Our understanding of the neural control of breathing-swallowing coordination (BSC) is largely unclear. Although brainstem control is undoubtedly predominant, this research investigated the hypothesis that the cortex becomes increasingly influential in BSC between birth and adulthood. The main paradigm used to test this primary hypothesis was a comparison of BSC in conditions along a continuum of volitional through non-volitional swallowing on the basis of a decreasing level of cortical activation along this continuum. Voluntarily-initiated swallows during wakefulness were at one end of the continuum and reflexively-initiated swallows during sleep were at the other extreme. Non-volitional wakeful swallows were considered between these two conditions. The BSC of ten infants between birth and 1 year of age and twenty adults between the ages of 20 and 75 years was recorded using non-invasive time-locked recording methods. In order to apply the 'continuum-of-volition' paradigm to swallowing conditions in infants, BSC was monitored during nutritive (breast- or bottle-feeding), non-nutritive wake, and sleep swallows. Infants were monitored longitudinally to determine whether maturation of the cortex and corticobulbar tracts during the first year of life influenced the patterns of BSC. In adults, BSC was monitored during three non-nutritive conditions: volitional, spontaneous wake, and sleep conditions. Post-swallow expiration was found to be predominant in all conditions for all participants at all ages. In addition, the infant results revealed that nutritive BSC matured during the first year of life and differed to non-nutritive wakeful BSC, particularly in the first 2 months of life. Non-nutritive wakeful and sleep BSC did not differ from one another. In summary, the infant results support increasing cortical input into volitional nutritive BSC, an early impact of feeding on BSC, and no difference between BSC when asleep and non-volitional non-nutritive swallows when awake. The results obtained from adults revealed that irrespective of the level of arousal, volitional BSC is different to non-volitional BSC. These results imply that cortical influence on BSC is limited to conditions in which swallowing is voluntarily initiated. The combined interpretation of infant and adult results suggest that cortical influence over BSC, although increasing with maturation, is limited to the volitional swallowing conditions of feeding in infants and during non-nutritive but volitional swallows in adults. From this, it can be deduced that the most likely cortical sites involved in BSC are those involved in the voluntary initiation or planning of swallowing. Infant and adult swallowing apnoea duration (SAD) was also compared across all of the above conditions. SAD was influenced by feeding throughout the first year of life but was not influenced by level of arousal at any stage in the first year or in adulthood. Also, SAD did not change with age in any swallowing condition during infancy. However, comparison of non-nutritive wake SAD across the lifespan revealed that SAD of newborns and young adults is shorter than that of elderly adults, with no difference between consecutive age-groups: newborns, one-year-olds, and young adults. These results suggest SAD is largely mature at birth and impervious to descending suprabulbar influence. Finally, the effects of volitional swallowing and level of arousal on peak submental surface electromyography (SEMG) was investigated in adults. Like BSC, submental muscle activity was influenced only by volitional swallowing, being longer for volitional than non-volitional swallows without being influenced by level of arousal. Since peak submental SEMG activity represents a measure of relative hyolaryngeal excursion, these results suggest that the cortex has some degree of influence over this particular feature of pharyngeal-stage swallowing.

