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Huff A, Karlen-Amarante M, Pitts T, Ramirez JM. Optogenetic stimulation of pre-Bötzinger complex reveals novel circuit interactions in swallowing-breathing coordination. Proc Natl Acad Sci U S A 2022; 119:e2121095119. [PMID: 35858334 PMCID: PMC9304034 DOI: 10.1073/pnas.2121095119] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 05/31/2022] [Indexed: 02/02/2023] Open
Abstract
The coordination of swallowing with breathing, in particular inspiration, is essential for homeostasis in most organisms. While much has been learned about the neuronal network critical for inspiration in mammals, the pre-Bötzinger complex (preBötC), little is known about how this network interacts with swallowing. Here we activate within the preBötC excitatory neurons (defined as Vglut2 and Sst neurons) and inhibitory neurons (defined as Vgat neurons) and inhibit and activate neurons defined by the transcription factor Dbx1 to gain an understanding of the coordination between the preBötC and swallow behavior. We found that stimulating inhibitory preBötC neurons did not mimic the premature shutdown of inspiratory activity caused by water swallows, suggesting that swallow-induced suppression of inspiratory activity is not directly mediated by the inhibitory neurons in the preBötC. By contrast, stimulation of preBötC Dbx1 neurons delayed laryngeal closure of the swallow sequence. Inhibition of Dbx1 neurons increased laryngeal closure duration and stimulation of Sst neurons pushed swallow occurrence to later in the respiratory cycle, suggesting that excitatory neurons from the preBötC connect to the laryngeal motoneurons and contribute to the timing of swallowing. Interestingly, the delayed swallow sequence was also caused by chronic intermittent hypoxia (CIH), a model for sleep apnea, which is 1) known to destabilize inspiratory activity and 2) associated with dysphagia. This delay was not present when inhibiting Dbx1 neurons. We propose that a stable preBötC is essential for normal swallow pattern generation and disruption may contribute to the dysphagia seen in obstructive sleep apnea.
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Affiliation(s)
- Alyssa Huff
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101
| | - Marlusa Karlen-Amarante
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101
| | - Teresa Pitts
- Department of Neurological Surgery, School of Medicine, University of Louisville, Louisville, KY 40202
| | - Jan Marino Ramirez
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA 98101
- Department of Neurological Surgery, School of Medicine, University of Washington, Seattle, WA 98108
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2
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Drulia TC, Kamarunas E, O'Donoghue C, Ludlow CL. An Exploration of Lung Volume Effects on Swallowing in Chronic Obstructive Pulmonary Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:2155-2168. [PMID: 34411488 DOI: 10.1044/2021_ajslp-20-00389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) limits respiration, which may negatively impact airway safety during swallowing. It is unknown how differences in lung volume in COPD may alter swallowing physiology. This exploratory study aimed to determine how changes in lung volume impact swallow duration and coordination in persons with stable state COPD compared with older healthy volunteers (OHVs). Method Volunteers ≥ 45 years with COPD (VwCOPDs; n = 9) and OHVs (n = 10) were prospectively recruited. Group and within-participant differences were examined when swallowing at different respiratory volumes: resting expiratory level (REL), tidal volume (TV), and total lung capacity (TLC). Participants swallowed self-administered 20-ml water boluses by medicine cup. Noncued (NC) water swallows were followed by randomly ordered block swallowing trials at three lung volumes. Estimated lung volume (ELV) and respiratory-swallow patterning were quantified using spirometry and respiratory inductive plethysmography. Manometry measured pharyngeal swallow duration from onset of base of tongue pressure increase to offset of negative pressure in the pharyngoesophageal segment. Results During NC swallows, the VwCOPDs swallowed at lower lung volumes than OHVs (p = .011) and VwCOPDs tended to inspire after swallows more often than OHVs. Pharyngeal swallow duration did not differ between groups; however, swallow duration significantly decreased as the ELV increased in VwCOPDs (p = .003). During ELV manipulation, the COPD group inspired after swallowing more frequently at REL than at TLC (p = .001) and at TV (p = .002). In conclusion, increasing respiratory lung volume in COPD should improve safety by reducing the frequency of inspiration after a swallow.
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Affiliation(s)
- Teresa C Drulia
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
- Davies School of Communication Sciences and Disorders, Texas Christian University, Fort Worth
| | - Erin Kamarunas
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Cynthia O'Donoghue
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
| | - Christy L Ludlow
- Department of Communication Sciences and Disorders, James Madison University, Harrisonburg, VA
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3
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Rowe LM, Connor NP, Russell JA. Respiratory-swallow coordination in a rat model of chemoradiation. Head Neck 2021; 43:2954-2966. [PMID: 34160109 DOI: 10.1002/hed.26782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 05/05/2021] [Accepted: 06/03/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Chemoradiation treatment (CRT) for head and neck cancer (HNC) is associated with postswallow inhale events that elevate the risk of penetration/aspiration. The purpose of this study was to assess the validity of a rat model for investigating the effect of CRT on respiratory-swallow coordination. METHODS Videofluoroscopic swallow study was performed on 10 Sprague-Dawley rats 3 months post-CRT (3 mg/kg Cisplatin, 10 fractions of 4.5 Gy/day radiotherapy to tongue base), and 10 naïve controls. We examined the effect of CRT on swallow apnea duration, diaphragm movement, and bolus kinematics. RESULTS CRT rats had a significant increase in postswallow inhale (p = 0.008), which was associated with significantly longer swallow apnea durations, lower diaphragm displacement at swallow onset, and faster pharyngoesophageal bolus speed. CONCLUSION The rat CRT model is valid for the study of respiratory-swallow coordination due to the consistency of findings in this study with those reported in clinical CRT studies in HNC.
