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Purpose: This study investigated articulatory patterns for American English /ɹ/ in children with and without a history of residual speech sound disorder (RSSD). It was hypothesized that children without RSSD would favor bunched tongue shapes, similar to American adults reported in previous literature. Based on clinical cueing practices, it was hypothesized that children with RSSD might produce retroflex tongue shape patterns at a higher relative rate. Finally, it was hypothesized that, among children who use a mixture of bunched and retroflex shapes, phonetic context would impact tongue shape as reported in the adult literature. Method: These hypotheses were tested using ultrasound data from a stimul-ability task eliciting /ɹ/ in syllabic, postvocalic, and onset contexts. Participants were two groups of children/adolescents aged 9-15 years: 36 with RSSD who completed a study of ultrasound biofeedback treatment and 33 with no history of RSSD. Tongue shapes were qualitatively coded as bunched or retroflex using a flowchart from previous research. Results: Children with no history of RSSD were found to use bunched-only tongue shape patterns at a rate higher than adults, but those who used a mixture of shapes for /ɹ/ followed the expected phonetic contextual patterning. Children with RSSD were found to use retroflex-only patterns at a substantially higher rate than adults, and those using a mixture of shapes did not exhibit the expected patterning by phonetic context. Conclusions: These findings suggest that clients receiving ultrasound biofeedback treatment for /ɹ/ may be most responsive to clinician cueing of retroflex shapes, at least early on. However, retroflex-only cueing may be a limiting and insufficient strategy, particularly in light of our finding of a lack of typical variation across phonetic contexts in children with remediated /ɹ/. Future research should more specifically track cueing strategies to better understand the relationship between clinician cues, tongue shapes, and generalization across a range of contexts. [ABSTRACT FROM AUTHOR]

Background: Assessing the internal condition of swallowing‐related muscles and muscle strength and size is important because their deterioration may lead to dysphagia. However, there are few reports on stiffness of swallowing‐related muscles measured using shear‐wave elastography (SWE) and their qualitative characteristics. Objectives: We measured stiffness of swallowing‐related muscles using SWE to investigate the relationship between muscle stiffness and body composition as well as other relevant variables in healthy adults. Methods: Thirty healthy adults were included in this cross‐sectional study. We evaluated stiffness of the genioglossus muscle (GGM) and geniohyoid muscle (GHM) using SWE. Skeletal muscle mass index, body mass index (BMI), handgrip strength, tongue pressure, and cross‐sectional areas of the muscles were measured, and we determined their relationship with muscle stiffness. Results: For muscle stiffness, the mean value for the middle GGM was 7.08 ± 1.92 kPa, that for the posterior GGM was 9.31 ± 2.68 kPa, and that for the GHM was 8.84 ± 2.15 kPa. In multiple regression analysis, with stiffness of the posterior GGM as the dependent variable, BMI (β = −.473, p =.039) was a significant negative explanatory variable. However, with the GHM stiffness as the dependent variable, BMI (β =.419, p =.033) was a significant positive explanatory variable. Conclusion: Stiffness of the posterior GGM was positively correlated with BMI and that of the GHM was negatively correlated with BMI. Stiffness, as measured using SWE, has the potential to capture the intramuscular characteristics of swallowing‐related muscles, particularly the posterior GGM. [ABSTRACT FROM AUTHOR]

Background: Masticatory function seems to play a role in the aetiology of obesity. However, literature on the association between oral myofunctional status and overweight and obesity in children and adolescents is scarce and contrasting. Objective: To compare masticatory performance, orofacial myofunctional status and tongue strength and endurance between children and adolescents with overweight and obesity and those with normal weight. Methods: Thirty children and adolescents with overweight and obesity and 30 subjects with normal weight matched for age and sex were recruited. All subjects were evaluated with the Test of Masticating and Swallowing Solids in Children (TOMASS‐C) for masticatory performance and with the Italian Orofacial Myofunctional Evaluation with Scores (I‐OMES) for the orofacial myofunctional status. Anterior and posterior maximum tongue pressures and tongue endurance were measured. Parents‐reported (PRO) duration of meals was recorded. Data were compared between the groups through the paired samples t‐test or the Wilcoxon signed‐rank test. Results: Children and adolescents with overweight showed significantly lower number of bites (p =.033), lower I‐OMES scores (p <.05), and shorter meal duration (p =.005) compared to their peers with normal weight. No significant differences were found between the two groups for the number of swallows, the number of masticatory cycles and the total time of the TOMASS‐C, and none of the tongue pressure measurements. Conclusions: Eating in children and adolescents with overweight and obesity is characterised by a larger bolus sizes and shorter PRO meal duration. Additionally, overweight and obesity seem to be associated with poorer orofacial skills and structures in the paediatric population. [ABSTRACT FROM AUTHOR]

Background: Tongue‐strengthening exercises may be used at home to strengthen swallowing‐related oropharyngeal muscles in community‐dwelling older adults with sarcopenic dysphagia; however, evidence of their effectiveness remains unclear. Objective: This study aimed to investigate the effects of a home‐based tongue‐strengthening exercise (hTSE) using portable tool on swallowing‐related oropharyngeal muscles in community‐dwelling older adults with sarcopenic dysphagia. Methods: Forth community‐dwelling older adults with sarcopenic dysphagia were enrolled in the study. The participants were randomly assigned to the experimental and control groups. 1‐Repetition Maximum (1‐RM) of tongue muscle was measured in the experimental group using the Iowa Oral Performance Instrument, and hTSE was performed using a portable tool with an intensity corresponding to approximately 70%–80% of the range based on the 1‐RM value (90 times/day, 5 days/week, for 8 weeks). The control group did not perform any tongue exercises. The primary outcome measures were tongue strength and thickness. The secondary outcome measure was suprahyoid muscle strength (digastric and mylohyoid muscles). Results: The experimental group showed significantly greater increases in suprahyoid muscle (mylohyoid and digastric) thickness (p =.01 and.011, d = 1.0 and.55), as well as tongue strength and thickness (p <.001 and.029, d = 2.2 and.6) than the control group. Conclusion: This study confirmed that hTSE using a portable tool is effective in increasing swallowing‐related oropharyngeal muscle activity in older adults with sarcopenic dysphagia. Therefore, hTSE is recommended as an inexpensive, safe, and easy‐to‐use therapy for sarcopenic dysphagia in older adults. [ABSTRACT FROM AUTHOR]

Background: Cognitive function plays a crucial role in human life, and its maintenance and improvement are essential in both young and older adults. Since cognitive decline can be associated with oral function decline, preventing the decline in both cognitive and oral functions is an urgent social issue. Several training methods to improve each function have been proposed. Previous studies have indicated that greater brain activity during training is associated with increased benefits for cognitive function. Although adding cognitive function elements to oral function training may promote the activation of brain activity during oral function training, the effects have not been validated. The main purpose of this study is to develop a novel training program that combines oral function training with cognitive training, which is expected to activate key brain regions involved in oral and cognitive functions, such as the left dorsolateral prefrontal cortex (DLPFC) and right medial prefrontal cortex (mPFC). Methods: Four types of training programs combining oral and cognitive training: PaTaKaRa × calculation, lip exercise × N-back, tongue exercise × inhibition, and tongue exercise × memory, were developed. Each program had seven levels of difficulty [level 0 (no cognitive load) and level 6 (maximum difficulty)]. Twelve healthy young adults participated in the study and were instructed to perform all four programs. Brain activity in the left DLPFC and right mPFC were measured during each training session using two-channel near-infrared spectroscopy (NIRS). Results: No significant brain activity was observed during training at level 0. Brain activity in the left DLPFC was significantly increased at levels 1 and 2 and in the left DLPFC and right mPFC at level 6 during PaTaKaRa × calculation training. Brain activity in the left DLPFC was significantly increased at level 6 during tongue exercise × inhibition training. Brain activity in the left DLPFC and right mPFC was significantly increased at level 6 during lip exercise × N-back training. Conclusion: Oral function training did not significantly increase brain activity; nevertheless, oral function with cognitive training stimulated brain activity in the prefrontal cortex. Trial registration: : UMIN-CTR. ID: UMIN000039678. date: 06/03/2020. [ABSTRACT FROM AUTHOR]

