Tongue Movement Patterns Research Articles

Movement patterns in tuba playing: comparison of an embouchure dystonia case with healthy professional tuba players using real-time MRI imaging.

Musculoskeletal problems in professional brass musicians are very common and often involve the muscles of the embouchure. In rare cases, embouchure dystonia (EmD), a task-specific movement disorder with a wide symptomatic and phenotypic variability, occurs. Following trumpeters and horn players, professional tuba players with and without EmD have now been studied using the latest real-time MRI technology to better understand the underlying pathophysiology. In the present study, the tongue movement patterns of 11 healthy professional artists and one subject suffering from EmD were compared. The tongue position in the anterior, intermediary and posterior oral cavity were converted into pixel positions based on seven previously generated profile lines, using the established software MATLAB. These data allow a structured comparison of tongue movement patterns between the patient and the healthy subjects, as well as between individual exercises. The main focus of the analysis was on an ascending 7-note harmonic series performed in different playing techniques (slurred, tongued, tenuto and staccato). Playing the ascending harmonics, a noticeable ascending tongue movement could be observed in the anterior part of the oral cavity in healthy tubists. In the posterior region, there was a slight decrease in oral cavity space. In the EmD patient, hardly any movement was observed at the tongue apex, but in the middle and posterior regions of the oral cavity there was an increase in size the higher the tone became. These distinct differences are relevant for the characterization and a better understanding of the clinical presentation of EmD. Concerning different playing techniques, it was apparent, that notes played slurred or staccato resulted in a larger oral cavity when compared to notes played tongued or tenuto, respectively. By using real-time MRI videos, the tongue movements of tuba players can be clearly observed and analyzed. The differences between healthy and diseased tuba players demonstrate the great effects of movement disorders in a small area of the tongue. In order to better understand the compensation of this motor control dysfunction, further studies should investigate further parameters of tone production in all brass players with a larger number of EmD patients additional to the observed movement patterns.

Numerical simulations for characterization of missing articulatory information in ultrasound imaging of speech

The air–tissue interface at the tongue surface allows submental (below the chin) B-mode ultrasound images to depict the shape of the tongue in real time, useful for measuring and understanding typical and disordered tongue articulation during speech production. However, parts of the tongue are obscured; depending on an individual speaker's anatomy and tongue movement patterns, the anterior tongue tip may be shadowed by the mandible bone and the sublingual airspace. To characterize this missing information about the tongue tip in ultrasound images, midsagittal ultrasound images were numericallysimulated. Three-dimensional anatomic models were constructed using magnetic resonance imaging (MRI) data to map tongue tissue, surrounding air, and an estimated position of the mandible. Pulse-echo ultrasound images were then numerically simulated using the open-source k-Wave toolbox. Acoustic properties of the medium and an imaging array model are identified that allow simulations to replicate features in ultrasound images recorded from the same speakers as the MRI data, while maintaining computational efficiency. The potential to recover missing information on the tongue tip position from reverberation artifacts is assessed.

Quantifying tongue tip visibility in ultrasound images of /r/ tongue shapes using numerical ultrasound simulations

Midsagittal ultrasound images provide important articulatory information about tongue shape by showing much of the tongue surface from the root to the tip. However, portions of the tongue tip are often obscured due to shadowing from the mandible bone and the sublingual airspace. Information about tongue tip position can be important for understanding tongue movement patterns, e.g., classification of a retroflex or bunched shape for the American English rhotic /r/. Here, numerical simulations of acoustic wave propagation in tissue were performed using the open-source k-Wave toolbox to recreate ultrasound images of the tongue for a range of retroflex and bunched tongue shapes segmented from magnetic resonance imaging (MRI). Extent of the tongue tip visibly missing from the simulated ultrasound images is quantified by comparison with the known tongue shape from MRI. The fraction of the tongue surface visible in ultrasound images is compared between tongue shapes that appear retroflex versus bunched in MRI. Implications for ultrasound biofeedback therapy are discussed, including possible ambiguity of retroflex versus bunched classification.

Ultrasonic Imaging Investigation of Tongue Movement Patterns of Cleft-Related Lateralized and Palatalized Misarticulation.

