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Cullins MJ, Connor NP. Differential impact of unilateral stroke on the bihemispheric motor cortex representation of the jaw and tongue muscles in young and aged rats. Front Neurol 2024; 15:1332916. [PMID: 38572491 PMCID: PMC10987714 DOI: 10.3389/fneur.2024.1332916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
Introduction Dysphagia commonly occurs after stroke, yet the mechanisms of post-stroke corticobulbar plasticity are not well understood. While cortical activity associated with swallowing actions is bihemispheric, prior research has suggested that plasticity of the intact cortex may drive recovery of swallowing after unilateral stroke. Age may be an important factor as it is an independent predictor of dysphagia after stroke and neuroplasticity may be reduced with age. Based on previous clinical studies, we hypothesized that cranial muscle activating volumes may be expanded in the intact hemisphere and would contribute to swallowing function. We also hypothesized that older age would be associated with limited map expansion and reduced function. As such, our goal was to determine the impact of stroke and age on corticobulbar plasticity by examining the jaw and tongue muscle activating volumes within the bilateral sensorimotor cortices. Methods Using the middle cerebral artery occlusion rat stroke model, intracortical microstimulation (ICMS) was used to map regions of sensorimotor cortex that activate tongue and jaw muscles in both hemispheres. Young adult (7 months) and aged (30 months) male F344 × BN rats underwent a stroke or sham-control surgery, followed by ICMS mapping 8 weeks later. Videofluoroscopy was used to assess oral-motor functions. Results Increased activating volume of the sensorimotor cortex within the intact hemisphere was found only for jaw muscles, whereas significant stroke-related differences in tongue activating cortical volume were limited to the infarcted hemisphere. These stroke-related differences were correlated with infarct size, such that larger infarcts were associated with increased jaw representation in the intact hemisphere and decreased tongue representation in the infarcted hemisphere. We found that both age and stroke were independently associated with swallowing differences, weight loss, and increased corticomotor thresholds. Laterality of tongue and jaw representations in the sham-control group revealed variability between individuals and between muscles within individuals. Conclusion Our findings suggest the role of the intact and infarcted hemispheres in the recovery of oral motor function may differ between the tongue and jaw muscles, which may have important implications for rehabilitation, especially hemisphere-specific neuromodulatory approaches. This study addressed the natural course of recovery after stroke; future work should expand to focus on rehabilitation.
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Affiliation(s)
- Miranda J. Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Nadine P. Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
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Rohl AH, Connor NP, Russell JA. Age-related sex differences in tongue strength and muscle morphometry in a rat model. Arch Oral Biol 2023; 155:105779. [PMID: 37556980 PMCID: PMC10592197 DOI: 10.1016/j.archoralbio.2023.105779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To investigate potential effects of sex on voluntary tongue strength, evoked twitch and tetanic tension, speed of contraction, and muscle fiber cross-sectional area in the muscles of the rat tongue. Additionally, we aimed to determine whether estrous cycle stage impacts any of the dependent variables as a pilot investigation into the use of female rats in a model of tongue exercise and aging. DESIGN Fischer 344-Brown Norway male and female rats in two age groups (16 middle-aged, 16 young-adult) were trained to use a tongue force operandum. Tongue muscle contraction, myosin heavy chain (MyHC) composition, and cross section area of the genioglossus and styloglossus muscles were examined. Vaginal lavage determined estrous cycle stage of the female rats daily. RESULTS The female group had significantly lower evoked twitch and tetanic tension, longer contraction times, and a smaller proportion of MyHC type IIa and MyHC type IIx in the styloglossus muscle. There was no significant sex effect in maximal voluntary tongue force (MVTF) despite a significant weight difference between the male and female groups. There were no significant age or sex effects in the genioglossus. Estrous cycle stage did not have a significant effect on any of the dependent variables. CONCLUSIONS Sex and age both have a significant effect on tongue muscle structure and physiology. While the female group showed reduced contraction speed and maximal twitch and tetanic tension relative to the male group, differences in muscle morphology appeared to vary by muscle.
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Affiliation(s)
- Andrea H Rohl
- Department of Neurosurgery, University of Iowa, USA.
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA; Department of Communication Sciences and Disorders, University of Wisconsin, Madison, USA
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Yoshinaka S, Yamaguchi K, Yanagida R, Ishii M, Nakagawa K, Yoshimi K, Nakane A, Matsuyama Y, Aida J, Tohara H. Tongue Strength of Older Adults Requiring Long-Term Care Varies throughout the Day. Geriatrics (Basel) 2023; 8:107. [PMID: 37987467 PMCID: PMC10660863 DOI: 10.3390/geriatrics8060107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 10/05/2023] [Accepted: 10/24/2023] [Indexed: 11/22/2023] Open
Abstract
Physical performance shows approximately 30% diurnal variation; however, diurnal variation in oral function remains unclear. This study aimed to determine the diurnal variation in oral and swallowing function in older adults requiring long-term care. The participants included 13 adults aged >60 years (3 men and 10 women, mean age: 77.2 ± 6.3 years, age range: 62-90 years) requiring long-term care. Tongue strength (TS) and oral mucosal moisture were measured as indices of oral and swallowing function, while hand grip strength was measured as an index of general muscle strength. The patients were asked to participate in a "test" after breakfast, lunch, and dinner on the same day. Multilevel linear regression analysis was used to examine diurnal differences in each item. Multilevel linear regression analysis with adjustment for age and sex revealed that TS was significantly higher at noon (p = 0.001) than in the morning. Therefore, caregivers who provide support during meals to older people requiring long-term care should consider the possibility of swallowing function differing according to the time of the day. In conclusion, it may be beneficial to establish a nutritional therapy that accounts for the diurnal variation in TS.