Background: Trigeminal neurostimulation of the dorsal anterior mucosal surface of the tongue has been proposed to treat a variety of pathologies and to promote neuro-muscular coordination and rehabilitation. Dental ULFTENS can also be considered a form of trigeminal neurostimulation applied to the skin surface bilaterally at the level of the tragus. It has been used for years in dentistry for practical and diagnostic purposes. Previous work has combined the two stimulation techniques showing an efficacy in improving HRV in healthy young women of dental ULFTENS applied to the mucosal surface of the tongue. This work sought to assess whether there is a difference in HRV in relation to the site of application of dental ULFTENS (tragus vs. tongue). If effective in reducing the activity of arousal circuits, this tongue-level stimulation technique could have new clinical applications. Material and method: A new intraoral device allowed electrical stimulation of the dorsal anterior mucosa of the tongue in 80 healthy young women divided into two groups: TUD group (ULFTENS stimulation on the mucosa of the tongue) and Tragus group (stimulation with ULFTENS bilaterally in the area of the tragus). The effects on HRV were monitored by photoplethysmographic wave (PPG). The HRV parameters studied were RMSSD, HF, LF, LF/HF. Results: Only the TUD group showed a significant change in selected HRV parameters that was maintained even in the epoch after the end of electrical stimulation. This effect can be considered as a vagal activation and an increased of HRV parameter. The Tragus group did not show significant change in the direction of increased HRV but showed an opposite trend. There were no undesirable or annoying effects of stimulation. Conclusion: Stimulation of the dorsal anterior (trigeminal) mucosal surface of the tongue with ULFTENS applied with an intraoral device was shown to be able to increase HRV while the same stimulation on tragus area, according to traditional dental ULFTENS procedure, did not show the same effects. Clinical implications: This stimulation technique could be an aid in the diagnosis and treatment of disorders characterized by autonomic disequilibrium such as, in the dental field, TMDs. Trial registration: "Effects of Trigeminal Neurostimulation on Heart Rate Variability: Comparing Tragus and Tongue Stimulation". ID number: NCT06549205. Date of first registration: August 1st 2024. https://clinicaltrials.gov/study/NCT06549205?id=%09NCT06549205&rank=1. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the effect of stimulus signal length on tongue and lip motion pattern stability in speakers diagnosed with amyotrophic lateral sclerosis (ALS) compared to healthy controls. Method: Electromagnetic articulography was used to derive articulatory motion patterns from individuals with mild (n = 27) and severe (n = 16) ALS and healthy controls (n = 25). The spatiotemporal index (STI) was used as a measure of articulatory stability. Two experiments were conducted to evaluate signal length effects on the STI: (a) the effect of the number of syllables on STI values and (b) increasing lengths of subcomponents of a single phrase. Two-way mixed analyses of variance were conducted to assess the effects of syllable length and group on the STI for the tongue tip (TT), tongue back (TB), and lower lip (LL). Results: Experiment 1 showed a significant main effect of syllable length (TT, p < .001; TB, p < .001; and LL, p < .001) and group (TT, p = .037; TB, p = .007; and LL, p = .017). TB and LL stability was generally higher with speech stimuli that included a greater number of syllables. Articulatory variability was significantly higher in speakers diagnosed with ALS compared to healthy controls. Experiment 2 showed a significant main effect of length (TT, p < .001; TB, p = .015; and LL, p < .001), providing additional support that STI values tend to be greater when calculated on longer speech signals. Conclusions: Articulatory stability is influenced by the length of speech signals and manifests similarly in both healthy speakers and persons with ALS. TT stability may be significantly impacted by phonemic content due to greater movement flexibility. Compared to healthy controls, there was an increase in articulatory variability in those with ALS, which likely reflects deviations in speech motor control. [ABSTRACT FROM AUTHOR]

Purpose: This article reports on jaw articulation, in connection with the segmental articulations of tongue tip and lips. The jaw is considered a syllable articulator as it opens and closes for each syllable, and the amount of jaw opening is related to syllable strength, given the same phonemic vowel. Here, we investigate the syllabic and the segmental articulations relationships to the acoustic segments. Method: We analyze electromagnetic articulography data of 18 Southern Swedish speakers by testing hypotheses based on the Descriptive Approach to Segmental Articulations. In this approach, articulatory movements are divided into fast intervals and steady states, and the crucial ("primary") articulators' deceleration and acceleration peaks align with the acoustic segment boundaries. Results: Previous findings on the lips and the tongue tip are confirmed. New results are the jaw as noncrucial ("nonprimary") does not align with the acoustic segment boundaries: Its steady states are shorter than consonant and vowel segments. Moreover, place of articulation of the coda affects the jaw cycle, while syllable type only affects jaw closing. No such effects are found on the edges of the jaw cycle, instead only gender affects jaw deceleration at syllable onset. Conclusions: The jaw is not crucial for the timing of the acoustic segment boundaries; also, syllable borders seem to not be affected by place of segmental articulation. The results strengthen the view of the jaw as syllable articulator providing a frame and the other articulators (e.g., lips and tongue tip) as the segmental articulators providing the content. [ABSTRACT FROM AUTHOR]

Purpose: Tongue anatomy and function is widely described as consisting of four extrinsic muscles to control position and four intrinsic muscles to control shape. This myoarchitecture cannot, however, explain independent tongue body and blade movement nor accurately model the subtlety of observed lingual shapes. This study presents the case for a finer neuromuscular structure and functional description. Method: Using the theoretical framework of the partitioning hypothesis, evidence for neuromuscular compartments of each of the lingual muscles was discerned by reviewing studies of lingual anatomy, hypoglossal nerve staining, hypoglossal motoneuron axon tracing, muscle fiber type distribution, and electromyography. Muscle fibers of the visible human female were manually traced to produce a three-dimensional atlas of muscular compartments. A kinematic study was undertaken to determine the degree of independent movement between different parts of the tongue. A simple biomechanical model was used to demonstrate how synergistic groups of compartments can control sectors of the tongue. Results: Results indicated as many as 10 compartments of genioglossus, two each of superior and inferior longitudinal, eight of styloglossus, three of hyoglossus, and six each of transversus and verticalis, while palatoglossus may not have a significant role in tongue function. Kinematic analysis indicated independent control of five sectors of the tongue body, and biomechanical modeling demonstrated how this control may be achieved. Conclusion: Evidence is presented for a lingual structure based on neuromuscular compartments, which work together to position and shape sectors of the tongue and independently control tongue body and blade. [ABSTRACT FROM AUTHOR]

Background: Laryngeal mask airway (LMA) has been increasingly used for airway management; however, LMA insertion can be difficult and cause adverse effects. Therefore, the rapid, safe, and effective insertion of LMA is necessary. This study aimed to compare the efficacy of the standard method with that of the 30° curved tongue depressor-aided technique for LMA insertion to determine the superior technique. Methods: This study included 154 patients aged 18–70 years (American Society of Anesthesiologists class I or II) scheduled for general anesthesia. The patients were randomly assigned to the standard LMA insertion group (Group C, n = 77) or the 30° curved tongue depressor-aided LMA insertion group (Group T, n = 77). The primary outcome evaluated was the first-attempt success rate. The secondary outcomes were the second-attempt success rate, insertion time, fiberoptic position grade, oropharyngeal leak pressure (OPLP), and adverse events. Results: The first-attempt success rate was significantly higher in Group T than in Group C (97.40% vs. 88.31%, P = 0.029). The second-attempt success rate (P = 0.209), insertion time (P = 0.340), fiberoptic position grade (P = 0.872), and OPLP (P = 0.203) were slightly improved in Group T; however, there was no statistical significance. Bleeding events were reduced in Group T than in Group C (6.49% vs. 14.29%); however, there was no statistical significance. The incidence of sore throat symptoms was significantly reduced in Group T than in Group C (5.19% vs. 15.58%, P = 0.035). Conclusions: The curved tongue depressor-aided technique significantly improved the first-attempt success rate of LMA insertion and reduced the incidence of sore throat symptoms. Trial registration: KCT0004964; Registered at https://cris.nih.go.kr on April 27, 2020. [ABSTRACT FROM AUTHOR]

Introduction: We examined the effects of four types of voicing on vocal tract movements by comparing the articulatory kinematics of whispered speech to habitual, loud, and soft conditions. Methods: Participants included 10 males and 10 females with no history of communication disorders. They read six stimulus sentences in habitual, loud, soft, and whispered conditions. An electromagnetic articulograph tracked the tongue, jaw, and lip movements. Analysis focused on the words we do from a longer sentence. Vertical tongue/jaw and horizontal lip movements were measured during the production of the retracted and rounded front and back vowels in we do. Results: Soft speech led to smaller and slower lip movements than in the habitual condition. Displacement increased for the tongue and jaw in loud and whispered speech compared to the habitual condition. Tongue and jaw velocity increased for loud but not for whispered speech compared to the habitual condition. Utterance duration increased for loud and whispered conditions. Discussion: The increasing tongue and jaw displacement and velocity from soft to habitual to loud speech reported here is consistent with previous accounts. Whispering was less intense than soft speech, yet it involved larger tongue and jaw movements than habitual speech, possibly reflecting a speaker's focus on greater articulatory clarity when the acoustic signal is the weakest. [ABSTRACT FROM AUTHOR]