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Affiliation(s)
- Linda M Rowe
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nadine P Connor
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - John A Russell
- Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Ohta J, Ishida S, Kawase T, Katori Y, Imai Y. A computational fluid dynamics simulation of liquid swallowing by impaired pharyngeal motion: bolus pathway and pharyngeal residue. Am J Physiol Gastrointest Liver Physiol 2019; 317:G784-G792. [PMID: 31566413 DOI: 10.1152/ajpgi.00082.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Common practices to improve the ability to swallow include modifying physical properties of foods and changing the posture of patients. Here, we quantified the effects of the viscosity of a liquid bolus and patient posture on the bolus pathway and pharyngeal residue using a computational fluid dynamics simulation. We developed a computational model of an impaired pharyngeal motion with a low pharyngeal pressure and no pharyngeal adaptation. We varied viscosities from 0.002 to 1 Pa·s and postures from -15° to 30° (from nearly vertical to forward leaning). In the absence of pharyngeal adaptation, a honey-like liquid bolus caused pharyngeal residue, particularly in the case of forward-leaning postures. Although the bolus speed was different among viscosities, the final pathway was only slightly different. The shape, location, and tilting of the epiglottis effectively invited a bolus to two lateral pathways, suggesting a high robustness of the swallowing process.NEW & NOTEWORTHY Thickening agents are often used for patients with dysphagia. An increase in bolus viscosity not only reduces the risk of aspiration but also can cause a residual volume in the pharynx. Because information obtained from videofluoroscopic swallowing studies is only two-dimensional, measurement of pharyngeal residue is experimentally difficult. We successfully quantified the three-dimensional bolus pathway and the pharyngeal residual volume using computational modeling and simulation.
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Affiliation(s)
- Jun Ohta
- Department of Otorhinolaryngology and Head and Neck Surgery, Tohoku University, Sendai, Japan
| | - Shunichi Ishida
- Graduate School of Engineering, Kobe University, Kobe, Japan
| | - Tetsuaki Kawase
- Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan.,Department of Audiology, Tohoku University, Sendai, Japan
| | - Yukio Katori
- Department of Otorhinolaryngology and Head and Neck Surgery, Tohoku University, Sendai, Japan
| | - Yohsuke Imai
- Graduate School of Engineering, Kobe University, Kobe, Japan
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5
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Ouahchi Y, Ben Salah N, Mjid M, Hedhli A, Abdelhedi N, Beji M, Toujani S, Verin E. Breathing pattern during sequential swallowing in healthy adult humans. J Appl Physiol (1985) 2018; 126:487-493. [PMID: 30412029 DOI: 10.1152/japplphysiol.00150.2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sequential liquid swallowing is a common daily occurrence during which coordination of deglutition and breathing are highly regulated to avoid pulmonary aspiration and to maintain hematosis. We studied the effects of sequential water swallowing (SWS) at fixed swallowing rates and with regular succession of swallows on respiration in healthy subjects. Thirty-one normal adults (19 men, 12 women) with a mean age of 27.96 ± 3.68 yr were explored at rest and during SWS (at 12 and 24 swallows/min). Respiration was recorded by intranasal air pressure changes and timing of deglutition by an acoustic method. Oxygen saturation [arterial O2 saturation from pulse oximetry ( SpO2 )] was monitored with a finger probe. During SWS, we determined the respiratory phase (inspiration or expiration) before and after each ingestion cycle (IC; period of sustained apnea including 1 or more swallows). We also measured inspiratory time (TI), expiratory time (TE), respiratory cycle duration (TT), respiratory rate (RR) and SpO2 at rest and during SWS. We showed that respiration was interrupted by sequential swallows determining a succession of ICs that were often preceded and followed by expiration. During SWS, TI decreased and TE increased compared with rest ( P < 0.01). However, TT, RR, and SpO2 did not change. It seems that the preferential coupling of swallowing with expiration during SWS is favored by an increase in TE to ensure airway protection, although the repetitive swallows, RR, and SpO2 were not altered during SWS. These data may be useful to study the effects of aging and pathological conditions on swallowing and breathing coordination during SWS. NEW & NOTEWORTHY Sequential water swallowing induces ingestion cycles that are often preceded and followed by expiration. Moreover, inspiratory time decreases and expiratory time increases during sequential swallowing compared with rest without changes in ventilatory cycle duration, respiratory rate, and oxygen saturation.