To explore the tongue movement patterns on Mandarin speaking children with repaired cleft palate with lateralized and palatalized misarticulation (LPM) using ultrasound imaging technique. A group of 20 subjects who were diagnosed with speech sound disorder after cleft palate repairment, and another group of 18 children with LPM were recruited. A group of 20 typical children were recruited as the control group. The ultrasonography was used to collect the articulation pattern of the 8 single vowels that are /a/, /o/, / ɘ/, /i/, /u/, /y/, /ɨ/, /ʉ/ in Mandarin Chinese. Various ultrasonic tongue parameters were analyzed from both sagittal and coronal planes. Compared with the control group, coronal height of peak point, coronal tongue dorsum constraint index, sagittal peak point offset distance, sagittal distance between tongue tip and peak point, and sagittal tongue dorsum constraint index of /ɘ/,/i/, /y/ and /ɨ/ were significantly smaller in the cleft-related lateralized and palatalized group (CLP) and noncleft-related lateralized and palatalized group (NLP) ( P < 0.05). Compared with the noncleft-related later- alized and palatalized group and control group, sagittal peak point offset distance of the vowels /ɘ/ and /i/ was significant smaller in the cleft-related lateralized and palatalized group group ( P < 0.05). The ultrasound images on the children with cleft palate showed a midline elevation of the tongue and a significant apical constriction. The children with LPM showed a midline elevation at the coronal plane and anterior movement of the tongue high point at the sagittal plane. The apical vowels were more informative and accurate in indicating the features of LPM than other vowels.

Influence of mandibular advancement on tongue dilatory movement during wakefulness and how this is related to oral appliance therapy outcome for obstructive sleep apnea.

To characterize how mandibular advancement splint (MAS) alters inspiratory tongue movement in people with obstructive sleep apnea (OSA) during wakefulness and whether this is associated with MAS treatment outcome. A total of 87 untreated OSA participants (20 women, apnea-hypopnea index (AHI) 7-102 events/h, aged 19-76 years) underwent a 3T MRI with a MAS in situ. Mid-sagittal tagged images quantified inspiratory tongue movement with the mandible in a neutral position and advanced to 70% of the maximum. Movement was quantified with harmonic phase methods. Treatment outcome was determined after at least 9 weeks of therapy. A total of 72 participants completed the study: 34 were responders (AHI < 5 or AHI ≤ 10events/h with >50% reduction in AHI), 9 were partial responders (>50% reduction in AHI but AHI > 10 events/h), and 29 nonresponders (change in AHI <50% and AHI ≥ 10 events/h). About 62% (45/72) of participants had minimal inspiratory tongue movement (<1 mm) in the neutral position, and this increased to 72% (52/72) after advancing the mandible. Mandibular advancement altered inspiratory tongue movement pattern for 40% (29/72) of participants. When tongue dilatory patterns altered with advancement, 80% (4/5) of those who changed to a counterproductive movement pattern (posterior movement >1 mm) were nonresponders and 71% (5/7) of those who changed to beneficial (anterior movement >1 mm) were partial or complete responders. The mandibular advancement action on upper airway dilator muscles differs between individuals. When mandibular advancement alters inspiratory tongue movement, therapeutic response to MAS therapy was more common among those who convert to a beneficial movement pattern.

Description of tongue movements on swallowing patterns

ObjectiveThe purpose of this study was to compare the different swallowing patterns regarding tongue movement during saliva swallowing in healthy participants. DesignSeventeen participants (23.0 ± 3.6 years old) were included in this cross-sectional study. The movement of the tongue (anterior, middle and posterior portions) on the three axes of space (inferior-superior, anterior-posterior and medial-lateral) was recorded using a 3D electromagnetic articulograph. The tongue movement patterns registered during saliva swallowing were classified according to Bourdiol et al. (2014) into Type I, II or III. ResultsThree swallowing patterns were identified (Type I, 64.7 %; Type II, 5.9 %; and Type III, 29.4 %). On the anterior-posterior axis, the displacement of the three portions of the tongue was significantly higher in Type III pattern compared with the Type I pattern. Furthermore, on the superior-inferior axis, the displacement of the anterior portion was significantly higher in Type III pattern compared with Type I pattern. In Type I pattern, on the inferior-superior axis, the smallest range of displacement occurred in the anterior portion of the tongue, followed by the middle and, finally, the posterior portion.In the analysis of Type III swallowing pattern, no significant differences were found on the range of displacement of the tongue portions on the three axes. ConclusionStatistical differences were found between swallowing patterns Type I and III regarding tongue movement. The frequency of pattern II found in the participants of this study was not high enough to compare the three patterns. However, the results obtained indicate that the methodology applied could be used to identify the patterns based on quantitative data.

Presbyphagia Diagnostics Using M-Mode Ultrasound: Changes in the Tongue Movement Pattern.

