Oropharyngeal Dysphagia Phenotypes Across Huntington's Disease Stages: Endoscopic Findings and Tongue Pressure Analysis.

Background: Oropharyngeal dysphagia (OD) is a common symptom in Huntington's disease (HD) and is associated with severe health and psychosocial consequences. Different OD phenotypes are defined on the basis of characteristic patterns at fiberoptic endoscopic evaluation of swallowing (FEES), and they may vary during disease progression. Objective: To describe OD phenotypes in different HD stages and to analyze their association with neurological data and tongue pressure measurements. Methods: Twenty-four patients with HD at different stages of disease progression underwent a FEES. Data on penetration/aspiration, pharyngeal residue, and OD phenotypes were gained. Neurological examination was performed with the Unified Huntington's Disease Rating Scale (UHDRS). Patient Maximum tongue pressure (MTP) and tongue endurance were measured. Results: We confirmed that the occurrence of penetration/aspiration increased with disease duration and pharyngeal residue increased from 16.7% to 100%, respectively. The most common OD phenotypes were oropharyngeal dyspraxia (91.7%), posterior oral incontinence (87.5%), and delayed pharyngeal phase (87.5%). These types of dysfunctions are already detectable in >80% of patients in the early disease stages. In more advanced stages, we also observed propulsion deficit (66.7%), resistive issue (54.2%), and protective deficit (37.5%). Propulsion deficit was associated with higher disease stage, greater motor dysfunction (UHDRS-I), and lower MTP and tongue endurance (p < 0.05). Conclusions: OD in HD results from a combination of different swallowing phenotypes. Early assessment of swallowing and periodical follow-ups are necessary to monitor OD severity and phenotypes and to revise diet recommendations.

Influence of sport expertise in facilitating and inhibiting the recognition of the opponent's intentions in sailing.

Starting from the proposed role of the mirror neuron system in the recognition of the intention underlying the actions of others, an experimental paradigm was implemented to test the role of sailing motor expertise in predicting the outcome of a competitor's action. It was hypothesized that subjects with experience in sailing would correctly interpret the maneuver performed due to the activation of domain specific motor representations of the same movements and that subjects who practiced a sport different from sailing would perform worse because of the activation of irrelevant motor patterns. For doing so, a series of video clips, in which a professional sailor performed a tack or a feint, have been manipulated so that the video clips would stop at the moment of the dunkin, namely, when the boat acquires speed to tack or continue straight ahead. The task consisted in predicting whether the action following the dunkin was an actual tack or a feint. The performance of 87 subjects, divided into three subgroups (sailors, tennis players, sedentary), was evaluated in terms of accuracy in identifying the sailor's intentions and correlated to age, gender, manual dominance, education, job, hours spent weekly playing videogames, and experience in playing sports. Results showed that the percentage of correct identifications of the intention to do a tack or feint was the highest in the group of sailors and the lowest in tennis players. An inverse relation between tennis experience and ability in recognizing the sailor's intention was found in the group of tennis players. Gender, age, manual dominance, education, job, and experience with videogames were not found to be correlated with performance. Findings support the possible implication of the mirror neuron system in maneuver detection in sailing and may be a starting point for the development of psychological training in this sport.