PROJECT SUMMARY Dysphagia, or difficulty swallowing, affects over 9 million adults in the US annually, with neurologic conditions, such as stroke and Parkinson’s disease (PD), being the number one cause of the disorder. Dysphagia in neurologic disease is associated with significant negative outcomes, such as prolonged hospitalization, respiratory compromise, depression, malnutrition, and mortality. A better understanding of both the central (neural) and physiological/biomechanical deficits seen in neurogenic dysphagia will enable better clinical management through improved identification of patients and the development of targeted and personalized therapeutic interventions. No current tools exist to enable the concurrent 3D visualization of swallowing physiological/biomechanical events along with the associated functional brain activity that drives those events. This project will optimize and validate a novel multimodal imaging method and analysis platform to visualize and quantify both swallowing physiology events and brain function during swallowing using magnetic resonance imaging. Using a recently-developed framework for fast dynamic imaging, a technique will be demonstrated and validated that will achieve full 3D imaging of the functional swallowing anatomy along with imaging of brain function, simultaneously. The resulting method will provide unprecedented high-spatial and high-temporal resolution images of the dynamic swallowing motions and the brain activity associated with this critical life-sustaining function and has the potential to offer a new state-of-the-art diagnostic and treatment outcome tool for neurogenic dysphagia. Utilizing the new multimodal imaging method, we will demonstrate the sensitivity to changes in swallowing function and neural activity by examining a group of young (aged 18-25 years old) and older (aged 60-85 years old) healthy adults performing incidental swallows and other oropharyngeal tasks. We will then establish the preliminary sensitivity of this new approach in identifying phenotypes of neurogenic dysphagia in patients with stroke and Parkinson’s disease (n=60 for each condition). The technique will enable the determination of differential dynamic motion and fMRI signatures of dysfunction within and across conditions/diseases. This line of research will have an important positive impact because it has the potential to improve neurogenic dysphagia characterization and to provide the foundation to start improving diagnostic accuracy, prognosis, and treatment of this debilitating condition in the future.