Objective: Although it has been suggested that a decline in oral function is one of the potential risk factors affecting mild cognitive impairment (MCI), evidence is insufficient to draw clear conclusions. This Japanese cross‐sectional study examined the association between tongue pressure (TP) and MCI in middle‐aged and older adults aged 36–84 years. Methods: Study participants were 1019 (368 men and 651 women). TP was evaluated using a TP measurement device. The maximum value of three measurements was used for analysis. MCI was defined as being present if a participant had a Japanese version of the Montreal Cognitive Assessment score of <26. Adjustment was made for age, smoking status, alcohol consumption, leisure‐time physical activity, body mass index, hypertension, dyslipidemia, diabetes mellitus, history of depression, number of teeth, employment, education, and household income. Results: The prevalence of MCI was 45.3%. Among women, compared with the lowest tertile of TP, the second and highest tertiles were significantly associated with a lower prevalence of MCI with a clear dose–response relationship; the adjusted odds ratio (95% confidence intervals) in the second and highest tertiles of TP were 0.54 (0.36–0.83) and 0.55 (0.36–0.84), respectively (p for trend = 0.005). In contrast, no statistically significant association was observed between TP and the prevalence of MCI among men. Conclusions: Our findings suggest that higher TP might be inversely associated with the prevalence of MCI in middle‐aged and older Japanese women. [ABSTRACT FROM AUTHOR]

Background: Low‐intensity continuous inspiratory muscle training improves its strength. The abdominal muscles are the main expiratory muscles, and their training may improve expiratory muscle strength. Respiratory muscle strength regulates coughing effectiveness, which is critical for pneumonia management. In older people, risk factors for the development of pneumonia were respiratory muscle weakness and swallowing impairment. Currently, the impact of high‐intensity intermittent inspiratory and abdominal muscle combined training on the respiratory, swallowing, and systemic muscles is unclear. Objective: We aimed to explore the effects of high‐intensity inspiratory muscle training combined with or without abdominal muscle training on respiratory muscle strength as well as the strength, mass, and performance of swallowing and systemic muscles. Methods: Twenty‐eight healthy adults were divided into two groups. Participants performed high‐intensity intermittent inspiratory muscle single or its combination with abdominal muscle training for 4 weeks. Respiratory muscle strength, swallowing muscle strength and mass, systemic muscle strength, mass and performance were measured at baseline, Week 2 and Week 4. Results: Both groups showed greater maximal respiratory pressures at Week 2 and Week 4 than baseline. Both groups showed improved tongue pressure and geniohyoid muscle thickness at Week 4. In addition, the combined training group improved body trunk muscle mass, handgrip strength and five‐time chair stand test, whereas the single training group did not. Conclusion: This study revealed that high‐intensity inspiratory muscle training improved inspiratory muscle strength and swallowing muscle strength and mass. Moreover, inspiratory and abdominal muscle combined training showed an additional benefit of improving systemic muscle strength, mass and performance. Clinical Trial Registration Number: UMIN000046724; https://upload.umin.ac.jp/cgi‐open‐bin/ctr/index.cgi?ctrno=UMIN000046724. [ABSTRACT FROM AUTHOR]

Background: High‐density surface electromyography (HD‐sEMG) has enabled non‐invasive analysis of motor unit (MU) activity and recruitment, but its application to swallowing‐related muscles is limited. Objective: We aimed to investigate the utility of HD‐sEMG for quantitatively evaluating the MU recruitment characteristics of the suprahyoid muscles during tongue elevation. Methods: We measured the sEMG activity of the suprahyoid muscles of healthy participants during tongue elevation using HD‐sEMG. Maximum voluntary contraction (MVC) was measured, followed by data collection during sustained and ramp‐up tasks to capture suprahyoid muscle activity. Changes in the temporal/spatial MU recruitment patterns within individual suprahyoid muscles were analysed. Results: This study enrolled 16 healthy young adults (mean age: 27.8 ± 5.3 years; eight males and eight females). Increasing muscle force corresponded to a decrease in modified entropy and correlation coefficient and an increase in the coefficient of variation. No significant differences were observed between male and female participants. Conclusion: The results of this study, consistent with those observed in other muscles, such as the vastus lateralis muscle, suggest that HD‐sEMG is a valuable and reliable tool for quantitatively evaluating MU recruitment in the suprahyoid muscles. This measurement technique holds promise for novel assessments of swallowing function. [ABSTRACT FROM AUTHOR]

Background: Neuroplasticity induced by mandibular advancement appliance (MAD) in patients with obstructive sleep apnoea (OSA) is poorly documented. Objective: This randomised placebo‐controlled crossover mechanistic study assessed the effects of short‐term use of a MAD on corticomotor excitability of the masseter and tongue in patients with OSA. Methods: Adults (n = 28) with mild or moderate OSA were randomly allocated to sleep with a MAD for 2‐weeks with 40% of the maximal protrusion (MAD active position) and without any jaw protrusion (MAD placebo position). The outcomes were assessed at baseline, and after 2 and 6 weeks, with a 2‐week washout period. The primary outcome was the amplitude of motor evoked potential (MEP) assessed on the right masseter, right side of tongue and right first dorsal interosseous with transcranial magnetic stimulation. Corticomotor map volume of the same muscles was also assessed. Repeated‐measures ANOVAs followed by Tukey test were applied to the data (p <.050). Results: There was a significant increase in the MEP amplitude of the masseter and tongue following the MAD active position compared with the baseline and MAD placebo (Tukey: p <.001). There were no significant MEP amplitude differences between the baseline and placebo positions (p >.050). Moreover, there was a significant increase in corticomotor map volume for the masseter and tongue muscles following the MAD active position compared with baseline and MAD placebo (Tukey: p <.003). Conclusion: Excitability of the masseter and tongue motor pathways is, at least transiently, increased in patients with OSA following a short‐term use of MAD. This novel finding of MAD‐induced neuroplasticity in corticomotor pathways may contribute to a further understanding of the mechanisms of oral appliances for treating OSA. [ABSTRACT FROM AUTHOR]

Background: Swallowing is a complex function that requires precise coordination between different muscles. Weakness in submental muscles can lead to complications such as pharyngeal residue and aspiration. Therefore, exercise interventions targeting these muscles, such as the Head‐Lift Exercise (HLE), are clinically important but pose challenges. Objective(s): This study aimed to compare the myoelectric activity of submental muscles during traditional Head‐Lift Exercise (HLE), Tongue‐Press Exercise (TPE) and Head Extension Tongue‐Press Exercise (HETPE), providing potential alternatives to HLE. Methods: Thirty healthy volunteers (22 females and 8 males, mean age 25.63 ± 5.27 years) participated in this cross‐sectional study. Surface electromyography (sEMG) recorded activity of the submental muscles bilaterally during HLE, TPE and HETPE. Participants performed each manoeuvre for 14 s, repeated three times in a counterbalanced order. Statistical analyses assessed differences in mean, maximum and median frequency of the sEMG signals among manoeuvres using repeated‐measures analysis of variance (RM‐ANOVA). The experienced irritation levels by participants during manoeuvres were also compared by the Friedman test. Results: HETPE exhibited significantly higher maximum sEMG activity compared to HLE and TPE (p <.05). Mean sEMG activity was significantly increased during HETPE compared to TPE. Median frequency was significantly lower during HETPE compared to the two other exercises, indicating greater muscle fatigue. Participants reported similar levels of irritation for HLE and HETPE, and significantly lower levels during TPE. Conclusion: These results indicate that HETPE is effective in activating and strengthening submental muscles, potentially serving as a viable alternative to HLE without added difficulty. Further research is recommended to assess the long‐term impacts on swallowing physiology in patients with dysphagia. [ABSTRACT FROM AUTHOR]

The human tongue has been long believed to be a window to provide important insights into a patient's health in medicine. The present study introduced a novel approach to predict patient age, gender, and weight inferences based on tongue images using pretrained deep convolutional neural networks (CNNs). Our results demonstrated that the deep CNN models (e.g., ResNeXt) trained on dorsal tongue images produced excellent results for age prediction with a Pearson correlation coefficient of 0.71 and a mean absolute error (MAE) of 8.5 years. We also obtained an excellent classification of gender, with a mean accuracy of 80% and an AUC (area under the receiver operating characteristic curve) of 88%. ResNeXt model also obtained a moderate level of accuracy for weight prediction, with a Pearson correlation coefficient of 0.39 and a MAE of 9.06 kg. These findings support our hypothesis that the human tongue contains crucial information about a patient. This study demonstrated the feasibility of using the pretrained deep CNNs along with a large tongue image dataset to develop computational models to predict patient medical conditions for noninvasive, convenient, and inexpensive patient health monitoring and diagnosis. [ABSTRACT FROM AUTHOR]