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Affiliation(s)
- Shin Yoshinaka
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Ryosuke Yanagida
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Miki Ishii
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
| | - Yusuke Matsuyama
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (Y.M.); (J.A.)
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (Y.M.); (J.A.)
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan; (S.Y.); (R.Y.); (M.I.); (K.N.); (K.Y.); (A.N.); (H.T.)
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Maehara T, Nishimura R, Yoshitake A, Tsukamoto M, Kadomatsu Y, Kubo Y, Okada R, Nagayoshi M, Tamura T, Hishida A, Takeuchi K, Wakai K, Naito M. Association of daily physical activity and leisure-time exercise with dysphagia risk in community-dwelling older adults: a cross-sectional study. Sci Rep 2023; 13:10893. [PMID: 37407654 DOI: 10.1038/s41598-023-37605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/24/2023] [Indexed: 07/07/2023] Open
Abstract
This study aimed to clarify the association of daily physical activity and leisure-time exercise with the risk of dysphagia in community-dwelling Japanese older adults using a questionnaire-based survey. We analyzed 3070 participants (1657 men, 1413 women; age 66 ± 4 years [mean ± SD]) of the Shizuoka and Daiko studies within the Japanese Multi-Institutional Collaborative Cohort study. We used the Dysphagia Risk Assessment for the Community-dwelling Elderly questionnaire to assess dysphagia risk and the International Physical Activity Questionnaire to assess daily physical activity and leisure-time exercise. Logistic regression analyses were used to evaluate the independent association of the amount of physical activity and leisure-time exercise with dysphagia risk. The proportion of participants with dysphagia risk was 27.5% (n = 844) and the risk was significantly higher in women (29.8%, n = 421) than in men (25.5%, n = 423; P = 0.008). Daily physical activity was not associated with dysphagia risk. A greater amount of leisure-time exercise was associated with lower dysphagia risk (P for trend = 0.003) and individuals in the highest leisure-time exercise quartile had a significantly lower odds ratio (0.68, 95% CI 0.52-0.89) than those in the lowest quartile, even after adjusting for the covariates.
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Affiliation(s)
- Tomoko Maehara
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan
- Department of Public Oral Health, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan
| | - Rumi Nishimura
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan
| | - Akari Yoshitake
- Division of Dentistry and Oral Surgery, Japan, Community Health Care Organization, Tokuyama Central Hospital, 1-1 Kodacho, Shunan, Yamaguchi, 745-0822, Japan
| | - Mineko Tsukamoto
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yuka Kadomatsu
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Yoko Kubo
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Rieko Okada
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mako Nagayoshi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Takashi Tamura
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Asahi Hishida
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Kenji Wakai
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-8550, Japan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8553, Japan.
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Fogarty MJ. Loss of larger hypoglossal motor neurons in aged Fischer 344 rats. Respir Physiol Neurobiol 2023:104092. [PMID: 37331418 DOI: 10.1016/j.resp.2023.104092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 06/20/2023]
Abstract
The intrinsic (longitudinal, transversalis and verticalis) and extrinsic (genioglossus, styloglossus, hyoglossus and geniohyoid) tongue muscles are innervated by hypoglossal motor neurons (MNs). Tongue muscle activations occur during many behaviors: maintaining upper airway patency, chewing, swallowing, vocalization, vomiting, coughing, sneezing and grooming/sexual activities. In the tongues of the elderly, reduced oral motor function and strength contribute to increased risk of obstructive sleep apnoea. Tongue muscle atrophy and weakness is also described in rats, yet hypoglossal MN numbers are unknown. In young (6-months, n=10) and old (24-months, n=8) female and male Fischer 344 (F344) rats, stereological assessment of hypoglossal MN numbers and surface areas were performed on 16µm Nissl-stained brainstem cryosections. We observed a robust loss of ~15% of hypoglossal MNs and a modest ~8% reduction in their surface areas with age. In the larger size tertile of hypoglossal MNs, age-associated loss of hypoglossal MNs approached ~30% These findings uncover a potential neurogenic locus of pathology for age-associated tongue dysfunctions.
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Affiliation(s)
- Matthew J Fogarty
- Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN 55905.
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Cullins MJ, Lenell C, Ciucci MR, Connor NP. Changes in ultrasonic vocalizations after unilateral cerebral ischemia in a rat stroke model. Behav Brain Res 2023; 439:114252. [PMID: 36496078 PMCID: PMC9795729 DOI: 10.1016/j.bbr.2022.114252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/30/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Stroke frequently results in communication impairments that negatively impact quality of life and overall recovery, yet the biological mechanisms underlying these changes are not well understood. Ultrasonic vocalizations (USVs) in rodent models of disease and aging have been used to improve our understanding of the biological mechanisms that underlie vocal deficits and their response to interventions. Changes in USVs after middle cerebral artery occlusion (MCAO) in mice have been reported, yet rat models have significant anatomical and behavioral advantages over mice, including the ability to vocally train rats with an established paradigm. We sought to determine whether a unilateral MCAO rat stroke model provides a biologically and behaviorally relevant way to study post stroke vocalization deficits. We hypothesized that left MCAO would be associated with changes in USVs. Six weeks after MCAO or sham-control surgery, USVs were recorded in rats using an established mating paradigm. Stroke was associated with differences in USV acoustics including more frequent use of simple calls characterized by shorter durations and restricted bandwidths. These parameters were also found to correlate with post stroke lingual weakness. This is the first study to describe changes to rat USVs using a stroke model. These results suggest the unilateral MCAO rat stroke model is a biologically and behaviorally relevant model to understand how stroke affects vocal behaviors.
