows from 20 patients with neurodegenerative diseases and 170 swallows from 51 healthy age-matched adults who underwent concurrent video fluoroscopy with non-invasive neck sensors. We used a linear mixed model and several supervised machine learning classifiers that use HRCA signal features and a leave-one-out procedure to differentiate between swallows. Twenty-two HRCA signal features were statistically significant (p < 0.05) for predicting whether swallows were from healthy people or from patients with neurodegenerative diseases. Using the HRCA signal features alone, logistic regression and decision trees classified swallows between the two groups with 99% accuracy, 100% sensitivity, and 99% specificity. This provides preliminary research evidence that HRCA can differentiate swallow function between healthy and patient populations.

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Acknowledgements

People: Thanks to Tara Smyth, BA, and Dan Kachnycz, BA for assistance with data collection and coding.

Funding

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD092239, while the data were collected under Award Number R01HD074819. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or National Science Foundation.

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Authors and Affiliations

  1. Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA, 15260, USA

    Cara Donohue & James L. Coyle

  2. Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, 15260, USA

    Yassin Khalifa & Ervin Sejdić

  3. Division of Geriatrics, Department of Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA

    Subashan Perera

  4. Department of Bioengineering, Swanson School of Engineering, Department of Biomedical Informatics, School of Medicine Intelligent Systems Program, School of Computing and Information, University of Pittsburgh, Pittsburgh, PA, 15260, USA

    Ervin Sejdić

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  1. Cara Donohue
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  4. Ervin Sejdić
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Correspondence to Cara Donohue.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Donohue, C., Khalifa, Y., Perera, S. et al. A Preliminary Investigation of Whether HRCA Signals Can Differentiate Between Swallows from Healthy People and Swallows from People with Neurodegenerative Diseases. Dysphagia 36, 635–643 (2021). https://doi.org/10.1007/s00455-020-10177-0

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