Suprahyoid Muscle Activity in Patients with Chagasic Megaesophagus

Aretuza Zaupa Gasparim El Gharib,Max Jean De Ornelas Toledo,Giédre Berretin-Felix,Roberto Oliveira Dantas,Diogo Francisco Rossoni

doi:10.1038/s41598-019-55402-5

Aretuza Zaupa Gasparim El Gharib, Max Jean De Ornelas Toledo + Show 3 more

Open Access

https://doi.org/10.1038/s41598-019-55402-5

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Abstract

The objective of this investigation was to evaluate the activity of the suprahyoid musculature during swallowing and to correlate the findings with the degree of megaesophagus, oral and pharyngeal videofluoroscopy and esophageal manometry in patients with achalasia caused by Chagas’ disease. Twenty-nine patients with positive serology for Trypanosoma cruzi and dysphagia (Chagas’ disease group) and 29 individuals matched by sex and age (control group) participated in the study. Surface electromyography of the suprahyoid musculature and videofluoroscopy during swallowing of paste and liquid consistencies were performed. Canonical correlation analysis of the MANOVA test results showed that the Chagas’ disease group had lower electromyographic activity when compared with controls. Overlapping circles of radiological findings were found for megaesophagus. The Spearman test showed a positive correlation between the electromyographic activity in the maximum voluntary isometric contraction and the time of pharyngeal transit for both liquid (p = 0.014) and paste (p = 0.047). The logistic regression test showed no association between electromyographic activity of the suprahyoid muscles and esophageal manometry results (p > 0.05). In conclusion, individuals with chagasic megaesophagus have reduced electromyographic activity of the suprahyoid muscles during swallowing, in addition to a greater recruitment of the suprahyoid musculature with increased pharyngeal transit time.

Highlights

Chagas’ disease (CD) or American trypanosomiasis is a potentially fatal infectious tropical disease of high morbidity, caused by the parasitic protozoan Trypanosomacruzi
The digestive form of the disease is common in central Brazil and Chile, it is practically non-existent in Amazonia, Colombia, Venezuela and Central America[3,4]
We found that recruitment of the supra-hyoid muscles is affected in CD patients when compared with healthy individuals, indicating disturbances in muscular activity during the pharyngeal phase of swallowing, and altered pharyngo-esophageal transit

Summary

Introduction

Chagas’ disease (CD) or American trypanosomiasis is a potentially fatal infectious tropical disease of high morbidity, caused by the parasitic protozoan Trypanosomacruzi. The digestive form of the disease is common in central Brazil and Chile, it is practically non-existent in Amazonia, Colombia, Venezuela and Central America[3,4]. In the State of Paraná, Southern Brazil, 14% and 20% of the patients present the digestive and cardiodigestive forms of CD, respectively[5], with dysphagia as one of the most frequent symptoms (26% of patients). In oral and pharyngeal phases of swallowing in patients with CD an increase in oral residues, longer pharyngeal clearance for paste bolus[10], longer pharyngeal clearance and upper esophageal transit[11], longer pharyngeal transit andlonger opening of the upper esophageal sphincter (UES)[9] were observed. Thistechnique has beenused as anaid in www.nature.com/scientificreports differentialdiagnosisandmonitoringof possible muscular disorders[15] and contributed to the assessment of swallowing dysfunction

Results

Discussion

Conclusion