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Affiliation(s)
- Miranda J Cullins
- University of Wisconsin-Madison, Department of Surgery, United States.
| | - Charles Lenell
- University of Wisconsin-Madison, Department of Surgery, United States; University of Wisconsin-Madison, Department of Communication Sciences and Disorders, United States
| | - Michelle R Ciucci
- University of Wisconsin-Madison, Department of Surgery, United States; University of Wisconsin-Madison, Department of Communication Sciences and Disorders, United States
| | - Nadine P Connor
- University of Wisconsin-Madison, Department of Surgery, United States; University of Wisconsin-Madison, Department of Communication Sciences and Disorders, United States
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Pu D, Yao TJ. The use and effects of whole-body exercises on swallowing function: A scoping review. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023. [PMID: 36759960 DOI: 10.1111/1460-6984.12858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Swallowing function can become impaired due to primary medical conditions or age-related presbyphagia, resulting in swallowing disorders, known as dysphagia. Specific manoeuvres that target different musculature have been innovated and researched, but whole-body exercises (WBE) that target multiple large groups of body systems and muscles have been rarely considered in dysphagia management, despite the causes of dysphagia being often systemic. AIMS To identify intervention studies that have used or incorporated WBE to target swallowing function in humans, and report on their findings. METHODS & PROCEDURES A scoping review was conducted given the paucity and novelty of this topic in research and practice. Key search terms were used to search five major databases on for all human studies published before 28 November 2022. Studies that were not interventional or used animal models were excluded. All swallowing and oromotor-related outcomes were extracted from the studies. Two researchers independently reviewed all search results following the PRISMA-ScR guideline before meeting to resolve any disagreements. MAIN CONTRIBUTION Final analysis was conducted on 11 papers that described 10 studies, with 10 papers (9 studies) reporting positive findings for swallowing or oromotor function-related outcomes. Studies ranged from randomised controlled trials to case studies in design. The study design and populations were heterogeneous, with outcome measures for swallowing and oromotor function ranging from subjective questionnaires to instrumental assessments. CONCLUSIONS & IMPLICATIONS Dysphagia rehabilitation that incorporates WBE as part of a comprehensive programme appears to be more beneficial than either WBE or swallowing-related interventions alone. This review is an initial attempt to systematically examine the evidence on this topic. There is a need for future research to study how WBE can be used, either alone or combined with traditional swallowing exercises, to influence swallowing function in different healthy and clinical populations. WHAT THIS PAPER ADDS What is already known on this subject Dysphagia rehabilitation usually focuses only on the swallowing muscles and structures of the head, neck, and respiratory system. Whole-body exercise (WBE) and fitness are associated with stronger performance of the tongue muscles, there may be transference potential of WBE to swallowing function. What this paper adds to existing knowledge This review found 10 studies conducted in the last decade that investigated the inclusion of WBE in programmes intended to improve swallowing and/or oromotor-related outcomes. The studies varied widely in design and methodology, but most reported evidence in support of the inclusion of WBE to improve or maintain swallowing and/or oromotor-related functions. What are the potential or actual clinical implications of this work? There is potential for WBE to have a synergistic effect on swallowing function when combined with traditional swallowing exercises. Future clinical research should compare different rehabilitation approaches with controls. Clinicians should enlist allied health professionals who can provide whole-body rehabilitation when managing dysphagia.
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Affiliation(s)
- Dai Pu
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, VIC, Australia
| | - Theresa Jingyun Yao
- Department of Otolaryngology-Head and Neck Surgery, Stanford Health Care, Palo Alto, CA, USA
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Differences between Maximum Tongue Force in Women Suffering from Chronic and Asymptomatic Temporomandibular Disorders-An Observational Study. Life (Basel) 2023; 13:life13010229. [PMID: 36676178 PMCID: PMC9866298 DOI: 10.3390/life13010229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Background: Temporomandibular disorders are craniofacial disorders characterized by the presence of chronic pain in masticatory muscles, with higher incidence in the women population. There is little research that has studied tongue force related to temporomandibular disorders, but there are a lot of studies that have demonstrated the impact of tongue force in vital functions, such as chewing, swallowing, phonation, or breathing. According to this, the aim of this study was to compare the maximum force of the tongue between females with chronic temporomandibular disorders and asymptomatic females. We also wanted to establish whether any relationship existed between the pain and fatigue versus the maximum force developed in females with chronic temporomandibular disorders. Material and methods: A cross-sectional study of 67 women between the ages of 18 and 65 years old was performed. The included women were assigned to one of two groups, according to whether they had chronic temporomandibular disorders or not. The procedure was the same for both groups. Outcome measures included the maximum tongue force, intensity of perceived orofacial pain, and intensity of perceived orofacial fatigue. Results: The results showed significant statistical differences for the maximum tongue force measurement between the chronic temporomandibular disorders group and the control group (p < 0.05) for all the movements, except the lip pressure measurement. Furthermore, the analysis revealed significant statistical differences between the intensity of perceived orofacial fatigue between the groups (p < 0.05). Moreover, the data showed no significant correlations between variables. Conclusion: The study found significant differences in maximum tongue force when comparing women with chronic temporomandibular disorders and asymptomatic women (being superior in these). Likewise, we found that the intensity of perceived orofacial fatigue after tongue exercises showed significant differences between groups. However, this study reveals no correlations between the intensity of perceived orofacial pain and fatigue and the maximum tongue force.