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Affiliation(s)
- Yacine Ouahchi
- Pneumology Department (RU 12SP06), La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia.,EA 3830, Research Group on Ventilatory Handicap, Rouen University , Rouen , France
| | - Nozha Ben Salah
- Pneumology Department (RU 12SP06), Mongi-Slim Hospital-La Marsa, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia
| | - Meriem Mjid
- Pneumology Department (RU 12SP06), La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia
| | - Abir Hedhli
- Pneumology Department (RU 12SP06), La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia
| | - Nour Abdelhedi
- Pneumology Department (RU 12SP06), La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia
| | - Majed Beji
- Pneumology Department (RU 12SP06), La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia
| | - Sonia Toujani
- Pneumology Department (RU 12SP06), La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar , Tunis , Tunisia
| | - Eric Verin
- EA 3830, Research Group on Ventilatory Handicap, Rouen University , Rouen , France.,Rouen University Hospital and EA 3830, Normandy University , Rouen , France
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Jestrović I, Coyle JL, Sejdić E. Differences in brain networks during consecutive swallows detected using an optimized vertex-frequency algorithm. Neuroscience 2017; 344:113-123. [PMID: 27989520 PMCID: PMC5303679 DOI: 10.1016/j.neuroscience.2016.11.047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 11/19/2022]
Abstract
Patients with dysphagia can have higher risks of aspiration after repetitive swallowing activity due to the "fatigue effect". However, it is still unknown how consecutive swallows affect brain activity. Therefore, we sought to investigate differences in swallowing brain networks formed during consecutive swallows using a signal processing on graph approach. Data were collected from 55 healthy people using electroencephalography (EEG) signals. Participants performed dry swallows (i.e., saliva swallows) and wet swallows (i.e., water, nectar-thick, and honey thick swallows). After standard pre-processing of the EEG time series, brain networks were formed using the time-frequency-based synchrony measure, while signals on graphs were formed as a line graph of the brain networks. For calculating the vertex frequency information from the signals on graphs, the proposed algorithm was based on the optimized window size for calculating the windowed graph Fourier transform and the graph S-transform. The proposed algorithms were tested using synthetic signals and showed improved energy concentration in comparison to the original algorithm. When applied to EEG swallowing data, the optimized windowed graph Fourier transform and the optimized graph S-transform showed that differences exist in brain activity between consecutive swallows. In addition, the results showed higher differences between consecutive swallows for thicker liquids.
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Affiliation(s)
- Iva Jestrović
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - James L Coyle
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA 15261, USA.
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Samson N, Praud JP, Quenet B, Similowski T, Straus C. New insights into sucking, swallowing and breathing central generators: A complexity analysis of rhythmic motor behaviors. Neurosci Lett 2016; 638:90-95. [PMID: 27956236 DOI: 10.1016/j.neulet.2016.12.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/25/2016] [Accepted: 12/08/2016] [Indexed: 10/20/2022]
Abstract
Sucking, swallowing and breathing are dynamic motor behaviors. Breathing displays features of chaos-like dynamics, in particular nonlinearity and complexity, which take their source in the automatic command of breathing. In contrast, buccal/gill ventilation in amphibians is one of the rare motor behaviors that do not display nonlinear complexity. This study aimed at assessing whether sucking and swallowing would also follow nonlinear complex dynamics in the newborn lamb. Breathing movements were recorded before, during and after bottle-feeding. Sucking pressure and the integrated EMG of the thyroartenoid muscle, as an index of swallowing, were recorded during bottle-feeding. Nonlinear complexity of the whole signals was assessed through the calculation of the noise limit value (NL). Breathing and swallowing always exhibited chaos-like dynamics. The NL of breathing did not change significantly before, during or after bottle-feeding. On the other hand, sucking inconsistently and significantly less frequently than breathing exhibited a chaos-like dynamics. Therefore, the central pattern generator (CPG) that drives sucking may be functionally different from the breathing CPG. Furthermore, the analogy between buccal/gill ventilation and sucking suggests that the latter may take its phylogenetic origin in the gill ventilation CPG of the common ancestor of extant amphibians and mammals.
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Affiliation(s)
- Nathalie Samson
- Neonatal Respiratory Research Unit, Department of Pediatric and Pharmacology-Physiology, Université de Sherbrooke, Qc, Canada
| | - Jean-Paul Praud
- Neonatal Respiratory Research Unit, Department of Pediatric and Pharmacology-Physiology, Université de Sherbrooke, Qc, Canada
| | - Brigitte Quenet
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France; Equipe de Statistique Appliquée ESPCI-Paris, PSL Research University, Paris, France
| | - Thomas Similowski
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département R3S), F-75013, Paris, France
| | - Christian Straus
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMRS1158 Neurophysiologie respiratoire expérimentale et clinique, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service d'Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée (Département R3S), F-75013, Paris, France.
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8
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Watts SA, Tabor L, Plowman EK. To Cough or Not to Cough? Examining the Potential Utility of Cough Testing in the Clinical Evaluation of Swallowing. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016; 4:262-276. [PMID: 28529824 DOI: 10.1007/s40141-016-0134-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The clinical swallowing evaluation (CSE) represents a critical component of a comprehensive assessment of deglutition. Although universally utilized across clinical settings, the CSE demonstrates limitations in its ability to accurately identify all individuals with dysphagia. There exists a need to improve assessment and screening techniques to improve health outcomes, treatment recommendations and ultimately mortality in individuals at risk for dysphagia. The following narrative review provides a summary of currently used validated CSE's and examines the potential role of cough testing and screening in the CSE. RECENT FINDINGS Recent evidence highlights a relationship between objective physiologic measurements of both voluntarily and reflexively induced cough and swallowing safety status across several patient populations. Although more research is needed across a wider range of patient populations to validate these findings; emerging data supports the consideration of inclusion of cough testing during the CSE as an index of airway defense mechanisms and capabilities in individuals at risk for aspiration. SUMMARY The sensorimotor processes of cough and swallowing share common neuroanatomical and functional substrates. Inclusion of voluntarily or reflexively induced cough testing in the CSE may aide in the identification of dysphagia and reduced airway protection capabilities.