Infants' preference for vowel harmony (VH, a phonotactic constraint that requires vowels in a word to be featurally similar) is thought to be language-specific: Monolingual infants learning VH languages show a listening preference for VH patterns by 6 months of age, while those learning non-VH languages do not (Gonzalez-Gomez et al., 2019; Van Kampen et al., 2008). We investigated sensitivity to advanced tongue root (ATR) harmony in Akan (Kwa, Niger-Congo) in 40 six-month-old multilingual infants (21 girls) in Ghana, West Africa (an understudied population), all learning Akan, Ghanaian English, and most of them several other understudied African languages (e.g., Ga, Ewe). We hypothesized that infants learning both ATR harmony and nonharmony languages would demonstrate sensitivity to ATR harmony. Using the central fixation procedure, infants were presented with disyllabic nonwords that were either harmonic (e.g., puti) or nonharmonic (e.g., petɔ) based on their ATR features. Infants demonstrated sensitivity to ATR harmony with a familiarity preference, listening longer to harmonic syllable sequences than nonharmonic ones. The relative amount of exposure to (an) ATR harmony language(s) did not modulate the preference. These results shed light on our understanding of early multilingualism: they suggest that early sensitivity to VH in multilinguals may be similar to monolingual infants learning other types of VH, irrespective of simultaneous experience with non-VH languages. We conclude with reflections on studying infant language acquisition in multilingual Africa. Public Significance Statement: The public significance of this study is to understand how learning multiple languages in Africa may affect infants' speech perception. [ABSTRACT FROM AUTHOR]

Purpose: Tongue manometry (i.e., tongue pressure measurement) is a commonly used assessment for patients with suspected oral-motor involvement in swallowing disorders. Availability of lingual manometry has changed in recent years, with the introduction of the Tongueometer device being a more affordable tongue manometry system. The purpose of this study was to test concurrent (criterion) validity of the Tongueometer compared to the current standard reference device, the Iowa Oral Performance Instrument (IOPI). Method: Adults without dysphagia were recruited for participation in this study. Standard lingual measurements (swallowing-related pressures, maximum isometric pressure [MIP], and maximum isometric endurance) were recorded, with the bulb anteriorly placed, with both devices, in a randomized order. The Bland--Altman method was used to determine concurrent (criterion) validity of these measurements compared to the clinical standard IOPI device. A recently available suggested corrective value by Curtis et al. (2023) was also applied, with comparisons made between devices both with and without the Curtis correction. Results: The final sample included 70 adult participants aged 20-89 years (Mage = 52.3 years). Measures with the Tongueometer device were significantly lower when compared with the same measures taken using the IOPI (p < .01) for all measures including MIP, endurance, and swallow pressures. The correction suggested by Curtis and colleagues did not ameliorate these differences. Conclusions: The Tongueometer lingual measurements were consistently lower compared to the IOPI. Clinical use of values taken with the Tongueometer device should be compared to normative data published for each specific device. Available features of each device (e.g., display, bulb texture, technology/application) should be considered when selecting which device to use with an individual patient. [ABSTRACT FROM AUTHOR]

Background: Oral frailty, characterised by reduced oral function, is associated with systemic health issues in older adults. Although the criteria for diminished oral function often focus on motor and secretory abilities, texture perception also plays a crucial role in health due to its impact on food intake and palatability. Objective: This study aimed to explore the relationship between thickness discrimination ability (TDA) and oral motor and secretory functions in healthy young individuals. Methods: Twenty‐eight adults were assessed for texture perception using eight concentrations of aqueous xanthan gum solutions to determine TDA scores. Measurements of occlusal force, masticatory performance, tongue pressure, stimulated salivary flow rate and tongue–lip motor function were conducted. Spearman's correlation analysis was used to evaluate the relationship between TDA scores and oral functions. Participants were divided into high‐sensitivity and low‐sensitivity groups based on their TDA scores to compare oral function test results. Results: The TDA scores varied among the participants, with higher scores correlating with higher masticatory performance (r = 0.41, p <.05). Masticatory performance in the high‐sensitivity group was significantly higher than in the low‐sensitivity group (211.9 ± 59.2 mg/dL vs. 157.9 ± 43.0 mg/dL, p =.013), with no significant differences in other oral functions. Conclusion: Masticatory performance was correlated with TDA, suggesting a link between the selection function of mastication and thickness discrimination. These findings highlight the potential relevance of texture perception in oral function and indicate the need for further exploration, particularly in older adults with declining oral health. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine whether increased raising of the back of the tongue is evident in children with repaired cleft palate with or without cleft lip (CP+/-CL). We hypothesized that children with CP+/-CL would show increased raising of the tongue dorsum, a compensatory pattern. Method: Secondary data analysis of mid-sagittal ultrasound tongue imaging data from 31 children with CP+/-CL and 29 typically developing children were used. We annotated the consonants /ʃ, t, s, k/ at the point of maximum constriction in an /aCa/ environment. Children with CP+/-CL said the tokens 10 times, typically developing children said them once. We automatically fitted splines to the tongue contour and extracted the Dorsum Excursion Index (DEI) for each consonant. This metric measures the relative use of the tongue dorsum, with more posterior consonants having higher values. We compared DEI values across groups and consonants using a linear mixed effects model. DEI was predicted by the interaction of consonant (baseline: /ʃ/) and speaker type (baseline: TD), including by-speaker random slopes for consonant and random intercepts for speaker. Results: Overall DEI was not higher in children with CP+/-CL compared to typically developing children. Between groups the only significant difference was the position of /k/ relative to /ʃ/, where the difference between these two consonants was smaller in the children with CP+/-CL. Conclusions: There was no support for the hypothesis that increased raising of the tongue dorsum is a common characteristic in children with repaired CP+/-CL. However, individual children may present with this pattern. [ABSTRACT FROM AUTHOR]

Purpose: The oral structures such as the tongue and lips have remarkable somatosensory capacities, but understanding the roles of somatosensation in speech production requires a more comprehensive knowledge of somatosensation in the speech production system in its entirety, including the respiratory, laryngeal, and supralaryngeal subsystems. This review was conducted to summarize the system-wide somatosensory information available for speech production. Method: The search was conducted with PubMed/Medline and Google Scholar for articles published until November 2023. Numerous search terms were used in conducting the review, which covered the topics of psychophysics, basic and clinical behavioral research, neuroanatomy, and neuroscience. Results and Conclusions: The current understanding of speech somatosensation rests primarily on the two pillars of psychophysics and neuroscience. The confluence of polymodal afferent streams supports the development, maintenance, and refinement of speech production. Receptors are both canonical and noncanonical, with the latter occurring especially in the muscles innervated by the facial nerve. Somatosensory representation in the cortex is disproportionately large and provides for sensory interactions. Speech somatosensory function is robust over the lifespan, with possible declines in advanced aging. The understanding of somatosensation in speech disorders is largely disconnected from research and theory on speech production. A speech somatoscape is proposed as the generalized, system-wide sensation of speech production, with implications for speech development, speech motor control, and speech disorders. [ABSTRACT FROM AUTHOR]

Purpose: This study determined the contributions of the anterior and posterior tongue regions in tongue pressure generation during regular saliva swallows (SSs) and effortful swallows (ESs) completed under two different instructions. The association between tongue pressure and perceived effort to swallow was also examined. Method: Forty healthy adults without swallowing disorders participated in this study, divided into two age groups: 20 younger (Mage = 21.95 years, SD = 4.43) and 20 older (Mage = 70.10 years, SD = 4.30). Simultaneous data acquisition involved submental surface electromyography, tongue manometry, and a visual analog scale across swallowing conditions (SS, ES with tongue emphasis, and ES with pharyngeal squeezing). The main outcome measures were tongue pressure during swallowing and perceived effort to swallow. Results: Overall tongue pressure during ESs with tongue emphasis and with pharyngeal squeezing was greater than that during SSs (R² = .78, p < .001). Moreover, tongue pressure during the ES with tongue emphasis was greater than that during the ES with pharyngeal squeezing (t = 25.63, p < .001). The posterior tongue region generated more pressure during SSs (R² = .64, p < .001) and the ES with tongue emphasis (R² = .55, p < .001) than the anterior tongue. Finally, a positive correlation was found between perceived effort and tongue pressure during swallowing (r = .75, 95% CI [0.72, 0.77]). Conclusions: Tongue pressure generation was affected by the type of instruction used to elicit ESs, and the posterior tongue showed relatively greater pressure contributions than the anterior tongue for ESs with tongue emphasis and SSs. Furthermore, age-related declines in pressure generation during swallowing were not evidenced in this study, underscoring the ability of healthy older individuals to appropriately modulate lingual pressure during ESs. Last, our results showed that the visual analog scale is a simple tool for rating swallowing effort during ESs, supporting its potential clinical use to train ESs. [ABSTRACT FROM AUTHOR]