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Yamaguchi K, Nakagawa K, Yoshimi K, Ariya C, Nakane A, Okumura T, Tohara H. The Cross-Sectional Area of the Middle and Base of the Tongue is Associated with Swallowing-Related Muscle Strength. Dysphagia 2022; 37:1723-1731. [PMID: 35278127 DOI: 10.1007/s00455-022-10431-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 02/25/2022] [Indexed: 12/16/2022]
Abstract
Muscle strength and function are generally positively correlated with muscle quantity and negatively correlated with muscle quality; however, the tongue shows a unique tendency, different from limb muscles. The relationship between the characteristics of each part of the tongue, muscle strength and function, and systemic factors has been unclear. The aim of the study was to investigate the relationship between cross-sectional area (CSA) and echo intensity (EI) of the middle and base of the tongue and swallowing, articulation function, and body composition. Eighty-nine healthy individuals were included in this cross-sectional study. Swallowing was assessed using tongue pressure (TP) and jaw opening force (JOF) as they indicate swallowing-related muscle strength. Articulation function was evaluated through oral diadochokinesis (ODK). Bioelectrical impedance analysis was performed for body composition. CSAs and EIs of the middle and base of the tongue were measured using ultrasound. Multiple regression analysis was used to examine the relationship between the characteristics of the tongue, swallowing-related muscle strength, and ODK. In multiple regression analysis with TP as the dependent variable, age (β = - 0.22, P < 0.01) and CSA of the middle part (β = 0.02, P < 0.01) were significant explanatory variables. In multiple regression analysis with JOF as the dependent variable, sex (β = - 2.76, P < 0.01) and CSA of the base (β = - 0.004, P < 0.05) were significant explanatory variables. Multiple regression analysis with articulation function as the dependent variable did not yield significant results. The CSA of the tongue is a better indicator of swallowing-related muscle strength than EI. Ultrasonography may be used for assessing swallowing-related muscle strength.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Chantaramanee Ariya
- Department of Preventive Dentistry, Naresuan University, 99 Moo 9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanlok, Phitsanulok, 65000, Thailand
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan
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Nishimune H, Stanford KG, Chen J, Odum JD, Rorie AD, Rogers RS, Wheatley JL, Geiger PC, Stanford JA. Forelimb Resistance Exercise Protects Against Neuromuscular Junction Denervation in the SOD1-G93A Rat Model of ALS. Degener Neurol Neuromuscul Dis 2022; 12:145-155. [PMID: 36444378 PMCID: PMC9700444 DOI: 10.2147/dnnd.s388455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION The symptoms of Amyotrophic Lateral Sclerosis (ALS) include muscle weakness and eventual paralysis. These symptoms result from denervation of the neuromuscular junction (NMJ) and motor neuron cell death in the brain and spinal cord. Due to the "dying back" pattern of motor neuron degeneration, protecting NMJs should be a therapeutic priority. Although exercise has the potential to protect against NMJ denervation, its use in ALS has been controversial. Most preclinical studies have focused on aerobic exercise, which report that exercise can be beneficial at moderate intensities. The effects of resistance exercise on NMJ preservation in limb muscles have not been explored. METHODS We trained male SOD1-G93A rats, which model ALS, to perform a unilateral isometric forelimb resistance exercise task. This task allows within-animal comparisons of trained and untrained forelimbs. We then determined the effects of isometric resistance exercise on NMJ denervation and AMP kinase (AMPK) activation in forelimb muscles. RESULTS Our results revealed that SOD1-G93A rats were able to learn and perform the task similarly to wildtype rats, even after loss of body weight. SOD1-G93A rats exhibited significantly greater NMJ innervation in their trained vs their untrained forelimb biceps muscles. Measures of activated (phosphorylated) AMPK (pAMPK) were also greater in the trained vs untrained forelimb triceps muscles. DISCUSSION These results demonstrate that isometric resistance exercise may protect against NMJ denervation in ALS. Future studies are required to determine the extent to which our findings generalize to female SOD1-G93A rats and to other subtypes of ALS.
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Affiliation(s)
- Hiroshi Nishimune
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, USA
- Tokyo Metropolitan Institute of Gerontology, Neurobiology of Aging, Tokyo, Japan
| | - Kimberly G Stanford
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jie Chen
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, USA
| | - James D Odum
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Alexander D Rorie
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Robert S Rogers
- Departments of Physiology and Basic Sciences, Kansas City University of Medicine and Biosciences, Joplin, MO, USA
| | - Joshua L Wheatley
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Paige C Geiger
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - John A Stanford
- Department of Molecular and Integrative Physiology, University of Kansas Medical Center, Kansas City, KS, USA
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11
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Bioenergetic Evaluation of Muscle Fatigue in Murine Tongue. Dysphagia 2022:10.1007/s00455-022-10537-y. [DOI: 10.1007/s00455-022-10537-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/26/2022] [Indexed: 11/21/2022]
Abstract
AbstractMuscle fatigue is the diminution of force required for a particular action over time. Fatigue may be particularly pronounced in aging muscles, including those used for swallowing actions. Because risk for swallowing impairment (dysphagia) increases with aging, the contribution of muscle fatigue to age-related dysphagia is an emerging area of interest. The use of animal models, such as mice and rats (murine models) allows experimental paradigms for studying the relationship between muscle fatigue and swallowing function with a high degree of biological precision that is not possible in human studies. The goal of this article is to review basic experimental approaches to the study of murine tongue muscle fatigue related to dysphagia. Traditionally, murine muscle fatigue has been studied in limb muscles through direct muscle stimulation and behavioral exercise paradigms. As such, physiological and bioenergetic markers of muscle fatigue that have been validated in limb muscles may be applicable in studies of cranial muscle fatigue with appropriate modifications to account for differences in muscle architecture, innervation ratio, and skeletal support. Murine exercise paradigms may be used to elicit acute fatigue in tongue muscles, thereby enabling study of putative muscular adaptations. Using these approaches, hypotheses can be developed and tested in mice and rats to allow for future focused studies in human subjects geared toward developing and optimizing treatments for age-related dysphagia.
