Abstract
The present study evaluates the effectiveness of a non-invasive wearable sensor system, combining accelerometers, surface electromyography, and artificial intelligence, to objectively characterize swallowing in elderly individuals affected by Parkinson's Disease, without clinically manifested dysphagia. A cohort of patients and healthy control subjects performed the same swallowing test protocol, including tasks with different viscosity boluses, positioning a commercial adhesive grid of High-Density surface Electromyography (HD-sEMG) electrodes on the submental muscle and a triaxial accelerometer over the thyroid cartilage. Relevant temporal and spectral features were extracted from electromyography data. Proper filtering and processing by machine learning and Principal Component Analysis allowed identification of two distinct clusters of subjects, one predominantly composed of controls with just a few patients, the other mostly crowded by patients. Excellent classification performances were achieved (accuracy = 83.3%, precision = 79.0%, recall = 90.7%, F1-score = 84.5%, Cohen's kappa = 0.67), revealing consistent differences in muscle activation patterns among subjects, even in the absence of clinically diagnosed dysphagia. These results support the feasibility of wearable sensor-based assessment as a reliable and non-invasive tool for the early detection of subclinical swallowing dysfunction in Parkinson's Disease.