Safe and efficient swallowing requires integrity of both motor and sensory systems. Prior studies have established that motor impairment in individuals with PD frequently manifests as abnormalities in swallowing biomechanics. In contrast, very few studies have investigated the contribution of sensory impairment towards pharyngeal biomechanics and airway protection in this patient cohort. This area should be addressed in light of evidence that the severity of limb motor dysfunction in PD does not reliably predict severity of dysphagia. Emerging data suggests that dysphagia in PD cannot be solely attributed to motor impairment, but may also be influenced by deficits in sensory aspects of airway protection. As an example, silent aspiration in up to 100% has been reported in individuals with PD due to laryngopharyngeal sensory deficits have. Even so, current research lacks information on the integration of both motor and sensory components that make up the swallowing process. The aim of this study was to document changes in airway protection with age, in PD and across severity levels of PD. The project was comprised of two parts. In part one, three parallel studies were conducted to assess a series of both motor and sensory airway mechanism (Chapters 4 to 9). In the first study, 16 young (8 males, age range 21.3 - 32.4) and 16 elder adults (8 males, age range 61.5 - 84.7), were assessed to investigate changes in airway protection that accompany ageing. In the second study, data from individuals diagnosed with PD across severity levels (Hoehn-Yahr 1 - 4, age range 64.2 - 84.5) were age and gender-matched to 16 healthy elders in order to examine the effects of PD on airway protection. In the third, the impact of disease severity was studied with data from 16 individuals in the earlier stages (Hoehn-Yahr ≤ 2, 13 males, age range 51.3 - 82.5, ) compared to 16 individuals in the later stages (Hoehn-Yahr ≥ 2.5, 10 males, age range 61.5 - 78.9). In part two of this project, two smaller, pilot studies were completed to probe the influence of pharmacologic and behavioural treatments on airway protection mechanisms. In the first pilot study, the effect of pharmacotherapy on airway protection was investigated in 10 patients 'on' and 'off' levodopa (Chapter 10). In the second study, 5 patients were assessed before and after completing the Lee Silverman Voice Treatment (LSVT) to document effects of speech rehabilitation on airway protection (Chapter 11). Multimodality assessment elicited data from all participants on both motor and sensory components of airway protection (Chapter 3). Specifically, breathing-swallowing coordination (BSC) and swallowing apnoea (SA) were captured using simultaneous directional nasal airflow and surface electromyography (sEMG). Standard, closed-loop spirometry was used to assess pulmonary function. Swallowing biomechanics were screened using a validated timed test of swallowing efficiency and further evaluated using fibreoptic endoscopic evaluation of swallowing (FEES). Finally, chemo-sensation of the laryngopharynx was determined with the administration of the inhalation cough challenge while mechanosensation was examined using FEES. Results suggest that motor control for airway protection is reasonably robust in PD, although sensory response is impaired. The predominant pattern for swallowing respiratory coordination was mid-expiration for all participants regardless of age and disease severity (Chapter 4). Individuals with PD demonstrated a reduction in average time and volume per swallow, leading to an overall decrease in swallowing capacity (Chapter 5). No difference was found for swallowing efficiency between those in early and later stages of PD. Pulmonary function measures were not significantly different as a function of age, PD or PD severity (Chapter 6). In summary, results from motor assessments contributing to airway protection support the robustness of breathing-swallowing coordination (BSC) and pulmonary function across research groups, but identify a reduction in overall swallowing efficiency in PD. Results from sensory assessments contributing to airway protection revealed that chemosensation was not different between age groups but base of tongue mechano-sensation was diminished in individuals with PD. Natural cough thresholds did not differ between young adults and elders but when asked to stifle coughing, elders were less able to do so compared to young adults (Chapter 7). For the first time, a reduction in mechano-reception at the base of tongue was recorded in individuals with PD (Chapter 8). These patients also demonstrated increased post swallow residual (Chapter 5), which offers an explanation for the complaint of globus in this population. These assessments highlight some compromise to sensory aspects of airway protection in PD. Overall, dysphagia had a negative impact on the quality of life of individuals with PD and even more as disease severity progresses (Chapter 9). Results from part two of the study looking at the effects of therapeutic interventions on airway protection revealed some unexpected findings. In chapter 10, results showed a reduction in pulmonary function when 'on' levodopa, but no differences in swallowing efficiency, BSC, or laryngopharyngeal chemo- and mechano-reception were observed. These results suggested a reduction in pulmonary function with levodopa without any increase in risk of airway protection compromise1. Unexpectedly and documented for the first time, the percentage of post swallow inspiration increased after LSVT (Chapter 11) but as with the levodopa study, this was also not accompanied by any apparent increase in aspiration risk. An increase in submental surface electromyography (sEMG) amplitude across all 5 participants may serve as a proxy measure of improvement in hyolaryngeal excursion. Finally, participants reported an overall improvement in social functioning and communication after LSVT. In conclusion, this study provided evidence that mechano-sensory aspect of airway protection is diminished in individuals with PD, possibly compromising airway protection. Patients not only demonstrated increased residue but the lack of sensation may prevent clearing or spontaneous multiple swallows. Overall, airway protection is maintained in ageing but swallowing efficiency declines in the presence of PD. This study contributes significantly to current research efforts in PD by expanding on existing reports regarding motor aspects of airway protection. Specifically, BSC, swallowing efficiency and evaluation of biomechanics using FEES research have never before been investigated exclusively in the PD population. Finally, the chemo- and mechano-sensation evaluated in this study are an important addition to the limited evidence that sensory impairment in individuals with PD potentially compromises airway protection. Results of the present study will serve as a platform upon which future studies may compare and expand.