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12
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Li WY, Jin H, Zou Y, Huang H, Wei Z, Kang J, Xue Y, Wang W. The Different Effect of Tongue Motor Task Training (TTT) and Strength Training (ST) on the Modulation of Genioglossus Corticomotor Excitability and upper airway stability in Rats. Sleep 2022; 45:6648555. [PMID: 35867628 DOI: 10.1093/sleep/zsac170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
STUDY OBJECTIVES the mechanical efficiency of upper airway (UA) muscles are pivotal in maintaining UA stability. We aimed to investigate if different tongue training approaches could differently induce signs of neuroplastic in the corticomotor pathways and upper airway stability changes. METHODS 36 Sprague-Dawley rats were trained daily for eight weeks to lick an isotonic force-sensing disc at targeting forces using 30-50% of maximal achieved lick force (MALF) for tongue task training (TTT) or targeting force set above 50%, 60% and 70% of MALF progressively for tongue strength training (TST). Corticomotor excitability was dynamically assessed by GG response to transcortical magnetic stimulation (TMS) at different sessions. GG EMG activity, GG ultrastructure and myosin heavy chain (MHC), UA dynamics were assessed after eight weeks. RESULTS After 4 weeks, GG TMS latencies decreased in both tongue training groups when compared with the control group (p<0.05) and this excitability was more stable in TTT group. After 8 weeks, both GG TMS response and EMG activity revealed increased excitability in TTT and TST groups. The apoptotic pathological morphology changes of GG ultrastructure were observed in TST group, but not TTT. Percentage of GG MHC type I fibers in TST group was higher than the control and TTT groups (p<0.05). The UA Pcrit decreased significantly in TTT group (p<0.05) and tend to decrease in TST group (p=0.09). CONCLUSION TTT could improve the UA stability and induce the neuroplastic changes more efficiently without training-induced muscle injury, while TST revealed a fatigue-resistance change in GG.
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Affiliation(s)
- Wen-Yang Li
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Hongyu Jin
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Ying Zou
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Hong Huang
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Zhijing Wei
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Jian Kang
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
| | - Yixue Xue
- Neurobiology department, College of Life Science, China Medical University, Shenyang, China
| | - Wei Wang
- Respiratory and critical care department, the First Hospital of China Medical University, Shenyang, China
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13
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Murphy ER, Thompson R, Osman KL, Haxton C, Brothers M, Lee L, Warncke K, Smith CL, Keilholz AN, Hamad A, Golzy M, Bunyak F, Ma L, Nichols NL, Lever TE. A Strength Endurance Exercise Paradigm Mitigates Deficits in Hypoglossal-Tongue Axis Function, Strength, and Structure in a Rodent Model of Hypoglossal Motor Neuron Degeneration. Front Neurosci 2022; 16:869592. [PMID: 35844238 PMCID: PMC9279620 DOI: 10.3389/fnins.2022.869592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/23/2022] [Indexed: 11/18/2022] Open
Abstract
The tongue plays a crucial role in the swallowing process, and impairment can lead to dysphagia, particularly in motor neuron diseases (MNDs) resulting in hypoglossal-tongue axis degeneration (e.g., amyotrophic lateral sclerosis and progressive bulbar palsy). This study utilized our previously established inducible rodent model of dysphagia due to targeted degeneration of the hypoglossal-tongue axis. This model was created by injecting cholera toxin B conjugated to saporin (CTB-SAP) into the genioglossus muscle of the tongue base for retrograde transport to the hypoglossal (XII) nucleus via the hypoglossal nerve, which provides the sole motor control of the tongue. Our goal was to investigate the effect of high-repetition/low-resistance tongue exercise on tongue function, strength, and structure in four groups of male rats: (1) control + sham exercise (n = 13); (2) control + exercise (n = 10); (3) CTB-SAP + sham exercise (n = 13); and (4) CTB-SAP + exercise (n = 12). For each group, a custom spout with adjustable lick force requirement for fluid access was placed in the home cage overnight on days 4 and 6 post-tongue injection. For the two sham exercise groups, the lick force requirement was negligible. For the two exercise groups, the lick force requirement was set to ∼40% greater than the maximum voluntary lick force for individual rats. Following exercise exposure, we evaluated the effect on hypoglossal-tongue axis function (via videofluoroscopy), strength (via force-lickometer), and structure [via Magnetic Resonance Imaging (MRI) of the brainstem and tongue in a subset of rats]. Results showed that sham-exercised CTB-SAP rats had significant deficits in lick rate, swallow timing, and lick force. In exercised CTB-SAP rats, lick rate and lick force were preserved; however, swallow timing deficits persisted. MRI revealed corresponding degenerative changes in the hypoglossal-tongue axis that were mitigated by tongue exercise. These collective findings suggest that high-repetition/low-resistance tongue exercise in our model is a safe and effective treatment to prevent/diminish signs of hypoglossal-tongue axis degeneration. The next step is to leverage our rat model to optimize exercise dosing parameters and investigate corresponding treatment mechanisms of action for future translation to MND clinical trials.