Background: This cross–sectional study aimed to identify factors associated with age-related changes in masticatory performance (MP) and oral diadochokinesis (ODK) and to provide normal values in healthy old adults for the diagnosis of oral frailty. Methods: A total of 385 participants were divided into three age groups (Gr1-3): 20–64 years, 65–74 years, and ≥ 75 years. To investigate tongue-lip motor function, ODK was assessed as the number of repetitions of the monosyllables /pa/ta/ka/. Four questionnaires were used to assess subjective masticatory ability, cognitive ability, and psychological status. MP, bite force, and occlusal area were tested to assess dynamic objective masticatory function, and the number of remaining teeth and functional tooth pairs were determined to assess static objective masticatory function. Handgrip strength (HG), oral dryness, and tongue pressure (TP) were assessed to identify influencing factors. Intergroup differences were evaluated by ANOVA and the Kruskal‒Wallis test, and correlations between ODK and orofacial factors were evaluated. Results: This study revealed significant age-related declines in TP, HG, and ODK, especially after 65 years of age. Factors affecting MP were posterior teeth, the Eichner index, bite force, occluding area, the Korean Mini-Mental State Examination (KMMSE) score, and ODK. Each ODK syllable was associated with different factors, but common factors associated with ODK were MP, HG, and PHQ-9 score. For the syllables /pa/ta/, the Eichner Index, TP, and oral dryness were also associated. For the syllable /ka/ in Gr3, MP, TP, HG, oral dryness, and the KMMSE score were associated. Conclusions: These results could provide practical guidelines for oral rehabilitation in old adults and contribute to improving the understanding of age-related changes in oral function and the multidimensional nature of masticatory dynamics. [ABSTRACT FROM AUTHOR]

Purpose: School-based speech-language pathologists are at the frontline for treating children with pediatric feeding disorders (PFDs). Often, speech-language pathologists are the primary allied health professionals who are charged with maximizing safety, supporting nutrition and neurodevelopmental growth. Due to the increasing need for assessment and treatment of PFDs in schools, it is fundamental that PFDs and dysphagia are detected, differentially diagnosed, and addressed to support developing children. This tutorial addresses the anatomy, physiology, and development of functional feeding and swallowing patterns across the spectrum of childhood for both PFDs and dysphagia. Method: A clinical expert review of the anatomy, physiology, and development of functional feeding and swallowing patterns in children across the spectrum of childhood will be completed. Conclusions: The aim of this tutorial is to support school-based speech-language pathologists in their understanding of the anatomy and physiology of feeding and swallowing. School-based speech-language pathologists should complete this tutorial with an increased understanding and breadth of knowledge related to typical anatomy and physiology versus atypical or disordered presentations. This tutorial would support school-based speech-language pathologists in determining whether a child presents with characteristics of oropharyngeal dysphagia and/or a PFD. [ABSTRACT FROM AUTHOR]

The electrophysiological function of the tongue involves complicated activities in taste sense, producing the perceptions of salty, sweet, bitter, and sour. However, therapies and prevention of taste loss arising from dysfunction in electrophysiological activity require further fundamental research. Optogenetics has revolutionized neuroscience and brought the study of sensory system to a higher level in taste. The year 2022 marks a decade of developments of optogenetics in taste since this technology was adopted from neuroscience and applied to the taste research. This review summarizes a decade of advances that define near‐term translation with optogenetic tools, and newly‐discovered mechanisms with the applications of these tools. The main limitations and opportunities for optogenetics in taste research are also discussed. [ABSTRACT FROM AUTHOR]

Background: There is no clear objective indicator for selecting soft foods that are required for food bolus formation in older people with impaired oral function. Objective: This study aimed to investigate the relationship between maximal isometric tongue pressure (MITP) and the mechanical properties of gels that can be crushed by the tongue. Methods: This study included 65 healthy participants aged 22–96 (young group; 15 males, 15 females; older dentate group; 7 males, 8 females; older edentulous group; 10 males, 10 females). MITP was measured by the balloon‐probe device. Agar gel with 10 different kinds of fracture force from 10N to 100N was used. The limit of fracture force of gels (LFFG) that were crushed by the tongue was measured by the up‐and‐down method. In the older edentulous group, two items were measured with and without dentures. Spearman's rank correlation coefficient was used to evaluate the relationship between MITP and LFFG in each group (p <.05). Results: There were positive correlations between MITP and LFFG in all groups (overall groups: rs =.66, young group: rs =.46, older dentate group: rs =.61, older edentulous group with dentures: rs =.60, older edentulous group without dentures: rs =.47). Conclusion: MITP and LFFG were positively correlated in young, older dentate and older edentulous groups, suggesting that MITP has the potential to be an objective indicator of the range of mechanical properties of soft food that can be crushed by the tongue. [ABSTRACT FROM AUTHOR]

Simple Summary: Oral squamous cell carcinoma of the tongue is the most common type of oral cavity cancer. The depth of tumor invasion is an important factor for both treatment planning and prognosis. In this study, we investigated the accuracy of intraoral ultrasound and magnetic resonance imaging (MRI) in assessing the depth of invasion in patients with oral tongue squamous cell carcinoma. Histopathological measurement of DOI was used as a reference standard. We conducted a prospective study including 30 patients planned for surgical treatment of oral tongue squamous cell carcinoma. Statistical analysis showed that intraoral ultrasound was more accurate than MRI for assessing the depth of invasion of oral tongue cancers. Clinical practice and guidelines could implement intraoral ultrasound accordingly. Oral squamous cell carcinoma (OSCC) of the tongue is the most common type of oral cavity cancer, and tumor depth of invasion (DOI) is an important prognostic factor. In this study, we investigated the accuracy of intraoral ultrasound and magnetic resonance imaging (MRI) for assessing DOI in patients with OSCC. Histopathological measurement of DOI was used as a reference standard. We conducted a prospective study including patients planned for surgical treatment of OSCC in the tongue. The DOI was measured in an outpatient setting by intraoral ultrasound and MRI, and was compared to the histopathological DOI measurements. Bland–Altman analysis compared the mean difference and 95% limits of agreement (LOA) for ultrasound and MRI, and the Wilcoxon signed-rank test was used to test for significance. The correlation was evaluated using Pearson's correlation coefficient. We included 30 patients: 26 with T1 or T2 tumors, and 4 with T3 tumors. The mean difference from histopathology DOI was significantly lower for ultrasound compared to MRI (0.95 mm [95% LOA −4.15 mm to 6.06 mm] vs. 1.90 mm [95% LOA −9.02 mm and 12.81 mm], p = 0.023). Ultrasound also led to significantly more correct T-stage classifications in 86.7% (26) of patients compared to 56.7% (17) for MRI, p = 0.015. The Pearson correlation between MRI and histopathology was 0.57 (p < 0.001) and the correlation between ultrasound and histopathology was 0.86 (p < 0.001). This prospective study found that intraoral ultrasound is more accurate than MRI in assessing DOI and for the T-staging of oral tongue cancers. Clinical practice and guidelines should implement intraoral ultrasound accordingly. [ABSTRACT FROM AUTHOR]

Design: A multisite, prospective, and randomized within-subject design study. Setting: Five university settings in varied geographical areas in the United States. Purpose: The purpose of this study was to compare lingual pressure generation using the Tongueometer (TO) and the Iowa Oral Performance Instrument (IOPI) in typically aging, community-dwelling adults during three measurement tasks: maximum isometric pressure (MIP), regular effort saliva swallow (RESS) pressure, and effortful saliva swallow pressure (ESP). Participants: Eighty-seven typically aging, community-dwelling adults (aged 55 years and over) with no self-reported history of swallowing or neurological disorders were recruited to complete this study. Results: Strong positive associations were found between the lingual pressure generation measures from the TO and IOPI in all tasks in typically aging adults, with Pearson correlations ranging from r = .780 to .874, p < .001. Agreement between the devices (Lin’s concordance correlation coefficient) ranged from moderate for the MIP (ρc = .78) and ESP (ρc = .61) tasks to weak agreement for the RESS task (ρc = .47). MIP, RESS pressure, and ESP were lower when measured by the TO compared with the IOPI, p < .001. Conclusions: The TO measures lingual pressure generation similarly to the IOPI but pressures register lower when using the TO than the IOPI in typically aging persons. This supports the need for developing normative values specific to the TO device or development of a valid and reliable conversion formula from TO to IOPI normative values. At this time, the clinical use of reference values from the TO should not be generalized to IOPI normative values. [ABSTRACT FROM AUTHOR]