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Affiliation(s)
- Stephanie A Watts
- Joy McCann Culverhouse Center for Swallowing Disorders, University of South Florida, 13330 USF Laurel Drive MDC Box 72, Tampa, FL 33612, USA.,Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, USA
| | - Lauren Tabor
- Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, USA.,Department of Speech, Language and Hearing Sciences, University of Florida, PO Box 117420, Gainesville, FL 32611, USA
| | - Emily K Plowman
- Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, USA.,Department of Speech, Language and Hearing Sciences, University of Florida, PO Box 117420, Gainesville, FL 32611, USA
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Wang CM, Li HY, Lee LA, Shieh WY, Lin SW. Non-invasive Assessment of Swallowing and Respiration Coordination for the OSA Patient. Dysphagia 2016; 31:771-780. [PMID: 27515710 DOI: 10.1007/s00455-016-9740-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 07/28/2016] [Indexed: 12/14/2022]
Abstract
The objectives of this study are to investigate swallowing and its coordination with respiration in patients with obstructive sleep apnea (OSA). This is a prospective cohort study conducted in a tertiary referred Medical Center. A non-invasive method of assessing swallowing was used to detect the oropharyngeal swallowing parameters and the coordination with respiration during swallowing. The system used to assess swallowing detected: (1) movement of the larynx using a force-sensing resistor; (2) submental muscle activity using surface electromyography; and (3) coordination with respiration by measuring nasal airflow. Five sizes of water boluses (maximum 20 mL) were swallowed three times, and the data recorded and analyzed for each participant. Thirty-nine normal controls and 35 patients with OSA who fulfilled the inclusion criteria were recruited. The oropharyngeal swallowing parameters of the patients differed from the controls, including longer total excursion duration and shorter duration of submental muscles contraction. A longer swallowing respiratory pause (SRP), temporary coordination with respiration during swallowing, was demonstrated in the patients compared with the controls. The frequency of non-expiratory/expiratory pre- and postswallowing respiratory phase patterns of the patients was similar with the controls. There was significantly more piecemeal deglutition in OSA patients when clumping 10- and 20-mL water boluses swallowing together (p = 0.048). Oropharyngeal swallowing and coordination with respiration affected patients with OSA, and it could be detected using a non-invasive method. The results of this study may serve as a baseline for further research and help advance research methods in obstructive sleep apnea swallowing studies.
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Affiliation(s)
- Chin-Man Wang
- Department of Physical Medicine and Rehabilitation, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No.5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305, Taiwan, ROC.
| | - Hsueh-Yu Li
- Department of Otorhinolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No.5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305, Taiwan, ROC.
| | - Li- Ang Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, No.5, Fu-Hsing Street, Gueishan District, Taoyuan City, 33305, Taiwan, ROC
| | - Wann-Yun Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan City, 33305, Taiwan, ROC
| | - Shih-Wei Lin
- Department of Pulmonary and Critical Care Medicine, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan City, 33305, Taiwan, ROC
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Pitts T, Hegland KW, Sapienza CM, Bolser DC, Davenport PW. Alterations in oropharyngeal sensory evoked potentials (PSEP) with Parkinson's disease. Respir Physiol Neurobiol 2016; 229:11-6. [PMID: 27090350 PMCID: PMC4888769 DOI: 10.1016/j.resp.2016.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 04/12/2016] [Accepted: 04/12/2016] [Indexed: 12/11/2022]
Abstract
Movement of a food bolus from the oral cavity into the oropharynx activates pharyngeal sensory mechanoreceptors. Using electroencephalography, somatosensory cortical-evoked potentials resulting from oropharyngeal mechanical stimulation (PSEP) have been studied in young healthy individuals. However, limited information is known about changes in processing of oropharyngeal afferent signals with Parkinson's disease (PD). To determine if sensory changes occurred with a mechanical stimulus (air-puff) to the oropharynx, two stimuli (S1-first; S2-s) were delivered 500ms apart. Seven healthy older adults (HOA; 3 male and 4 female; 72.2±6.9 years of age), and thirteen persons diagnosed with idiopathic Parkinson's disease (PD; 11 male and 2 female; 67.2±8.9 years of age) participated. Results demonstrated PSEP P1, N1, and P2 component peaks were identified in all participants, and the N2 peak was present in 17/20 participants. Additionally, the PD participants had a decreased N2 latency and gated the P1, P2, and N2 responses (S2/S1 under 0.6). Compared to the HOAs, the PD participants had greater evidence of gating the P1 and N2 component peaks. These results suggest that persons with PD experience changes in sensory processing of mechanical stimulation of the pharynx to a greater degree than age-matched controls. In conclusion, the altered processing of sensory feedback from the pharynx may contribute to disordered swallow in patients with PD.
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Affiliation(s)
- Teresa Pitts
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery University of Louisville, Louisville, KY, United States.
| | - Karen Wheeler Hegland
- Department of Speech, Language, and Hearing Sciences University of Florida, Gainesville, FL, United States
| | - Christine M Sapienza
- Brooks Rehabilitation College of Healthcare Sciences Jacksonville University, Jacksonville, FL, United States
| | - Donald C Bolser
- Department of Physiological Sciences University of Florida, Gainesville, FL, United States
| | - Paul W Davenport
- Department of Physiological Sciences University of Florida, Gainesville, FL, United States
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11
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Jestrović I, Coyle JL, Sejdić E. Decoding human swallowing via electroencephalography: a state-of-the-art review. J Neural Eng 2015; 12:051001. [PMID: 26372528 PMCID: PMC4596245 DOI: 10.1088/1741-2560/12/5/051001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Swallowing and swallowing disorders have garnered continuing interest over the past several decades. Electroencephalography (EEG) is an inexpensive and non-invasive procedure with very high temporal resolution which enables analysis of short and fast swallowing events, as well as an analysis of the organizational and behavioral aspects of cortical motor preparation, swallowing execution and swallowing regulation. EEG is a powerful technique which can be used alone or in combination with other techniques for monitoring swallowing, detection of swallowing motor imagery for diagnostic or biofeedback purposes, or to modulate and measure the effects of swallowing rehabilitation. This paper provides a review of the existing literature which has deployed EEG in the investigation of oropharyngeal swallowing, smell, taste and texture related to swallowing, cortical pre-motor activation in swallowing, and swallowing motor imagery detection. Furthermore, this paper provides a brief review of the different modalities of brain imaging techniques used to study swallowing brain activities, as well as the EEG components of interest for studies on swallowing and on swallowing motor imagery. Lastly, this paper provides directions for future swallowing investigations using EEG.