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Affiliation(s)
- Erika R. Murphy
- Department of Speech, Language and Hearing Sciences, School of Health Professions, University of Missouri, Columbia, MO, United States
| | - Rebecca Thompson
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
| | - Kate L. Osman
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Chandler Haxton
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
| | - Margaret Brothers
- Department of Speech, Language and Hearing Sciences, School of Health Professions, University of Missouri, Columbia, MO, United States
| | - Li Lee
- Department of Radiology, School of Medicine, University of Missouri, Columbia, MO, United States
- Research Division, Biomolecular Imaging Center, Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, United States
| | - Kristen Warncke
- Department of Radiology, School of Medicine, University of Missouri, Columbia, MO, United States
- Research Division, Biomolecular Imaging Center, Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, United States
| | - Catherine L. Smith
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
| | - Amy N. Keilholz
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
| | - Ali Hamad
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, United States
| | - Mojgan Golzy
- Biostatistics Unit, Department of Family and Community Medicine, University of Missouri, Columbia, MO, United States
| | - Filiz Bunyak
- Department of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, United States
| | - Lixin Ma
- Department of Radiology, School of Medicine, University of Missouri, Columbia, MO, United States
- Research Division, Biomolecular Imaging Center, Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, United States
| | - Nicole L. Nichols
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO, United States
- *Correspondence: Nicole L. Nichols,
| | - Teresa E. Lever
- Department of Speech, Language and Hearing Sciences, School of Health Professions, University of Missouri, Columbia, MO, United States
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States
- Department of Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
- Teresa E. Lever,
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14
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Yamaguchi K, Nakagawa K, Yoshimi K, Ariya C, Nakane A, Okumura T, Tohara H. Higher extracellular water/total body water ratio is associated with lower tongue and grip strength: a cross-sectional study. J Prosthodont Res 2022; 67:231-237. [PMID: 35732420 DOI: 10.2186/jpr.jpr_d_21_00296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to investigate the relationship between tongue factors (tongue strength and tongue volume), systemic factors (grip strength and walking speed), and the extracellular water/total body water ratio. METHODS This cross-sectional study included community-dwelling adults. Body water composition and skeletal muscle mass index were measured using bioelectrical impedance analysis. Moreover, tongue grip strength, tongue volume, occlusal support condition (Eichner classification), and walking speed were measured. Multiple linear regression analysis was performed to investigate the relationship between the tongue and systemic factors as dependent variables and body water composition. RESULTS We included 171 community-dwelling adults (62 men and 109 women) aged 70.0 years (interquartile range: 8). Tongue strength (r=-0.22, p=0.004) and grip strength (r=-0.39, p<0.001) were correlated with the extracellular water/total body water ratio. In multiple linear regression analysis, tongue strength was associated with the extracellular water/total body water ratio (β=-0.20, p=0.034), and grip strength was associated with the extracellular water/total body water ratio (β=-0.12, p=0.047), sex, body mass index, skeletal muscle mass index, and occlusal support condition. CONCLUSIONS A higher extracellular water/total body water ratio indicates lower tongue and grip strength. Dentists and dental hygienists should be aware of systemic factors present in patients with lower tongue and grip strength. These findings may lead to further medical investigations and diagnosis of other systemic diseases.
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Affiliation(s)
- Kohei Yamaguchi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kazuharu Nakagawa
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Kanako Yoshimi
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Chantaramanee Ariya
- Department of Preventive Dentistry, Naresuan University, 99 Moo 9, Phitsanulok-Nakhon Sawan Road, Tha Pho, Mueang Phitsanlok 65000, Thailand
| | - Ayako Nakane
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Takuma Okumura
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
| | - Haruka Tohara
- Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
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15
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Assays of Tongue Force, Timing, and Dynamics in Rat and Mouse Models. Brain Res Bull 2022; 185:49-55. [PMID: 35469932 PMCID: PMC10187612 DOI: 10.1016/j.brainresbull.2022.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/13/2022] [Accepted: 04/20/2022] [Indexed: 12/18/2022]
Abstract
Communication and swallowing are highly complex sensorimotor events that are tightly linked to respiration and vital to health and well-being. The tongue is a complex organ, often described as a muscular hydrostat, that is crucial for maintaining airway patency, preparing and safely transporting food/liquid, and rapidly changing position and shape for speech. As with any complex behavior, tongue function can be compromised with aging, diseases/conditions, trauma, or as a pharmacologic side effect. As such, modeling lingual function and dysfunction for basic and translational research is paramount; understanding how the nervous system controls tongue function for complex behavior is foundational to this work. Non-invasive access to tongue tissues and kinematics during awake behavior has been historically challenging, creating a critical need to measure tongue function in model systems. Germane to this field of study are the instruments and assays of licking/lapping and drinking, including tongue force and timing measures, many of which were designed or modified by Dr. Stephen C. Fowler. The focus of this paper is to review some of the important contributions of measuring tongue behaviors in awake rats and mice and how these have been modified by other researchers to advance translational science.