Masters of Science in Medicine / The relationship between COPD and laryngopharyngeal sensitivity has not been previously determined. Limited research into the relationship between COPD and swallow function suggests that patients with COPD are at increased risk of aspiration. One possible mechanism for this is a reduction in laryngopharyngeal sensitivity (LPS). Reduced laryngopharyngeal sensitivity (LPS) has been associated with an increased risk of aspiration in pathologies such as stroke, however impaired LPS has not been examined with respect to aspiration risk in COPD. The Aims of this study were to investigate the effect of COPD on laryngopharyngeal sensation using Laryngopharyngeal Sensory Discrimination Testing (LPSDT) and to determine whether a relationship between LPS and swallow function in patients with proven COPD exists. Method: 20 patients with proven COPD and 11 control subjects underwent LPSDT utilising an air-pulse stimulator (Pentax AP4000) via a nasendoscope (Pentax FNL10AP). The threshold of laryngopharyngeal sensation was measured by the air pressure required to elicit the laryngeal adductor reflex (LAR). A number of further examinations were also completed for COPD subjects. These included respiratory function testing, self-reporting questionnaire on swallowing ability (SSQ), bedside clinical examination of swallowing (MASA) and endoscopic assessment of swallowing (EAS). Results: subjects with COPD had a significantly higher LAR threshold when compared to their normal healthy counterparts (p<0.001). Positive correlations were identified for the relationships between MASA score and EAS results for presence of laryngeal penetration / aspiration (p<0.04), vallecular residue (p<0.01) and piriform residue (p<0.01). Conclusion: Patients with COPD have significantly reduced mechanosensitivity in the laryngopharynx. Patients with COPD also have impaired swallow function characterised primarily by pharyngeal stasis. These changes may place patients with COPD at increased risk of aspiration.

OBJECTIVE:: Evidence-based interventions for pill swallowing training exist but are primarily implemented in pediatric specialty hospitals. Given increasing interest in the translation of brief and effective interventions to the wider population, there is a need to examine medication acceptance in a normative sample. METHODS:: Participants (N ≤ 304) completed the Medication Acceptance Survey, which assessed child/adolescent liquid and pill medication history and acceptance as well as parental interest in pill swallowing training. RESULTS:: Results showed that 30 "40% of youth had rejected/refused a pill or liquid formulation. Over half were unable to swallow a standard size pill or small capsule. Despite these difficulties, most parents did not express interest in an empirically supported pill swallowing training intervention. CONCLUSIONS:: The results provide directions for future research as well as the translation of pill swallowing interventions to primary care.

No description available.

No description available.

Background Parkinson’s disease (PD) is one of the most common neurodegenerative diseases in Europe. Besides motor dysfunction, PD is characterized by several non-motor and secondary motor features, such as weight change, sialorrhea, constipation and swallowing problems. Of these, swallowing is one of the most critical, as it is associated with aspiration pneumonia and consequently is the comorbidity with the highest mortality rate. Swallowing problems affect four of every five patients with PD, and even mild swallowing problems have notable psychosocial effects for patients and their caregivers. Consequently, it is essential to find treatment strategies for PD that may alleviate symptoms for patients with swallowing problems and their potential consequences. Deep Brain Stimulation (DBS) is a surgical treatment option for PD, which improves overall motor function and quality of life, but its effect on swallowing function is not clear. The purpose of this thesis was to contribute to the understanding of the effect of deep brain stimulation in the subthalamic nucleus (STN DBS) and the caudal zona incerta (cZI DBS) on pharyngeal swallowing function and on swallow-specific quality of life in patients with PD. The specific aims were to assess longitudinally the effect of STN DBS and cZI DBS on swallowing at 6 and 12 months postoperatively, in order to identify possible effects of the DBS on swallowing function. In addition, the effects of cZI DBS on ratings of swallowing-related non-motor and secondary motor features such as body weight changes, sialorrhea and speech problems were to be assessed. Methods Eleven PD patients with STN DBS (Paper I) and seventeen patients with cZI DBS (Paper II-IV) were included in this thesis. All patients were evaluated preoperatively and 6 and 12 months postoperatively. The effect of STN DBS and cZI DBS on swallowing was assessed with Fibreoptic-Endoscopic Evaluation of Swallowing (FEES) according to a predefined protocol including Penetration-Aspiration scale, Secretion Severity scale, preswallow spillage, pharyngeal residue, and pharyngeal clearance. Self-assessments were addressed using a visual analogue scale. The cZI DBS patients also completed the Swallowing Quality of Life (SWAL-QOL) questionnaire. Weight changes measured by Body Mass Index, and specific items from the Unified Parkinson’s Disease Rating Scale were also examined. Nine controls without