Background: Evaluation of low tongue pressure is used to diagnose oral hypofunction. The pathophysiology of oral hypofunction is hypothesized to be associated with oral dysfunction related to ageing. Depression in older adults is a major problem and is related to handgrip strength, which is related to tongue pressure. We hypothesized that low tongue pressure could indicate depression mood in community‐dwelling older adults. Objectives: This study aimed to measure maximum tongue pressure and compare it to the responses to the Kihon Checklist (KCL), which is used to check mental and physical deterioration of community‐dwelling older adults. Methods: A total of 49 community‐dwelling independent older adults with stable dental condition (23 men, 26 women; median age, 79 years) answered the KCL, which contained questions on frailty status, cognitive function, nutritional and sarcopenia status. Oral function was measured to assess oral hypofunction. The relationship between tongue pressure differences and frailty status, cognitive function, nutritional and sarcopenia status was analysed using logistic regression analyses after adjusting for age and sex. Results: Nine participants (6 men and 3 women; median age, 81 years) had a tongue pressure <23.0 kPa, which was the lowest limit of the standard value of maximum tongue pressure in patients aged ≥70 years. Logistic regression analyses showed that only Question 21, which is related to a lack of fulfilment in daily life, was significantly associated with low tongue pressure (p =.027). Conclusion: Low tongue pressure may be associated with sociopsychological factors in older adults. [ABSTRACT FROM AUTHOR]

Taste plays a fundamental role in an animal's ability to detect nutrients and transmits key dietary information to the brain, which is crucial for its growth and survival. Providing alternative terrestrial ingredients early in feeding influences the growth of rainbow trout (RT, Oncorhynchus mykiss). Thus, the present study aimed to assess the influence, via long-term feeding (from the first feeding to 8 months), of alternative plant ingredients (V diet for vegetable diet v. C diet for a control diet) in RT on the mechanism of fat sensing at the gustatory level. After the feeding trial, we studied the pathways of the fat-sensing mechanism in tongue tissue and the integrated response in the brain. To this end, we analysed the expression pattern of free fatty acid receptors (ffar) 1 and 2, markers of calcium-signalling pathways (phospholipase C β , Orai, Stim or Serca), the serotonin level (a key neurotransmitter in taste buds) and the expression pattern of appetite-regulating neuropeptides in the hypothalamus (central area of appetite regulation). The results revealed that the V diet modified the expression pattern of ffar1 and paralogs of ffar2 genes in tongue tissue, along with differential regulation of calcium-signalling pathways and a defect in serotonin level and brain turnover, without influencing neuropeptide expression. This study is the first to support that changes in feeding behaviour of RT fed a V diet could be due to the difference in nutrient sensing and a decrease in hedonic sensation. We revealed that RT have similar fat-detection mechanisms as mammals. [ABSTRACT FROM AUTHOR]

Aim: Tongue strength plays an important role in the process of food intake, and low tongue pressure has been associated with aspiration pneumonia, cognitive decline, and mortality. However, special equipment for tongue pressure measurement is uncommon in general practice. Recently, the serum creatinine‐to‐cystatin C (Cr/CysC) ratio has been validated as a marker of muscle volume mass. Thus, we aimed to investigate the association of the serum Cr/CysC ratio with tongue pressure in a cross‐sectional study. Methods: This single‐center, cross‐sectional study enrolled 73 participants (mean age, 71.7 years; men, 49.3%) who regularly attended the hospital for treatment of chronic disease. A tongue pressure of <30 kPa was defined as low tongue pressure. We evaluated the relationships between the serum Cr/CysC ratio and tongue pressure using multiple regression analysis. Results: The serum Cr/CysC ratio was correlated with tongue pressure (R2 = 0.25, P < 0.0001). In multiple regression analyses adjusted for confounders including age, sex, body mass index, and serum albumin, the association remained significant (P = 0.0001). In logistic analyses, the multivariable‐adjusted odds ratios of the Cr/CysC ratio for tertiles 1 and 2 compared with tertile 3 for low tongue pressure were 7.81 (95% confidence interval, 1.45–51.73) and 2.71 (95% confidence interval, 0.60–13.19), respectively. Conclusions: We demonstrated that a decreased serum Cr/CysC ratio was associated with a higher risk of low tongue pressure. Our findings suggest that this simple serum surrogate marker may be a first step toward an intervention for oral function by general practitioners. Geriatr Gerontol Int 2024; 24: 102–108. [ABSTRACT FROM AUTHOR]

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Introduction: Dysphagia can affect more than 50% of stroke patients in the acute phase. Aspiration pneumonia is a serious complication that can be prevented with dysphagia screening and assessment. Measurement of tongue elevation pressure is suggested to be a useful tool in aspiration risk screening. Objective: This study aimed to assess the diagnostic accuracy of maximum anterior tongue elevation strength (Pmax) in acute stroke care. Method: In this prospective study, data were collected in a neurology department (stroke center) where patients formed a consecutive case series. The sample consisted of thirty stroke patients who failed an initial dysphagia screening. Patients underwent anterior tongue elevation strength measurement (index test) during bedside dysphagia assessment by a speech-language pathologist and flexible endoscopic evaluation of swallowing (reference test) by an otorhinolaryngologist on the same day. Outcome variables (index values in kPa, reference values interpreted on the penetration-aspiration scale) were used for estimating measures of diagnostic accuracy in aspiration risk screening. Results: Ten patients aspirated on instrumental evaluation. At the cut-off point of ≤ 34 kPa the analysis showed 90% sensitivity, 35% specificity, 41% positive predictive value, and 88% negative predictive value. The area under the curve (AUC) for Pmax was AUC = 0.700 (95% CI [0.500–0.900]). Conclusion: Although individuals with low anterior tongue elevation strength tend to have a higher risk of aspiration, this variable alone is not capable of screening aspiration in acute stroke. In combination with a thorough noninstrumental bedside examination, it might have the potential to reduce the number of false positive cases. Further studies in this area would be worthwhile. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a common chronic condition in which upper airway collapse interferes with breathing during sleep, reducing sleep quality. Untreated OSA can impair a patient's health and quality of life. The recommended first-line treatment for OSA in adults is positive airway pressure, but difficulty tolerating this device limits adherence to treatment for many patients. Treatment with an implanted hypoglossal nerve stimulation (HNS) device is a relatively new second-line option for these patients, and is gaining more widespread use. Clinicians who treat OSA or provide other healthcare services to patients with HNS implants should be familiar with these devices. This article reviews HNS technology and relevant OSA pathophysiology, along with device candidacy criteria, efficacy, risks, and considerations related to use of other medical technologies for patients with HNS implants. [ABSTRACT FROM AUTHOR]

Background: Improving chewing function of older adults increases the health-related quality of life. Few studies indicated the correlation between tongue, lip strength on masticatory performance in older people. The study aimed to investigate the association between lip, tongue strength on chewing pattern in aging population. Methods: The older adults had independent daily intake without assistance were enrolled. They had intact dentition and no periodontitis. To estimate the number of chewing strokes and chewing time by consuming a cornstarch cookie were used to represent chewing pattern. Lip and tongue pressure were evaluated with an Iowa Oral Performance Instrument. Linear regression analysis was used to analyze the lip and tongue pressure associated with the chewing time and strokes. Spearman's correlation analysis was utilized to evaluate the associations among chewing time and chewing strokes or lip and tongue pressure. Results: 35 women and 35 men with an average age of 73.2 years were investigated. Tongue pressure was significantly related to the chewing time and the number of chewing strokes (p = 0.01 and 0.03). There was a close association between chewing time and the number of chewing strokes (p < 0.0001). The correlation between lip and tongue pressure was significant (p < 0.0001). Conclusion: The tongue strength significantly related to chewing ability in aging population. Increasing the tongue strength greatly reduced the number of chewing strokes and chewing time. Good masticatory ability could increase the motor function of tongue; raising the tongue strength might be able to improve mastication in older adults. [ABSTRACT FROM AUTHOR]