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16
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Glass TJ, Figueroa JE, Russell JA, Krekeler BN, Connor NP. Progressive Protrusive Tongue Exercise Does Not Alter Aging Effects in Retrusive Tongue Muscles. Front Physiol 2021; 12:740876. [PMID: 34744782 PMCID: PMC8567011 DOI: 10.3389/fphys.2021.740876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose: Exercise-based treatment approaches for dysphagia may improve swallow function in part by inducing adaptive changes to muscles involved in swallowing and deglutition. We have previously shown that both aging and progressive resistance tongue exercise, in a rat model, can induce biological changes in the genioglossus (GG); a muscle that elevates and protrudes the tongue. However, the impacts of progressive resistance tongue exercise on the retrusive muscles (styloglossus, SG; hyoglossus, HG) of the tongue are unknown. The purpose of this study was to examine the impact of a progressive resistance tongue exercise regimen on the retrusive tongue musculature in the context of aging. Given that aging alters retrusive tongue muscles to more slowly contracting fiber types, we hypothesized that these biological changes may be mitigated by tongue exercise. Methods: Hyoglossus (HG) and styloglossus (SG) muscles of male Fischer 344/Brown Norway rats were assayed in age groups of young (9 months old, n = 24), middle-aged (24 months old, n = 23), and old (32 months old, n = 26), after receiving an 8-week period of either progressive resistance protrusive tongue exercise, or sham exercise conditions. Following exercise, HG and SG tongue muscle contractile properties were assessed in vivo. HG and SG muscles were then isolated and assayed to determine myosin heavy chain isoform (MyHC) composition. Results: Both retrusive tongue muscle contractile properties and MyHC profiles of the HG and SG muscles were significantly impacted by age, but were not significantly impacted by tongue exercise. Old rats had significantly longer retrusive tongue contraction times and longer decay times than young rats. Additionally, HG and SG muscles showed significant MyHC profile changes with age, in that old groups had slower MyHC profiles as compared to young groups. However, the exercise condition did not induce significant effects in any of the biological outcome measures. Conclusion: In a rat model of protrusive tongue exercise, aging induced significant changes in retrusive tongue muscles, and these age-induced changes were unaffected by the tongue exercise regimen. Collectively, results are compatible with the interpretation that protrusive tongue exercise does not induce changes to retrusive tongue muscle function.
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Affiliation(s)
- Tiffany J Glass
- Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, WI, United States
| | | | - John A Russell
- Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, WI, United States
| | - Brittany N Krekeler
- Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, WI, United States.,Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, United States
| | - Nadine P Connor
- Department of Surgery-Otolaryngology, University of Wisconsin-Madison, Madison, WI, United States.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, United States
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17
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Cullins MJ, Russell JA, Booth ZE, Connor NP. Central activation deficits contribute to post stroke lingual weakness in a rat model. J Appl Physiol (1985) 2021; 130:964-975. [PMID: 33600285 DOI: 10.1152/japplphysiol.00533.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Lingual weakness frequently occurs after stroke and is associated with deficits in speaking and swallowing. Chronic weakness after stroke has been attributed to both impaired central activation of target muscles and reduced force-generating capacity within muscles. How these factors contribute to lingual weakness is not known. We hypothesized that lingual weakness due to middle cerebral artery occlusion (MCAO) would manifest as reduced muscle force capacity and reduced muscle activation. Rats were randomized into MCAO or sham surgery groups. Maximum volitional tongue forces were quantified 8 wk after surgery. Hypoglossal nerve stimulation was used to assess maximum stimulated force, muscle twitch properties, and force-frequency response. The central activation ratio was determined by maximum volitional/maximum stimulated force. Genioglossus muscle fiber type properties and neuromuscular junction innervation were assessed. Maximum volitional force and the central activation ratio were significantly reduced with MCAO. Maximum stimulated force was not significantly different. No significant differences were found for muscle twitch properties, unilateral contractile properties, muscle fiber type percentages, or fiber size. However, the twitch/tetanus ratio was significantly increased in the MCAO group relative to sham. A small but significant increase in denervated neuromuscular junctions (NMJs) and fiber-type grouping occurred in the contralesional genioglossus. Results suggest that the primary cause of chronic lingual weakness after stroke is impaired muscle activation rather than a deficit of force-generating capacity in lingual muscles. Increased fiber type grouping and denervated NMJs in the contralesional genioglossus suggest that partial reinnervation of muscle fibers may have preserved force-generating capacity, but not optimal activation patterns.NEW & NOTEWORTHY Despite significant reductions in maximum volitional forces, the intrinsic force-generating capacity of the protrusive lingual muscles was not reduced with unilateral cerebral ischemia. Small yet significant increases in denervated NMJs and fiber-type grouping of the contralesional genioglossus suggest that the muscle underwent denervation and reinnervation. Together these results suggest that spontaneous neuromuscular plasticity was sufficient to prevent atrophy, yet central activation deficits remain and contribute to chronic lingual weakness after stroke.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
| | - John A Russell
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
| | - Zoe E Booth
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin
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18
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Huang H, Li W, Jin H, Zhang L, Wei Z, Wang W. Tongue Strength Training Increases Daytime Upper Airway Stability in Rats. Nat Sci Sleep 2021; 13:1653-1661. [PMID: 34588832 PMCID: PMC8473720 DOI: 10.2147/nss.s328214] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Tongue strength training (TST) has been shown to decrease the apnea-hypopnea index in some patients with obstructive sleep apnea (OSA). However, whether TST modulates the central regulation of genioglossus and influences the stability of the upper airway remains unknown. The purpose of this study was to dynamically assess the effect of TST on the upper airway. METHODS Sixteen adult male Sprague-Dawley rats were studied to explore the mechanism of TST improving the upper airway function. The rats were randomly assigned to the normal control (NC) and TST groups. The TST group underwent 8-week progressive resistance tongue exercise training. Transcranial magnetic stimulation (TMS) responses and EMG activities were consistently recorded for 2 h on days 0, 14, 28, and 56 of the experiments in both groups. Theoretical critical pressure (Pcrit) value was measured on days 0, 14, 28, and 56. RESULTS The TST group showed shorter TMS latency and higher genioglossus EMG activity, which lasted from 5 min to 80 min after training on day 56 of training, than the NC group. The TST group showed significantly lower theoretical Pcrit values on days 28 and 56 of training than the NC group (-4.07±0.92 vs -3.12±0.77 cmH2O, P< 0.05, -4.66±0.74 vs -3.07±0.38 cmH2O, P< 0.01). CONCLUSION This study revealed that an 8-week TST could gradually and transiently increase corticomotor excitability of genioglossus, elevate the genioglossus EMG activity, and ultimately enhance the stability of the upper airway during daytime. Moreover, improved neuromuscular excitability occurred prior to the enhanced upper airway stability. These findings provide a theoretical foundation for TST as a promising treatment for OSA patients.