PD were included in Paper IV, by answering the SWAL-QOL questionnaire. Results No clear effect of DBS on swallowing function or swallow-specific quality of life could be observed. There was no effect of DBS on the occurrence of aspiration, secretion, pharyngeal residue or clearance in the study groups with STN DBS or cZI DBS. Patients with STN DBS reported a subjective improvement in swallowing function with DBS stimulation turned on at 6 and 12 months after surgery. In patients with cZI DBS, the median body mass index was postoperatively increased with 1.1kg/m2 and the median increase in weight were +3.0 kg after 12 months with cZI DBS. The scores from the SWAL-QOL questionnaire were high overall in the group with cZI DBS, and the scores were unaffected by the cZI DBS surgery and stimulation. The SWAL-QOL total score was not significantly different between the PD patients and the controls, but the scores from the ‘burden’ and the ‘symptom’ subscales were worse in PD patients. Conclusions STN DBS or cZI DBS did not have a negative effect on swallowing function or ratings of swallow-specific ‘quality of life’ aspects in this cohort. Patients with STN DBS reported a self-perceived improvement in swallowing function when DBS was turned on. With regard to swallowing, patients with cZI DBS had an overall good quality of life throughout the conduct of the study and their swallow-specific quality of life was not negatively affected by cZI DBS. There seems to be no increased risk for aspiration or penetration due to surgery or stimulation for either the STN DBS or the cZI DBS groups. cZI DBS caused weight gain postoperatively. Since the sample sizes in these cohorts are small, the findings need to be confirmed in larger studies.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2017-01-13T11:19:37Z No. of bitstreams: 2 Dissertação - Inez Janaina de Lima Amaral - 2016.pdf: 3470243 bytes, checksum: 505c91c5b53d230db5e57a0e95e981ab (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-01-16T11:00:26Z (GMT) No. of bitstreams: 2 Dissertação - Inez Janaina de Lima Amaral - 2016.pdf: 3470243 bytes, checksum: 505c91c5b53d230db5e57a0e95e981ab (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-01-16T11:00:26Z (GMT). No. of bitstreams: 2 Dissertação - Inez Janaina de Lima Amaral - 2016.pdf: 3470243 bytes, checksum: 505c91c5b53d230db5e57a0e95e981ab (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2016-11-09 / The control of the symptoms of dysphagia in patients with Multiple Sclerosis (MS) has been underestimated by clinicians, patients and caregivers. Dysphagia has a prevalence between 33-43% of this population. The evaluation of the swallowing has been a major challenge in clinical practice, and without a unified method of diagnosis in this population. Identify patients with dysphagia in the early stages of MS is fundamental in preventing complications such as malnutrition, dehydration and death. The aim of this study was to identify the presence or absence of swallowing desorders in patients diagnosed with MS in the Reference and Research Center for Multiple Sclerosisin the University Hospital of the Federal University of Goiás, in the midwest of Brazil. This was a cross-sectional study between july 2015 and march 2016, with 73 patients above 18 years old with definite diagnosis of MS. It was excluded patients from other health units, outside the scope of the suty period, without clinical conditions associated with other diseases or who did not agree to participate. The presence of dysphagia was found at 30.14% of the patients. This finding meets the results in other studies. The main manifestations were dificulties in qualifying and propel the food bolus, with changes in the oral and pharyngeal phases of swallowing. Thus, it is necessary the evaluation and monitoring of this population, guarateeing early intervention, reducing the risks to the quality of life. / O controle dos sintomas da disfagia nos pacientes com Esclerose Múltipla (EM) vem sendo subestimado pelos clínicos, pacientes e cuidadores. A disfagia tem prevalência conhecida entre 33-43% desta população. A avaliação da deglutição tem sido um grande desafio na prática clínica, e sem um método diagnóstico unificado para esta população. Identificar os pacientes com disfagia nos estágios iniciais da EM é fundamental na prevenção de complicações como desnutrição, desidratação e óbito. O objetivo deste estudo foi identificar a presença ou não de alterações da deglutição de pacientes com diagnóstico de EM em atendimento no Centro de Referência e Investigação em Esclerose Múltipla do Hospital das Clínicas da Universidade Federal de Goiás, no Centro-oeste do Brasil. Este foi um estudo transversal entre julho de 2015 e março de 2016, com 73 pacientes, acima de 18 anos de idade com diagnóstico definitivo de EM. Foram excluídos pacientes deoutras unidades de saúde, fora do período de abrangência do estudo, sem condições clínicas, com outras enfermidades associadas ou que não concordaram em participar do estudo. A presença de disfagia foi encontrada em 30,14% dos pacientes. Esse achado vem de encontro com outros estudos. As principais manifestações observadas foram dificuldades de qualificação e propulsão do bolo alimentar, demonstrando comprometimento da fase oral e faríngea da deglutição. Assim, faz-se necessário a avaliação e acompanhamento desta população, garantindo a intervenção de forma precoce, diminuindo os riscos para a qualidade de vida.