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Affiliation(s)
- Iva Jestrović
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - James L. Coyle
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA
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12
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Wang CM, Shieh WY, Chen JY, Wu YR. Integrated non-invasive measurements reveal swallowing and respiration coordination recovery after unilateral stroke. Neurogastroenterol Motil 2015; 27:1398-408. [PMID: 26176581 DOI: 10.1111/nmo.12634] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/16/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oropharyngeal dysphagia is common after a stroke. Understanding the physiology of swallowing and its coordination with respiration in stroke recovery is crucially important. METHODS A non-invasive swallowing assessment method was used to detect oropharyngeal swallowing and respiration coordination simultaneously during the swallowing process. This system detected movement of the larynx, submental muscle activity, and nasal airflow. Six different sizes of water boluses (maximum of 20 mL) were swallowed and assessed for each subject. KEY RESULTS We recruited 59 healthy participants and 38 first ever unilateral stroke patients completed baseline and follow-up assessments at 3, 6, and 9 months poststroke. The results showed that oropharyngeal swallowing parameters in unilateral stroke deviate from normal patterns. For respiration coordination, the unilateral stroke group had longer swallowing apnea duration but similar frequencies of pre- and postswallowing respiratory phase patterns compared with the healthy controls. The probability of piece-meal deglutition was higher in the stroke group than in the control group. Additionally, there were gradually decreasing piece-meal deglutition probabilities among the stroke patients at follow-up, and none differed statistically from those of the controls at 6 months poststroke. CONCLUSIONS & INFERENCES The non-invasive swallowing and respiration assessment method applied in this study detected the changes manifested in swallowing and respiration during the subacute phase of recovery in 6 months after a unilateral stroke. The study results serve as a baseline for further research and help advance dysphagia research methodologies. These assessments may be combined with bedside evaluations for clinical application.
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Affiliation(s)
- C-M Wang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - W-Y Shieh
- Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan
| | - J-Y Chen
- Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Y-R Wu
- Department of Neurology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
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13
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Jestrović I, Coyle JL, Sejdić E. Characterizing functional connectivity patterns during saliva swallows in different head positions. J Neuroeng Rehabil 2015; 12:61. [PMID: 26206139 PMCID: PMC4513710 DOI: 10.1186/s12984-015-0049-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 06/12/2015] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The anatomical rationale and efficacy of the chin tuck in improving airway protection for some people with swallowing disorders have been well researched and established. However, there are still open questions regarding whether brain activity for swallowing control is altered while performing this chin-tuck maneuver. METHODS In this study, we collected EEG signals from 55 healthy adults while swallowing in the neutral and chin-tuck head positions. The time-frequency based synchrony measure was used to form brain networks. We investigated both the small-world properties of these brain networks and differences among the constructed brain networks for the two head positions during swallowing tasks. RESULTS We showed that brain networks for swallowing in both head positions exhibit small-world properties. Furthermore, we showed that swallowing in the chin-tuck head position affects brain networks in the Alpha and Gamma frequency bands. CONCLUSIONS According to these results, we can tell that the parameter of head position should be considered in future investigations which utilize EEG signals during swallowing activity.
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Affiliation(s)
- Iva Jestrović
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
| | - James L Coyle
- Department of Communication Science and Disorders, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Ervin Sejdić
- Department of Electrical and Computer Engineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
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14
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Troche MS, Brandimore AE, Godoy J, Hegland KW. A framework for understanding shared substrates of airway protection. J Appl Oral Sci 2014; 22:251-60. [PMID: 25141195 PMCID: PMC4126819 DOI: 10.1590/1678-775720140132] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/06/2014] [Indexed: 02/01/2023] Open
Abstract
Deficits of airway protection can have deleterious effects to health and quality of
life. Effective airway protection requires a continuum of behaviors including
swallowing and cough. Swallowing prevents material from entering the airway and
coughing ejects endogenous material from the airway. There is significant overlap
between the control mechanisms for swallowing and cough. In this review we will
present the existing literature to support a novel framework for understanding shared
substrates of airway protection. This framework was originally adapted from Eccles'
model of cough28 (2009) by Hegland,
et al.42 (2012). It will serve to
provide a basis from which to develop future studies and test specific hypotheses
that advance our field and ultimately improve outcomes for people with airway
protective deficits.
