Objective: The study focused on high-density surface electromyography (HD-sEMG) as a novel method to understand the electrophysiological characteristics of swallowing-related muscles in patients with Parkinson’s disease (PD) and detect physiological changes following electrical interventions.

Background: Patients with PD frequently develop aspiration pneumonia, leading to a worsened outcome. Proper swallowing assessment and intervention are essential. Various novel evaluations have been explored, one of which is HD-sEMG, which enables the non-invasive assessment of motor unit (MU) activity and recruitment characteristics.

Method: We evaluated the patients with PD (Hoehn–Yahr stages 2–4) and healthy elderly as controls. The suprahyoid muscles, which play a key role in the oral and pharyngeal phases of swallowing, were selected for the evaluation. Electrical activity in these muscles during tongue elevation was measured using HD-sEMG. First, maximum voluntary contraction (MVC) was assessed. Next, sustained tasks were performed to capture suprahyoid muscle activity, and several parameters, including modified entropy, coefficient of variation, correlation coefficient, and root mean square (RMS), were analyzed. Moreover, the physiological change of cervical interferential current stimulation over 8 weeks were examined in patients with PD using HD-sEMG.

Results: Initially, the method was tested multiple times in healthy individuals to confirm the absence of systematic errors and to ensure the results were consistent with previous studies on the quadriceps femoris. A total of 22 patients with PD (median age 71 years [range 61–84]) and 14 healthy controls (median age 74 years [range 65–85]) were included. The RMS at 60% MVC was significantly lower in patients with PD compared to healthy controls. After cervical interferential current stimulation, the correlation coefficients at 40% and 60% MVC significantly decreased, and the RMS at 60% MVC significantly increased. However, no clear objective improvement in aspiration, including findings from the videofluoroscopic examination, was observed.

Conclusion: HD-sEMG of the suprahyoid muscles revealed low action potential and poor recruitment in patients with PD. Furthermore, the technique showed potential for detecting early electrophysiological changes following electrical stimulation interventions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/physiological-assessment-of-swallowing-related-muscles-in-patients-with-parkinsons-disease-characteristics-and-utility-of-high-density-surface-electromyography/