Purpose: Somatosensory feedback, including proprioception, is important for speech production. This study evaluates proprioceptive acuity of the tongue using a position-matching task and determining if proprioceptive acuity impacts speech motor control in healthy adult talkers. Method: Twenty-five young adults with no history of speech, language, or hearing disorders had their tongue movements recorded with an electromagnetic articulograph while completing a position-matching task. Participants were also asked to repeat two sentences that differed in the somatosensory feedback obtained. One sentence provided both tactile and proprioceptive feedback, whereas the other primarily provided proprioceptive feedback. Results: Participants ranged in proprioceptive acuity as measured by the positionmatching task. Talkers with smaller position-matching errors and, therefore, higher proprioceptive acuity had smaller movements and slower speeds for both sentences. Talkers with lower proprioceptive acuity had reduced speech movement stability for the sentence that primarily provides proprioceptive feedback. Conclusion: Proprioceptive acuity of the tongue can be evaluated using a position-matching task, and acuity is associated with more efficient speech movements and greater speech movement stability, particularly when producing utterances that provide less tactile feedback. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the effect of intensity dosing during tongue exercise on tongue pressure generation, adherence, and perceived effort. Design: This was a five-site, prospective, randomized clinical trial. Outcome measures were obtained across multiple baselines, biweekly during exercise, and 4-weeks post-intervention. Setting: The general community at each study site. Participants: Typically aging adults between 55-82 years of age with no history of neurological or swallowing disorders. Eighty-four volunteers completed the study. Interventions: Participants were randomly assigned to one of four exercise groups: (a) maximum intensity/no biofeedback, (b) progressive intensity/no biofeedback, (c) maximum intensity/biofeedback, and (d) progressive intensity/biofeedback. Half of the participants completed a maintenance exercise program. Outcome measures: Maximum isometric pressure (MIP), regular effort saliva swallow pressure, adherence, and the Borg Rating of Perceived Exertion Scale. Results: All exercise protocols were efficacious for gains in MIP (large effect sizes; Cohen's d). Group 3 made gains in regular effort saliva swallow pressure (medium effect size). There was a significant change in perceived exertion for regular effort saliva swallow pressure at 8 weeks. Tongue pressure gains were maintained at 1 month, regardless of maintenance group status. Mean adherence across groups was high. Conclusions: All groups improved pressure generation. Intensity dosing differences did not affect strength gains, adherence, or detraining. Regular effort saliva swallow pressure may be most responsive to maximum intensity with biofeedback. The findings suggest flexibility in approach to tongue exercise protocols. Tongue muscles may differ from limb muscles in terms of dose response and neuroplasticity principles. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated (a) the effects of the effortful swallow under two different instructions (tongue emphasis vs. pharyngeal squeezing) on hyoid displacement and hyoid--larynx approximation, (b) the association between tongue pressure and hyolaryngeal movement during normal swallowing and the effortful swallow produced with tongue emphasis, and (c) age-related differences in hyolaryngeal movement during normal and effortful swallows (tongue emphasis vs. pharyngeal squeezing) in healthy individuals. Method: Forty healthy adults (20 younger and 20 older) swallowed their saliva as they normally do (normal swallow) and performed the effortful swallow with tongue emphasis and pharyngeal squeezing. Tongue-to-palate pressure during swallowing was measured using the Iowa Oral Performance Instrument, hyolaryngeal movement was measured using ultrasonography, and submental surface electromyography was used to track swallows. Results: Results revealed differences in hyolaryngeal movement across swallowing types. Both types of effortful swallows showed greater hyolaryngeal movement than normal swallows. Additionally, hyolaryngeal movement was greater during the effortful swallow with tongue emphasis than the effortful swallow with pharyngeal squeezing. Age-related differences were found only in hyoid--larynx approximation during the effortful swallow with tongue emphasis (younger > older adults). Furthermore, moderate positive correlations were identified between tongue pressure and hyolaryngeal movement during normal swallows and the effortful swallow with tongue emphasis. Conclusions: The findings show that varying instructions of the effortful swallow affect hyolaryngeal movement differently, suggesting that clinicians may need to individualize the effortful swallow instruction according to the physiological impairments of each patient. Additionally, natural age-related changes in swallowing physiology do not seem to affect an individual's ability to perform the effortful swallow or to impact hyolaryngeal movement. Finally, the association between tongue pressure and hyolaryngeal movement during normal swallows and the effortful swallow with tongue emphasis suggests that the tongue plays a critical role in swallowing, priming subsequent swallowing events. [ABSTRACT FROM AUTHOR]

Introduction: The conventional rigid-90° and rigid-70° laryngostroboscopy has been so far considered the gold standard in assessing the vibratory behavior of the vocal folds and the glottal closure configuration during phonation. Meanwhile, this rigid laryngostroboscopy is more and more replaced by flexible chip-on-tip systems. The aim of this study was to evaluate the influence of these different endoscopic techniques on glottal closure configuration and on visibility of the complete focal fold length including anterior commissure during phonation. Methods: Twenty-one euphonic subjects were enrolled (mean age 34.6 ± 9.5; m = 10, f = 11). They were examined with the three laryngoscopic techniques (conventional rigid-90°, rigid-70°, and flexible chip-on-tip laryngoscopy during low and high voice pitch with soft and loud voice intensity). For evaluating the degree of glottal closure, a modified classification of Södersten et al. was applied and the visibility of the anterior commissure was evaluated. The correlation of the three endoscopic techniques was assessed with Cohen and Fleiss' kappa. Results: In even low loud phonation, the rigid-90° and rigid-70° endoscopies revealed a complete closure of the glottis in only 47.6% of subjects but with flexible endoscopy in 81%. The complete vocal fold length with anterior commissure was best visible with flexible endoscopy in 90.5% in low-soft and high-soft phonation. The rigid-90° endoscopy showed a slight agreement in comparison with the flexible endoscopy in regard to the types of vocal fold closure with a Cohen's kappa coefficient k = 0.199. The rigid-90° endoscopy showed an almost perfect agreement with k = 0.84 when compared to the rigid-70° endoscopy. The flexible endoscopy compared to the rigid-70° endoscopy showed a fair agreement with k = 0.346. Conclusion: We found mainly corresponding results in both rigid-90° and rigid-70° endoscopic techniques which can be explained by the same transoral approach with the tongue pulled out, whereas the flexible transnasal endoscopy mainly gives a better view on the anterior commissure. The influence of transorally or transnasally guided endoscopic techniques needs to be considered in interpretation of laryngostroboscopic parameters like vocal fold closure and supraglottal hyperactivity. [ABSTRACT FROM AUTHOR]

Background: Physical performance improvement through whole-body exercise may have a positive impact on dysphagia via improvement of maximum tongue pressure (MTP). Aims: The present study aimed to quantitatively analyze whether improvement in physical performance reduces dysphagia by improving MTP in patients with acute heart failure (AHF). Methods: A total of 146 patients with AHF and dysphagia were included. Dysphagia was defined as a functional oral intake scale (FOIS) score < 6. The short physical performance battery (SPPB) indexed physical performance. A two-wave cross-lagged mediation model was used to examine whether an improvement in SPPB results improves the FOIS score via an improvement in MTP. The SPPB, MTP, and FOIS scores (T1: baseline, T2: hospital discharge) were included in the model. Results: A total of 146 patients were included in the final analysis. The SPPB result at T1 positively affected MTP (β = 0.150, P = 0.030) and the FOIS score (β = 0.249, P = 0.002) at T2. MTP at T1 also positively affected the FOIS score at T2 (β = 0.189, P = 0.026). Furthermore, the SPPB result indirectly affected the FOIS score by affecting the MTP (indirect effect = 0.028; 95% CI = 0.010, 0.078). Discussion: This study contributes to the knowledge base regarding the potential of exercise therapy as a new treatment strategy for dysphagia in patients with AHF. Conclusion: An improvement in SPPB results improved the FOIS score by improving the MTP in patients with AHF. [ABSTRACT FROM AUTHOR]

Breathing usually occurs without awareness unless there are problems such as asthma, emphysema, allergies, or viral infections. Infant and child development may affect how we breathe as adults. This article includes discussion of the benefits of nasal breathing, factors that contribute to mouth breathing, how babies' breastfeeding and chewing decreases the risk of mouth breathing, and recommendations that parents may implement to support healthy development of a wider palate. A link to a video presentation also is included: How the Tongue Informs Healthy (or Unhealthy) Neurocognitive Development, by Karindy Ong, MA, CCC-SLP, CFT. [ABSTRACT FROM AUTHOR]