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Affiliation(s)
- Michelle Shevon Troche
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
| | | | - Juliana Godoy
- Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Karen Wheeler Hegland
- Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, FL, USA
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15
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Wang CM, Chen JY, Chuang CC, Tseng WC, Wong AMK, Pei YC. Aging-related changes in swallowing, and in the coordination of swallowing and respiration determined by novel non-invasive measurement techniques. Geriatr Gerontol Int 2014; 15:736-44. [PMID: 25257507 DOI: 10.1111/ggi.12343] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2014] [Indexed: 12/23/2022]
Abstract
AIM Previous studies have shown that the process of swallowing changes with aging, a phenomenon known as presbyphagia. These subtle and subclinical age-related changes make older adults more vulnerable to dysphagia during disease insults. However, there are limited studies of the swallowing process in older adults, because measurements are typically invasive or require exposure to X-rays. In the present study, we used integrated non-invasive measurements to determine aging-related changes of swallowing, and in the coordination of swallowing and respiration for a population of healthy participants. METHODS The non-invasive system provided measurements of larynx movement with piezoelectric sensors, submental muscle activity with surface electromyography and respiration-swallowing coordination by measurement of nasal airflow. We recruited 112 healthy participants from the community, 35 in a young-age group (age 20-30 years), 38 in a middle-age group (age 31-50 years) and 39 in an old-age group (age 51-70 years). RESULTS The oropharyngeal swallowing parameters of the old-age group had delayed onset latency and longer swallowing apnea duration relative to the other groups, and these differences were greater for larger boluses. The middle- and old-age groups had less expiratory-expiratory respiratory phase pattern than the young-age group. The probability of piecemeal deglutition was highest in the old-age group and lowest in the young-age group. These results show that the phases of oropharyngeal swallowing and the coordination of swallowing with respiration gradually change with aging. CONCLUSIONS We used integrated non-invasive measurements to document age-related changes in swallowing, and in the coordination of swallowing and respiration in healthy adults.
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Affiliation(s)
- Chin-Man Wang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Ji-Yih Chen
- Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Chiung-Cheng Chuang
- Department of Biomedical Engineering, Chung Yuan Christian University, Chungli, Taiwan
| | - Wen-Chun Tseng
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan
| | - Alice M K Wong
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Yu-Cheng Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan.,Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
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16
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Abe K, Weisz SEM, Dunn RL, DiGioacchino MC, Nyentap JA, Stanbouly S, Theurer JA, Bureau Y, Affoo RH, Martin RE. Occurrences of yawn and swallow are temporally related. Dysphagia 2014; 30:57-66. [PMID: 25240300 DOI: 10.1007/s00455-014-9573-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 09/10/2014] [Indexed: 12/19/2022]
Abstract
Yawning is a stereotyped motor behavior characterized by deep inhalation and associated dilation of the respiratory tract, pronounced jaw opening, and facial grimacing. The frequency of spontaneous yawning varies over the diurnal cycle, peaking after waking and before sleep. Yawning can also be elicited by seeing or hearing another yawn, or by thinking about yawning, a phenomenon known as "contagious yawning". Yawning is mediated by a distributed network of brainstem and supratentorial brain regions, the components of which are shared with other airway behaviors including respiration, swallowing, and mastication. Nevertheless, the possibility of behavioral coordination between yawning and other brainstem-mediated functions has not been examined. Here we show, with a double-blind methodology, a greater-than-fivefold increase in rest (saliva) swallowing rate during the 10-s period immediately following contagious yawning elicited in 14 adult humans through the viewing of videotaped yawn stimuli. Sixty-five percent of yawns were followed by a swallow within 10 s and swallows accounted for 26 % of all behaviors produced during this post-yawn period. This novel finding of a tight temporal coupling between yawning and swallowing provides preliminary evidence that yawning and swallowing are physiologically related, thus extending current models of upper airway physiology and neurophysiology. Moreover, our finding suggests the possibility that yawning plays a role in eliciting rest swallowing, a view not considered in previous theories of yawning. As such, the present demonstration of a temporal association between yawning and swallowing motivates a re-examination of the longstanding question, "Why do we yawn?".
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Affiliation(s)
- Kimiko Abe
- School of Communication Sciences and Disorders, Faculty of Health Sciences, Western University, London, ON, N6A 5B9, Canada,
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17
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Spearman DG, Poliacek I, Rose MJ, Bolser DC, Pitts T. Variability of the pharyngeal phase of swallow in the cat. PLoS One 2014; 9:e106121. [PMID: 25171095 PMCID: PMC4149527 DOI: 10.1371/journal.pone.0106121] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 07/28/2014] [Indexed: 11/18/2022] Open
Abstract
Objective The pharyngeal phase of swallow has been thought to be a stereotypical motor behavior. Study Design This is a prospective, preclinical, hypothesis driven, one group by three-task design. Methods We sought to compare the effects of pharyngeal swabbing, water only, and water plus punctate mechanical stimulation on the spatiotemporal features of the pharyngeal phase of swallow in the cat. Swallow was elicited under these three conditions in six anaesthetized cats. Electromyographic activity was recorded from seven muscles used to evaluate swallow: mylohyoid, geniohyoid, thyrohyoid, thyroarytenoid, thyropharyngeus, cricopharyngeus, and parasternal. Results Pharyngeal swabbing in comparison to the other stimulus conditions, results in decreases in post-swallow cricopharyngeus activity (upper esophageal sphincter); a significant increase in parasternal (schluckatmung; swallow breath) activity; and increases in thyrohyoid (laryngeal elevator), thyroarytenoid (laryngeal adductor) and parasternal muscles burst duration. Pearson correlations were found of moderate strength between 19% of burst duration comparisons and weak to moderate relationships between 29% of burst amplitude comparisons. However, there were no positive significant relationships between phase durations and electromyogram amplitudes between any of the muscles studied during swallow. Conclusions The results support the concept that a stereotypical behavior, such as pharyngeal swallowing in animal models, can be modified by sensory feedback from pharyngeal mucosal mechanoreceptors. Furthermore, differences in swallow phase durations and amplitudes provide evidence that separate regulatory mechanisms exist which regulate spatial and temporal aspects of the behavior.