Age-related physiological changes of the swallowing act impair particularly the oral phase and the tongue function, which is very important for bolus preparation and transfer. At present, there are no easily applicable methods for measurement of this phase of swallowing. This study was designed to investigate the deglutitive tongue movement by M-mode ultrasound and to compare the collected parameters of different age groups. In this exploratory prospective study, the tongue and its movements of 20 younger and 30 older women were examined during swallowing by B-mode and M-mode ultrasound. Preexisting dysphagia or malnutrition as well as psychic or neurological deficits were excluded by clinical examination and screening with the Mini Nutritional Assessment-Short Form (MNA-SF), the Gugging Swallowing Screen (GUSS), the Mini-Mental State Examination (MMSE) and the Barthel Index. The data were compared with each other and statistically analyzed. With increasing age, a change in the tongue movement pattern becomes apparent. In the group of older women, the vertical lingual movement had a smaller amplitude (p < 0.001) and a shorter time to the maximum amplitude (p < 0.03) than in the group of younger women. However, there were no differences in the tongue diameter (p > 0.4). The tongue movement pattern appears to be subject to age-specific changes, in contrast to anatomy. The use of M-mode ultrasonography is an easy, radiation-free and cost-effective method for the assessment of the oral phase of swallowing. Limitations are the widely scattered values of the ultrasound findings. Further studies are needed for validation and definition of standard values for this promising method.

Quantitative analysis of tongue movement in 14 phonemes of Brazilian Portuguese.

The aim of this study was to characterize the ultrasonographic pattern of tongue movement in 14 consonant phonemes of Brazilian Portuguese (BP), seeking to identify and describe ultrasonographic parameters that could grasp the difference of manner and place of articulation among these phonemes. We selected 20 individuals with typical speech production, aged between 20-30 years of both genders. The selected stimuli included the 14 lingual consonant BP phonemes in the intervocalic context of [a]. Data were collected and analyzed with the use of ultrasound, and the AAA (Articulate Assistant Advanced) and the Ultra-CATS (The Ultrasonographic Contour Analyzer for Tongue Surfaces) softwares. Three ultrasound parameters were used for data analysis: anteriority index (AI), global average of tongue height (GA) and relative anteriority index (RAI). Data were statistically analyzed. ANOVA showed a significant effect on the parameters and the RAI differentiated phonemes as the place (alveolar, pre-palatal, palatal and velar) and manner of articulation (fricative, nasal and occlusive); GA differentiate phonemes only as the place of articulation (alveolar, pre-palatal and velar). There was no single US parameter that could differentiate place and manner of articulation simultaneously. The clinical application for analysis of speech production disorders require the use of at least two ultrasound parameters: one to distinguish the place and another to distinguish the articulation manner.

Ultrasound study for patterns of tongue movement in diphthongs, triphthongs, and vowel sequences in Korean, Japanese, and Mandarin

Diphthongs have formant transitions sensitive to speaking rate, stress, vowel quality, and language ability. Tongue movement typically shows a functional “pivot” where the palate to tongue distance is almost constant; some combinations result in an “arch,” with only part of the tongue moving [Iskarous, J. Phon. 33, 363-381, 2005]. Here, ultrasound images of the tongue in Korean, Japanese, and Mandarin diphthongs and triphthongs (Mandarin) (vowel sequences in Korean and Japanese) were analyzed. Five repetitions of 6 nonwords were presented in Hangul, Hiragana or both Pinyin and a character for a word with the same vowel on tone 1. Diphthongs were [ai, ei, au] and triphthongs/sequence of three vowels were [iau, ieu, and uai]. All the ultrasound image frames for the target vowels were traced and superimposed. Preliminary results indicate that most vowel quality pairs resulted in a pivot pattern, with some arch patterns as well. Even in Mandarin triphthongs, there were generally two pivots, even though phonologically the sequence is considered a single vowel nucleus. Several approaches to quantifying this effect will be presented. It is possible that the success in producing a pivot could indicate mastery of production, both in development and in second language learning.

Associations between tongue movement pattern consistency and formant movement pattern consistency in response to speech behavioral modifications.

