Su ve Tükürük Yutma İmgelemesinde Doğal ve İndüklenmiş Durumların EEG Tabanlı Karşılaştırması

Öz

Yutma güçlüğü (disfaji), bireyler için yemek yeme ve sıvı tüketimini ağrılı ve stresli bir deneyim hâline getirebilir. Bu çalışma, yutma imgelemesinin sinirsel karşılıklarını araştırarak sürecin elektrofizyolojik açıdan daha iyi anlaşılmasını sağlamayı ve rehabilitasyon stratejilerinin geliştirilmesine katkıda bulunmayı amaçlamaktadır. Bu doğrultuda üç deneysel paradigma tasarlanmıştır: (i) doğal su yutma, (ii) görsel uyarıcı ile indüklenmiş tükürük yutma ve (iii) bir yudum suyun görsel uyarıcı ile indüklenmiş yutulması. Her bir koşul, görsel ipuçlarıyla yönlendirilen hem gerçek yutma hem de motor imgeleme görevlerini içermektedir. EEG verileri, her bir koşul için 15 tekrar olmak üzere, 30 katılımcıdan (15 erkek, 15 kadın) 16 kanaldan kaydedilmiştir. Gürültü giderme ve sinyal parçalama gibi önişleme adımlarının ardından, spektral ağırlık merkezi, ortalama ve medyan frekans ile bant güçleri gibi toplam 176 frekans alanı özelliği çıkarılmıştır. Özelliklerin normalliği Shapiro-Wilk testi ile değerlendirilmiştir. Normal dağılım gösteren özellikler (11 kanaldan elde edilen spektral ağırlık merkezi) tekrarlayan ölçümler için tek yönlü ANOVA ile, normal dağılmayan özellikler ise Friedman testi ile analiz edilmiştir. İstatistiksel analiz sonuçları, tüm özelliklerin %76,7’sinin üç farklı yutma durumu arasında anlamlı farklılık gösterdiğini ortaya koymuştur. Bu bulgular, EEG tabanlı özelliklerin farklı yutma imgeleme türleri arasında etkili bir şekilde ayrım yapabileceğini ve disfaji rehabilitasyonuna yönelik beyin-bilgisayar arayüzü uygulamaları için önemli bir potansiyel sunduğunu göstermektedir.

Anahtar Kelimeler

• Disfaji
• EEG
• Yutma
• İmgeleme
• İstatistiksel analiz

EEG-Based Comparative Study of Brain Activity during Imagined Natural and Induced Water and Saliva Swallowing

Abstract

Dysphagia often makes eating and drinking painful, stressful, and socially isolating, potentially leading to malnutrition, dehydration, weight loss, and respiratory infections. In this study, the relationship between swallowing and brain signals was examined to contribute to the electrophysiological understanding of the imagination of swallowing and rehabilitation of dysphagia patients. To examine the swallowing event, three different experiments were conducted. The experiments included (i) natural water swallowing, (ii) swallowing saliva in an induced manner, and (iii) swallowing a sip of water in an induced manner. Visual cues on a computer monitor were used to induce the perception of swallowing and imagination. EEG data from 16 channels obtained during 15 trials of these experimental paradigms from 30 subjects (15 men) were subjected to different processes such as noise removal, selection of signal segments corresponding to the imagination of swallowing, extraction of frequency domain features, and statistical analysis. Eleven features such as spectral centroid, mean and median frequency, delta, theta, alpha and beta band powers, and relative band powers obtained from 16 channels (a total of 176 features) were first subjected to the Shapiro-Wilks normality test individually. As a result of this test, the statistical analyses were carried out with the help of repeated measures one-way ANOVA test for the features with normal distribution (spectral centroid from 11 channels), and the Friedman test for the features with non-normal distribution (spectral centroid from the remaining 5 channels and all other features from 16 channels). As a result of these tests, it is seen that 76.7% of all features yield statistically significant differences between 3 different swallowing approaches. We suggest that identifying discriminative EEG-based features could significantly contribute to the development of novel brain-machine interface applications for dysphagia rehabilitation.

Keywords

• Dysphagia
• EEG
• swallowing
• imagination
• statistical analysis

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