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Affiliation(s)
- Daniel G. Spearman
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, United States of America
| | - Ivan Poliacek
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, United States of America
- Institute of Medical Biophysics, Jessenius Faculty of Medicine, Comenius University, Martin, Slovak Republic
| | - Melanie J. Rose
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, United States of America
| | - Donald C. Bolser
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, United States of America
| | - Teresa Pitts
- Department of Physiological Sciences, University of Florida, Gainesville, Florida, United States of America
- * E-mail:
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18
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Hegland KW, Okun MS, Troche MS. Sequential voluntary cough and aspiration or aspiration risk in Parkinson's disease. Lung 2014; 192:601-8. [PMID: 24792231 DOI: 10.1007/s00408-014-9584-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Accepted: 04/07/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Disordered swallowing, or dysphagia, is almost always present to some degree in people with Parkinson's disease (PD), either causing aspiration or greatly increasing the risk for aspiration during swallowing. This likely contributes to aspiration pneumonia, a leading cause of death in this patient population. Effective airway protection is dependent upon multiple behaviors, including cough and swallowing. Single voluntary cough function is disordered in people with PD and dysphagia. However, the appropriate response to aspirate material is more than one cough, or sequential cough. The goal of this study was to examine voluntary sequential coughing in people with PD, with and without dysphagia. METHODS Forty adults diagnosed with idiopathic PD produced two trials of sequential voluntary cough. The cough airflows were obtained using pneumotachograph and facemask and subsequently digitized and recorded. All participants received a modified barium swallow study as part of their clinical care, and the worst penetration-aspiration score observed was used to determine whether the patient had dysphagia. RESULTS There were significant differences in the compression phase duration, peak expiratory flow rates, and amount of air expired of the sequential cough produced by participants with and without dysphagia. CONCLUSIONS The presence of dysphagia in people with PD is associated with disordered cough function. Sequential cough, which is important in removing aspirate material from large- and smaller-diameter airways, is also impaired in people with PD and dysphagia compared with those without dysphagia. There may be common neuroanatomical substrates for cough and swallowing impairment in PD leading to the co-occurrence of these dysfunctions.
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Affiliation(s)
- Karen Wheeler Hegland
- Department of Speech, Language and Hearing Sciences, University of Florida, 336 Dauer Hall, Gainesville, FL, 32611, USA,
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19
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Bautista TG, Dutschmann M. Ponto-medullary nuclei involved in the generation of sequential pharyngeal swallowing and concomitant protective laryngeal adduction in situ. J Physiol 2014; 592:2605-23. [PMID: 24639482 DOI: 10.1113/jphysiol.2014.272468] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Both swallowing and respiration involve postinspiratory laryngeal adduction. Swallowing-related postinspiratory neurons are likely to be located in the nucleus of the solitary tract (NTS) and those involved in respiration are found in the Kölliker-Fuse nucleus (KF). The function of KF and NTS in the generation of swallowing and its coordination with respiration was investigated in perfused brainstem preparations of juvenile rats (n = 41). Orally injected water evoked sequential pharyngeal swallowing (s-PSW) seen as phasic, spindle-shaped bursting of vagal nerve activity (VNA) against tonic postinspiratory discharge. KF inhibition by microinjecting isoguvacine (GABAA receptor agonist) selectively attenuated tonic postinspiratory VNA (n = 10, P < 0.001) but had no effect on frequency or timing of s-PSW. KF disinhibition after bicuculline (GABAA receptor antagonist) microinjections caused an increase of the tonic VNA (n = 8, P < 0.01) resulting in obscured and delayed phasic s-PSW. Occurrence of spontaneous PSW significantly increased after KF inhibition (P < 0.0001) but not after KF disinhibition (P = 0.14). NTS isoguvacine microinjections attenuated the occurrence of all PSW (n = 5, P < 0.01). NTS bicuculline microinjections (n = 6) resulted in spontaneous activation of a disordered PSW pattern and long-lasting suppression of respiratory activity. Pharmacological manipulation of either KF or NTS also triggered profound changes in respiratory postinspiratory VNA. Our results indicate that the s-PSW comprises two functionally distinct components. While the primary s-PSW is generated within the NTS, a KF-mediated laryngeal adductor reflex safeguards the lower airways from aspiration. Synaptic interaction between KF and NTS is required for s-PSW coordination with respiration as well as for proper gating and timing of s-PSW.
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Affiliation(s)
- Tara G Bautista
- Florey Institute of Neuroscience and Mental Health, Gate 11, Royal Parade, University of Melbourne, Victoria, 3052, Australia
| | - Mathias Dutschmann
- Florey Institute of Neuroscience and Mental Health, Gate 11, Royal Parade, University of Melbourne, Victoria, 3052, Australia
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20
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Bautista TG, Sun QJ, Pilowsky PM. The generation of pharyngeal phase of swallow and its coordination with breathing: interaction between the swallow and respiratory central pattern generators. PROGRESS IN BRAIN RESEARCH 2014; 212:253-75. [PMID: 25194202 DOI: 10.1016/b978-0-444-63488-7.00013-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Swallowing and breathing utilize common muscles and an anatomical passage: the pharynx. The risk of aspiration of ingested material is minimized not only by the laryngeal adduction of the vocal folds and laryngeal elevation but also by the precise coordination of swallows with breathing. Namely, swallows: (1) are preferentially initiated in the postinspiratory/expiratory phase, (2) are accompanied by a brief apnea, and (3) are often followed by an expiration and delay of the next breath. This review summarizes the expiratory evidence on the brainstem regions comprising the central pattern generator (CPG) that produces the pharyngeal stage of swallow, how the motor acts of swallowing and breathing are coordinated, and lastly, brainstem regions where the swallowing and respiratory CPGs may interact in order to ensure "safe" swallows.