The degree of speech movement pattern consistency can provide information about speech motor control. Although tongue motor control is particularly important because of the tongue's primary contribution to the speech acoustic signal, capturing tongue movements during speech remains difficult and costly. This study sought to determine if formant movements could be used to estimate tongue movement pattern consistency indirectly. Two age groups (seven young adults and seven older adults) and six speech conditions (typical, slow, loud, clear, fast, bite block speech) were selected to elicit an age- and task-dependent performance range in tongue movement pattern consistency. Kinematic and acoustic spatiotemporal indexes (STI) were calculated based on sentence-length tongue movement and formant movement signals, respectively. Kinematic and acoustic STI values showed strong associations across talkers and moderate to strong associations for each talker across speech tasks; although, in cases where task-related tongue motor performance changes were relatively small, the acoustic STI values were poorly associated with kinematic STI values. These findings suggest that, depending on the sensitivity needs, formant movement pattern consistency could be used in lieu of direct kinematic analysis to indirectly examine speech motor control.

Tongue movement pattern in speakers with dysarthria in production of “Ohio”

A different range of tongue motion during speech production has been assumed in speakers with dysarthria across different severity groups based on the previous findings in acoustic vowel space. To further confirm these findings, this study examined the tongue movement pattern in speakers with dysarthria during the production of “Ohio,” a target word that requires the consecutive production of multiple vowels. Ten speakers with dysarthria of varying severity participated in this study. Three dimensional electromagnetic articulography (Wave system) was utilized to identify tongue movement trajectory during the target word production. Each speaker produced three repetitions of the word “Ohio” in the carrier phrase “I say a__ again.” X, y, and z coordinate values from the tongue sensor (positioned approximately 25 mm from the tongue apex) were recorded. Statistical analyses showed that speakers with severe dysarthria produced a) less overall tongue movement, b) slower speed, c) less absolute tongue advancement-retraction and tongue height movement, and d) greater distance between starting /o/ and ending /o/ positions than speakers with mild dysarthria. Results are discussed with regard to the interpretation of tongue movement displacement and trajectory shape difference in speakers with dysarthria across different severity groups.

A study of three-dimensional tongue movement patterns during production of the five vowels in normal subjects using ultrasonography

A study of three-dimensional tongue movement patterns during production of the five vowels in normal subjects using ultrasonography

Fluoroscopic Evaluation of Tongue and Jaw Movements During Mastication in Healthy Humans

When chewing solid food, part of the bolus is propelled into the oropharynx before swallowing; this is named stage II transport (St2Tr). However, the tongue movement patterns that comprise St2Tr remain unclear. We investigated coronal jaw and tongue movements using videofluorography. Fourteen healthy young adults ate 6 g each of banana, cookie, and meat (four trials per foodstuff). Small lead markers were glued to the teeth and tongue surface to track movements by videofluorography in the anteroposterior projection. Recordings were divided into jaw motion cycles of four types: stage I transport (St1Tr), chewing, St2Tr, and swallowing. The range of horizontal tongue motion was significantly larger during St1Tr and chewing than during St2Tr and swallowing, whereas vertical tongue movements were significantly larger during chewing and St2Tr than during swallowing. Tongue movements varied significantly with food consistency. We conclude that the small horizontal tongue marker movements during St2Tr and swallowing were consistent with a "squeeze-back" mechanism of bolus propulsion. The vertical dimension was large in chewing and St2Tr, perhaps because of food particle reduction and transport in chewing and St2Tr.

Spatiotemporal Coupling of the Tongue in Amyotrophic Lateral Sclerosis

The primary aim of the investigation was to identify deficits in spatiotemporal coupling between tongue regions in amyotrophic lateral sclerosis (ALS). The relations between disease-related changes in tongue movement patterns and speech intelligibility were also determined. Methods The authors recorded word productions from 11 individuals with ALS with mild, moderate, and severe dysarthria using an x-ray microbeam during word productions. A coupling index based on sliding window covariance was used to determine disease-related changes in the coupling between the tongue regions across each word. The results indicated decreased spatiotemporal coupling of mid-posterior tongue regions and reduced tongue speed in the ALS-moderate subgroup. Changes in the range of tongue coupling relations and speed of movement were highly correlated with speech intelligibility. These results provide new insights into the loss of lingual motor control due to ALS and suggest that measures of tongue performance may provide useful indicators of bulbar disease severity and progression.

Radiological analysis of swallowing and functional outcomes after hypopharyngo-laryngectomy with reconstruction using a jejunal autograft

Conclusion: We report a distinct pattern of tongue movement. This is interpreted as a compensatory mechanism after hypopharyngo-laryngectomy with reconstruction using a jejunal autograft. Passage through the oesophagus is mainly passive. Objective: Swallowing is normally initiated voluntarily, and afterwards presumed to be controlled by brainstem reflexes. Resection of the hypopharynx with reconstruction may affect this control. This study attempted to perform a biomechanical analysis of the motility in the small bowel graft and suggest possible implications for surgical management. We also analysed how oesophageal passage is affected by surgery. Methods: Five patients underwent a radiological examination of the neopharyngeal conduit and oesophagus and completed a simple questionnaire. Results: The radiological examinations revealed a distinct pattern of tongue movement in all patients, resulting in varying degrees of thrust. Passage through the jejunal graft was mainly passive, but observations of progressive reduction in diameter of the graft indicated muscular tone that may preserve pressure generated by the lingual thrust. The oesophageal transport appeared to be rather passive and largely depended upon the effect of gravity. Two of five patients were unable to eat normal food. Their impaired swallowing resulted in severely reduced quality of life.