Swallowing problems, and the often-associated sequelae including pneumonia, malnutrition, and dehydration are common, potentially life-threatening conditions suffered by many elderly individuals. The combination of cognitive, physical, and sensory impairments commonly seen in individuals with dementia and following stroke often results in eating needs going unmet, leading to increased morbidity and premature mortality. The functional limitations of many of these individuals frequently result in decreased mealtime independence and necessitate extensive or total assistance (i.e., dependence) with consuming food and liquids. Despite the implication of increased safety associated with feeding assistance, the influence and potential risk of absent pre-oral cues are unclear, especially in an already taxed system. This study investigated the cooperative relationships between the sequential sensorimotor acts involved in eating and swallowing, focusing on the anticipatory stage, under various sensory-loss conditions. Kinematic data from the lips, jaw, and hand were obtained from 24 healthy younger adults (ages 18-30) and 24 healthy older adults (ages 70-85) under four different conditions: typical self-feeding, typical assisted feeding (i.e., loss of proprioceptive cues), sensory loss self-feeding (i.e., loss of visual cues and degradation of auditory cues), and sensory loss assisted feeding (i.e., loss/degradation of auditory, proprioceptive, and visual cues). During typical self-feeding, all participants began the mouth opening gesture shortly after the onset of hand movement toward the mouth and prior to the onset of oral sensation. However, differences in the timing of anticipatory onset and offset lip movements were observed between older and younger adults and also on the basis of the presence/absence of feeding dependency and sensory loss. Older adults initiated lowering movement earlier than younger adults given the availability of proprioceptive and/or visual cues. In addition to demonstrating earlier lip lowering, during both self-feeding conditions older adults more consistently attended to the timing between lip lowering onset and hand movement onset as compared to both the younger adults and other relative timing pairs. Given the absence of proprioceptive cues (i.e., during assisted feeding), the onset of anticipatory lip movement was delayed. Sensory loss (i.e., loss of visual cues, reduction in auditory cues) alone did not negatively impact the onset of lip movement for either group as compared to typical self-feeding. Conversely, the presence of sensory loss more negatively impacted the offset of lip movement as compared to the absence of proprioception (e.g., the offset of lip movement was later given only visual/auditory loss as compared to assisted feeding). The presence of both feeding dependence and sensory loss had the greatest negative impact on the timing of both the onset and offset of anticipatory lip movement. These findings suggest that deglutition should be considered as beginning prior to the onset of oral sensation and highlight the necessity of better understanding the role that pre-oral, or anticipatory, sensorimotor information may play in the overall eating and deglutitory process. As older adults consistently demonstrated a "compensatory advantage" via earlier and less variable movement onset given the availability of proprioceptive and/or visual cues, continued investigation into these age-related differences is important. This study provides a first step in clarifying the relationship between these pre-oral cues and anticipatory oral posturing during eating and swallowing, allowing for a better understanding of the potential for increased risk assisted feeding recommendations may elicit. However, the differences observed between older and younger adults, particularly under conditions of sensory loss, may be further exacerbated in a taxed system, potentially increasing risk for various patient populations.