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Affiliation(s)
- Tara G Bautista
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia; Australian School of Advanced Medicine, Macquarie University, North Ryde, New South Wales, Australia.
| | - Qi-Jian Sun
- Australian School of Advanced Medicine, Macquarie University, North Ryde, New South Wales, Australia
| | - Paul M Pilowsky
- Heart Research Institute, Newtown, New South Wales, Australia
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21
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Effect of Taste Sensation on Cough Reflex Sensitivity. Lung 2013; 192:9-13. [DOI: 10.1007/s00408-013-9515-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 10/02/2013] [Indexed: 11/25/2022]
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22
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Tsujimura T, Udemgba C, Inoue M, Canning BJ. Laryngeal and tracheal afferent nerve stimulation evokes swallowing in anaesthetized guinea pigs. J Physiol 2013; 591:4667-79. [PMID: 23858010 DOI: 10.1113/jphysiol.2013.256024] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We describe swallowing reflexes evoked by laryngeal and tracheal vagal afferent nerve stimulation in anaesthetized guinea pigs. The swallowing reflexes evoked by laryngeal citric acid challenges were abolished by recurrent laryngeal nerve (RLN) transection and mimicked by electrical stimulation of the central cut ends of an RLN. By contrast, the number of swallows evoked by upper airway/pharyngeal distensions was not significantly reduced by RLN transection but they were virtually abolished by superior laryngeal nerve transection. Laryngeal citric acid-evoked swallowing was mimicked by laryngeal capsaicin challenges, implicating transient receptor potential vanilloid 1 (TRPV1)-expressing laryngeal afferent nerves arising from the jugular ganglia. The swallowing evoked by citric acid and capsaicin and evoked by electrical stimulation of either the tracheal or the laryngeal mucosa occurred at stimulation intensities that were typically subthreshold for evoking cough in these animals. Swallowing evoked by airway afferent nerve stimulation also desensitized at a much slower rate than cough. We speculate that swallowing is an essential component of airway protection from aspiration associated with laryngeal and tracheal afferent nerve activation.
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Affiliation(s)
- Takanori Tsujimura
- B. J. Canning: Johns Hopkins Asthma and Allergy Center, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA.
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23
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Bonis JM, Neumueller SE, Krause KL, Pan LG, Hodges MR, Forster HV. Contributions of the Kölliker-Fuse nucleus to coordination of breathing and swallowing. Respir Physiol Neurobiol 2013; 189:10-21. [PMID: 23774145 DOI: 10.1016/j.resp.2013.06.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 05/03/2013] [Accepted: 06/05/2013] [Indexed: 11/28/2022]
Abstract
Herein we compare the effects of perturbations in the Kölliker-Fuse nucleus (KFN) and the lateral (LPBN) and medial (MPBN) parabrachial nuclei on the coordination of breathing and swallowing. Cannula was chronically implanted in goats through which ibotenic acid (IA) was injected while awake. Swallows in late expiration (E) always reset while swallows in early inspiration (I) never reset the respiratory rhythm. Before cannula implantation, all other E and I swallows did not reset the respiratory rhythm, and had small effects on E and I duration and tidal volume (VT). However, after cannula implantation in the MPBN and KFN, E and I swallows reset the respiratory rhythm and increased the effects on I and E duration and VT. Subsequent injection of IA into the KFN eliminated the respiratory phase resetting of swallows but exacerbated the effects on I and E duration and VT. We conclude that the KFN and to a lesser extent the MPBN contribute to coordination of breathing and swallowing.
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Affiliation(s)
- J M Bonis
- Medical College of Wisconsin, Department of Physiology, Milwaukee, WI, United States.
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24
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Contribution of medullary raphé to control of coughing—Codeine trials in cat. Respir Physiol Neurobiol 2012; 184:106-12. [DOI: 10.1016/j.resp.2012.08.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2012] [Revised: 07/16/2012] [Accepted: 08/10/2012] [Indexed: 12/15/2022]
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25
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Robbins J. Upper aerodigestive tract neurofunctional mechanisms: lifelong evolution and exercise. Head Neck 2011; 33 Suppl 1:S30-6. [PMID: 21910155 DOI: 10.1002/hed.21902] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2011] [Indexed: 11/10/2022] Open
Abstract
The transformation of the upper aerodigestive tract--oral cavity, pharynx, and larynx--serves the functions of eating, speaking, and breathing during sleeping and waking hours. These life-sustaining functions may be produced by a central neural sensorimotor system that shares certain neuroanatomic networks while maintaining separate neural functional systems and network structures. Current understanding of development, maturation, underlying neural correlates, and integrative factors are discussed in light of currently available imaging modalities and recently emerging interventions. Exercise and an array of additional treatments together seem to provide promising translational pathways for evidence-based innovation, novel habilitation, and rehabilitation strategies and delay, or even prevent neuromuscular decline cross-cutting functions and supporting quality of life throughout increasingly enduring lifespans.
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Affiliation(s)
- JoAnne Robbins
- Geriatric Research Education and Clinical Center, William S Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA.
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