Tongue Movements During Water Swallowing in Healthy Young and Older Adults

The purpose of this study was to explore the nature and extent of variability in tongue movement during healthy swallowing as a function of aging and gender. In addition, changes were quantified in healthy tongue movements in response to specific differences in the nature of the swallowing task (discrete vs. sequential swallows). Electromagnetic midsagittal articulography (EMMA) was used to study the swallowing-related movements of markers located in midline on the anterior (blade), middle (body), and posterior (dorsum) tongue in a sample of 34 healthy adults in 2 age groups (under vs. over 50 years of age). Participants performed a series of reiterated water swallows, in either a discrete or a sequential manner. This study shows that age-related changes in tongue movements during swallowing are restricted to the domain of movement duration. The authors confirm that different tongue regions can be selectively modulated during swallowing tasks and that both functional and anatomical constraints influence the manner in which tongue movement modulation occurs. Sequential swallowing, in comparison to discrete swallowing, elicits simplification or down-scaling of several kinematic parameters. The data illustrate task-specific stereotyped patterns of tongue movement in swallowing, which are robust to the effects of healthy aging in all aspects other than movement duration.

重度歯周疾患患者に矯正治療を併用して審美，機能回復を行った１症例

The patient was a 44-year-old woman who presented with masticatory and esthetic problems. She had discoloration of CR filling of a maxillary anterior tooth, marginal discoloration, anterior protrusion, median diastema, and closed bite where the mandibular anterior tooth region occluded with the maxillary alveolar region, tooth 8 elongation and tooth 4 defect. Periodontal and orthodontic treatments were therefore performed for esthetic and functional recovery. After prosthodontic therapy, postoperative management techniques are crucial, including thorough plaque control, use of a retainer to prevent teeth from moving back towards the original positions (Begg technique), muscle function therapy (improving tongue movement patterns and strengthening the lingual and oral sphincter muscles) and occlusal adjustment. In the present patient, the effectiveness of orthodontic therapy before prosthodontic therapy was reaffirmed: dentine can be preserved, prosthodontic therapy is easier to perform, and therapeutic outcomes are highly predictable.

Patterns of tongue movement

This study investigates tongue dynamics during speech production. The focus is on the deformation of the whole midsagittal edge of the tongue in transitions between lingual segments, rather than the movement of individual points of the tongue, which is the traditional focus of tongue dynamics research. Based on the analysis of 600 lingual transitions from an X-ray database of speech, it is shown that there are only two basic patterns of tongue movement, the pivot and the arch, which are independent of the starting and ending segments of a transition. It is then argued that the acoustic effect of these patterns of tongue deformation is to make the acoustic signal as articulatorily-transparent as possible.

Does Barium Influence Tongue Behaviors During Swallowing?

The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8 healthy participants in 2 age groups (<30 years, >50 years) using electromagnetic midsagittal articulography. Differences included smaller sip size, longer oropharyngeal transit times, and greater variability in tongue movement patterns with opaque liquids compared to nonopaque liquids, but effect sizes for these differences were small. Transit times were significantly longer for older participants than younger participants. We recommend matching radiopaque bolus size in videofluoroscopy to the patient's habitually preferred sip mass for comparator nonopaque liquids.

Variability in tongue movement kinematics during normal liquid swallowing.

This study sought to develop a quantitative kinematic description of tongue movement for liquid swallowing in a group of 12 healthy subjects. X-ray microbeam technology was used to track the positions of six small pellets attached to the tongue and jaw while subjects swallowed water at 2- and 10-mL bolus volumes. A feature common to all subjects was a prominent rostral movement of the dorsal region of the tongue. In addition, all subjects consistently increased the displacement and maximum speed of this tongue movement with increased bolus volume. However, detailed movement analysis showed a variety of tongue movement patterns for the group. This variability across subjects was large enough that it was surprisingly difficult to provide a low-dimension quantitative description of the tongue kinematics during liquid swallowing.