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-19T12:46:56Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação mestrado PDF 2.pdf: 3481619 bytes, checksum: e31665f0e33c8a71059ef95f341a0b3a (MD5) / Made available in DSpace on 2016-08-19T12:46:56Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação mestrado PDF 2.pdf: 3481619 bytes, checksum: e31665f0e33c8a71059ef95f341a0b3a (MD5) Previous issue date: 2016-02-29 / A esclerose múltipla (EM) é uma desordem neurológica progressiva e crônica que pode levar a severas incapacidades incluindo as alterações das funções do sistema estomatognático, como por exemplo a deglutição. As pesquisas atuais relatam a presença dessas alterações na EM entretanto, há poucos estudos que utilizem instrumentos que auxiliem no diagnóstico das alterações da deglutição. Assim surgiu o interesse de desenvolver uma pesquisa utilizando a Eletromiografia de Superfície (EMGs) que é uma técnica segura e não invasiva e bastante utilizada no monitoramento da atividade elétrica muscular. O objetivo principal desse estudo foi caracterizar a atividade eletromiográfica dos músculos da deglutição na EM. Método: o projeto foi desenvolvido no ambulatório de reabilitação do Hospital da Restauração Governador Paulo Guerra (HR) e teve como população 30 indivíduos oriundos do setor de Neurologia, com diagnóstico definitivo de EM, de ambos os sexos e com média de idade 37,57 anos. Também foram avaliados 30 indivíduos sem nenhuma patologia neurológica como grupo de comparação. Foi realizada uma entrevista para coleta dos dados pessoais dos voluntários com EM e dos voluntários que serviram como grupo de comparação selecionados entre os funcionários do referido hospital. Foi realizada também análise do prontuário para coleta dos dados clínicos dos indivíduos com EM. Em seguida foi aplicado o questionário DYMUS que é utilizado para detectar os sinais da disfagia na EM e também foi utilizado o Protocolo de Avaliação Eletromiográfica da Deglutição para obter os sinais da atividade elétrica da musculatura avaliada. Conclusão: Quanto pior o estado clínico do paciente com EM menor será a atividade elétrica da musculatura suprahioidea e que o aumento da atividade elétrica do músculo masseter está relacionado com o aumento da dificuldade de deglutição. O aumento da atividade elétrica de masseter parece ter relação com mecanismos compensatórios que buscam o melhor sinergismo muscular possível durante a deglutição de saliva e líquido. Estudos futuros devem avançar na busca da relação da atividade elétrica dessa musculatura com outros dados clínicos e instrumentais relacionados à deglutição na EM na medida em que nossos achados ressaltaram diferenças no comportamento da musculatura relacionada à deglutição dos pacientes em relação a uma população saudável. / The multiple sclerosis (MS) is a chronic progressive neurological disorder which can lead to severe disabilities including changes in Stomatognathic system functions such as swallowing. The current research report the presence of these changes on in however, there are few studies that use instruments to aid in the diagnosis of the changes of swallowing. Thus arose the interest of developing a research using surface electromyography (SEMG) which is a safe and noninvasive technique widely used in muscle electrical activity monitoring. The main objective of this study was to characterize the electromyographic activity of the swallowing muscles in on. Method: the project was developed in the Rehabilitation Clinic of the Hospital da Restauração Governor Paulo Guerra (HR) and 30 individuals from the population sector of Neurology, with definitive diagnosis, of both sexes and averaging 37.57 age years. 30 individuals were also evaluated with no neurological pathology as the comparison group. An interview was held to collect the personal data of the volunteers with MS and of the volunteers who served as a comparison group selected from the staff of that hospital. Chart analysis also was held for collection of clinical data of individuals with in. Then we applied the questionnaire DYMUS which is used to detect the signs of dysphagia and was also used in the Electromyographic Assessment of swallowing Protocol for signs of electrical activity of the muscles evaluated. Conclusion: it is concluded that the worse the clinical state of the patient with lesser will be the electrical activity of the muscles suprahioidea and that the increase in electrical activity of the masseter muscle is related to the increased difficulty swallowing. The increase in electrical activity of masseter seems to have relationship with compensatory mechanisms that seek the best synergy possible muscle during swallowing of saliva and fluid. Future studies should go forward in search of the relationship between the electrical activity of this muscle with other clinical and instrumental data related to swallowing in on to the extent that our findings underscored differences in behavior related to swallowing muscles of patients with respect to a healthy population.