Background: Oral‐motor performance for speech and swallowing, and verbal fluency represent important domains that can determine frailty thresholds in older people. Objectives: The study aims to explore the association between oral‐motor performance and verbal fluency to achieve a comprehensive measurement of the frailty phenotype. Methods and Procedures: An exploratory and inferential cross‐sectional study was carried out in two nursing homes and 2 day care centres. The study comprised a sample of 95 individuals with a mean age of 83 years. The oral‐diadochokinesis test (ODDK), water swallow test (WST), time of mastication and swallowing (TOMASS), maximum tongue pressure, verbal fluency, physical phenotype and Mini‐Mental State Examination (MMSE) were used as measurements variables. Results: The comparison of mean values between the performance of observed and normative values for the target population was shown to be statistically significant for all the measurements and between the pre‐frail and frail. Conclusions: The results of this study add to the growing body of evidence that oral‐motor function for speech and swallowing and verbal fluency are relevant to the diagnosis and management of the frailty condition in older people. The frailty syndrome is more than just the traditionally observed physical function, rather it is a multidimensional construct, where additional dimensions should be considered when evaluating frailty in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Current electromagnetic tongue tracking devices are not amenable for daily use and thus not suitable for silent speech interface and other applications. We have recently developed MagTrack, a novel wearable electromagnetic articulograph tongue tracking device. This study aimed to validate MagTrack for potential silent speech interface applications. Method: We conducted two experiments: (a) classification of eight isolated vowels in consonant–vowel–consonant form and (b) continuous silent speech recognition. In these experiments, we used data from healthy adult speakers collected with MagTrack. The performance of vowel classification was measured by accuracies. The continuous silent speech recognition was measured by phoneme error rates. The performance was then compared with results using data collected with commercial electromagnetic articulograph in a prior study. Results: The isolated vowel classification using MagTrack achieved an average accuracy of 89.74% when leveraging all MagTrack signals (x, y, z coordinates; orientation; and magnetic signals), which outperformed the accuracy using commercial electromagnetic articulograph data (only y, z coordinates) in our previous study. The continuous speech recognition from two subjects using MagTrack achieved phoneme error rates of 73.92% and 66.73%, respectively. The commercial electromagnetic articulograph achieved 64.53% from the same subject (66.73% using MagTrack data). Conclusions: MagTrack showed comparable results with the commercial electromagnetic articulograph when using the same localized information. Adding raw magnetic signals would improve the performance of MagTrack. Our preliminary testing demonstrated the potential for silent speech interface as a lightweight wearable device. This work also lays the foundation to support Mag- Track’s potential for other applications including visual feedback–based speech therapy and second language learning. [ABSTRACT FROM AUTHOR]

Electropalatography (EPG) has been used in the past 50 years for studying the patterns of contact between the tongue and the palate during speech production in typical speakers and those with speech disorders due to different causes. At the 7th EPG Symposium in Japan that was held online on 24 January 2021 (see: ), a panel of invited experts discussed their views regarding further developments and application of the technique. This paper provides a summary of this discussion. EPG offers information on articulation which cannot be replaced by other instrumental measures of speech. Identified areas for further hardware development are thinner EPG plates, better dental and palatal coverage, wireless connectivity, and sensors that provide additional articulatory information (e.g. tongue pressure, tongue-palate distance). EPG can serve as a resource for teaching speech disorders and phonetics. Furthermore, EPG therapy can be combined with telepractice in the speech therapy of clients with speech disorders. [ABSTRACT FROM AUTHOR]

Purpose: In overtone singing a singer produces two pitches simultaneously, a low-pitched, continuous drone plus a melody played on the higher, flutelike and strongly enhanced overtones of the drone. The purpose of this study was to analyse underlying acoustical, phonatory and articulatory phenomena. Methods: The voice source was analyzed by inverse filtering the sound, the articulation from a dynamic MRI video of the vocal tract profile, and the lip opening from a frontal-view video recording. Vocal tract cross-distances were measured in the MR recording and converted to area functions, the formant frequencies of which computed. Results: Inverse filtering revealed that the overtone enhancement resulted from a close clustering of formants 2 and 3. The MRI material showed that for low enhanced overtone frequencies (FE) the tongue tip was raised and strongly retracted, while for high FE the tongue tip was less retracted but forming a longer constriction. Thus, the tongue configuration changed from an apical/anterior to a dorsal/posterior articulation. The formant frequencies derived from the area functions matched almost perfectly those used for the inverse filtering. Further, analyses of the area functions revealed that the second formant frequency was strongly dependent on the back cavity, and the third on the front cavity, which acted like a Helmholtz resonator, tuned by the tongue tip position and lip opening. Conclusions: This type of overtone singing can be fully explained by the well-established source-filter theory of voice production, as recently found by Bergevin et al. [1] for another type of overtone singing. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the hypothesis that younger speakers and speakers with more severe speech sound disorders are more likely to use simpler (undifferentiated) tongue gestures due to difficulties with, or immaturity of, lingual motor control. Method: The hypothesis is tested using cross-sectional secondary data analysis of synchronous audio and high-speed ultrasound recordings from children with idiopathic speech sound disorders (n = 30, aged 5;0–12;11 [years;months]) and typically developing children (n = 29, aged 5;8–12;10), producing /a/, /t/, /ɹ/, /l/, /s/, and /ʃ/ in an intervocalic /aCa/ environment. Tongue shape complexity is measured using NINFL (Number of INFLections) and modified curvature index (MCI) from splines fitted to ultrasound images at the point of maximal lingual gesture. Age, perceived accuracy, and consonant are used as predictors. Results: The results suggest that as age increases, children with speech sound disorders have lower MCI compared to typically developing children. Increase in age also led to decrease of MCI for the typically developing group. In the group of children with speech sound disorders, perceptually incorrect /ɹ/ productions have lower MCI than correct productions, relative to /a/. Conclusions: There is some evidence of systematic tongue shape complexity differences between typically developing children and children with speech sound disorders when accounting for increase in age. Among children with speech sound disorders, increase in age and perceptually incorrect consonant realizations are associated with decreasing tongue shape complexity. [ABSTRACT FROM AUTHOR]

In the present study a comprehensive protocol to assess chewing in four children with Down syndrome is provided and described. One baseline and four assessment meals were conducted across four textures of foods to investigate the presence or absence of components of chewing (bite down, chew and tongue lateralization), as well as movements associated with the development of chewing. Results showed that at baseline all participants ate their typical diet (i.e., pureed food) but no chewing components or movements were observed. The findings of the assessment protocol indicated that it offers a prescriptive assessment of chewing and its components across different food textures. The results of the assessment provided useful information for clinicians by identifying a potential starting point for interventions to address chewing deficits. Furthermore, the findings add to the existing literature on the role of tongue lateralization and specific tongue movements in chewing. Implications of the findings for chewing interventions and future research are discussed. [ABSTRACT FROM AUTHOR]

Purpose: Objective measures of lingual strength are used in both clinical practice and research to provide information regarding the ability of the tongue to contribute to safe and efficient swallowing. The Iowa Oral Performance Instrument (IOPI) is the most frequently used tongue pressure manometer and is considered to be the gold standard. The Tongueometer device was developed to circumvent IOPI shortcomings including bulb slippage, cost, and patient utility. As such, the aims of this pilot study were to examine the validity of the Tongueometer and to obtain comparative adult reference values. Method: Using the Tongueometer, participants completed three trials of anterior and posterior maximum isometric lingual pressure and regular effort saliva swallow tasks. Moreover, 41% of participants also completed all trials using the IOPI. Independent-samples t tests compared maximum means between the IOPI and Tongueometer. Concurrent validity was assessed using Lin's concordance correlations. Associations were evaluated using independent-samples t tests (sex) and Pearson correlation coefficient (age). Results: Seventy-six healthy participants (48 women, 28 men) with no history of swallowing difficulty were included in the study (Mage = 50 ± 21). Across all lingual pressure task measures, mean maximum Tongueometer measures strongly correlated with corresponding IOPI measures (anterior: concordance correlation coefficient [CCC] = 0.74, p < .000; posterior: CCC = 0.81, p < .000; swallow: CCC = 0.62, p < .000). Tongueometer and IOPI mean anterior maximum isometric lingual pressures were not statistically different, whereas posterior lingual pressures and pressures elicited during swallowing were statistically different (p < .01). A significant negative correlation was found between age and maximum anterior tongue pressure (r = -.43, p < .01). No significant association of sex on maximum tongue pressure was observed. Conclusion: Overall, this pilot research suggests that the Tongueometer is a valid tool for clinical use in measuring lingual strength and swallowing function. [ABSTRACT FROM AUTHOR]

The article focuses on the perception versus physiology of the tongue in voice pedagogy and explores historical perspectives from influential voice pedagogues, such as Manuel García II, Lilli Lehmann, William Vennard, D. Ralph Appelman, Richard Miller, and Peter Ladefoged.