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Affiliation(s)
- Hong Huang
- Institute of Respiratory and Critical Care, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Wenyang Li
- Institute of Respiratory and Critical Care, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Hongyu Jin
- Institute of Respiratory and Critical Care, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Lei Zhang
- Institute of Respiratory and Critical Care, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Zhijing Wei
- Institute of Respiratory and Critical Care, The First Hospital of China Medical University, Shenyang, People's Republic of China
| | - Wei Wang
- Institute of Respiratory and Critical Care, The First Hospital of China Medical University, Shenyang, People's Republic of China
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19
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Kletzien H, Kelm-Nelson CA, Wang S, Suzuki M, Connor NP. Myogenic marker expression as a function of age and exercise-based therapy in the tongue. Exp Gerontol 2020; 142:111104. [PMID: 33017670 PMCID: PMC7748063 DOI: 10.1016/j.exger.2020.111104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/29/2020] [Accepted: 09/24/2020] [Indexed: 12/30/2022]
Abstract
Degeneration of tongue muscles with aging may contribute to swallowing deficits observed in elderly people. However, the capacity for tongue muscle stem cells (SCs) to regenerate and repair the aged tongue and improve tongue strength following tongue exercise (a current clinical treatment) has never been examined. We found that the expression of regenerative, myogenic markers were impaired with age and may be related to increased expression of senescent marker p16INK4a. Tongue strength increased in young adult and old rats following exercise and was related to the expression of Pax7, MyoD, myogenin, and p16INK4a. Our study also suggests that strengthening of tongue muscles via clinical rehabilitation strategies also increased the expression of SC regenerative markers in the tongue throughout the exercise duration.
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Affiliation(s)
- Heidi Kletzien
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States of America; Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America; Department of Stem Cell and Regenerative Biology, Harvard University, United States of America.
| | - Cynthia A Kelm-Nelson
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America
| | - Sabrina Wang
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America
| | - Masatoshi Suzuki
- Department of Biomedical Engineering, University of Wisconsin-Madison, United States of America; Department of Comparative Biosciences, University of Wisconsin-Madison, United States of America
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, United States of America
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20
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Krekeler BN, Weycker JM, Connor NP. Effects of Tongue Exercise Frequency on Tongue Muscle Biology and Swallowing Physiology in a Rat Model. Dysphagia 2020; 35:918-934. [PMID: 32130514 DOI: 10.1007/s00455-020-10105-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/25/2020] [Indexed: 11/28/2022]
Abstract
Age-related changes in muscle composition and function are often treated using exercise, including muscles of the tongue to treat swallowing impairments (dysphagia). Although tongue exercise is commonly prescribed, optimal tongue exercise doses have not been determined. The purpose of this study was to evaluate effects of varying tongue exercise frequency on tongue force, genioglossus muscle fiber size, composition and metabolism, and swallowing in a rat model. We randomized 41 old and 40 young adult Fischer 344/Brown Norway rats into one of four tongue exercise groups: 5 days/week; 3 days/week; 1 day/week; or sham. Tongue force was higher following all exercise conditions (vs sham); the 5 day/week group had the greatest change in tongue force (p < 0.001). There were no exercise effects on genioglossus (GG) fiber size or MyHC composition (p > 0.05). Significant main effects for age showed a greater proportion of Type I fibers in (p < 0.0001) and increased fiber size of IIa fibers (p = 0.026) in old. There were no significant effects of citrate synthase activity or PGC-1α expression. Significant differences were found in bolus speed and area (size), but findings were potentially influenced by variability. Our findings suggest that tongue force is influenced by exercise frequency; however, these changes were not reflected in characteristics of the GG muscle assayed in this study. Informed by findings of this study, future work in tongue dose optimization will be required to provide better scientific premise for clinical treatments in humans.
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Affiliation(s)
- Brittany N Krekeler
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Goodnight Hall, 1300 University Ave, Madison, WI, 53706, USA. .,Department of Surgery-Otolaryngology, Clinical Science Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA. .,Department of Communication Sciences and Disorders, Northwestern University, Swallowing Cross-Systems Collaborative, 2240 Campus Drive, Evanston, IL, 60208, USA.
| | - Jacqueline M Weycker
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Goodnight Hall, 1300 University Ave, Madison, WI, 53706, USA.,Department of Surgery-Otolaryngology, Clinical Science Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA
| | - Nadine P Connor
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Goodnight Hall, 1300 University Ave, Madison, WI, 53706, USA.,Department of Surgery-Otolaryngology, Clinical Science Center, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA
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Cullins MJ, Wenninger JM, Cullen JS, Russell JA, Kleim JA, Connor NP. Tongue Force Training Induces Plasticity of the Lingual Motor Cortex in Young Adult and Aged Rats. Front Neurosci 2019; 13:1355. [PMID: 31920514 PMCID: PMC6931318 DOI: 10.3389/fnins.2019.01355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/02/2019] [Indexed: 11/24/2022] Open
Abstract
Tongue exercise programs are used clinically for dysphagia in aged individuals and have been shown to improve lingual strength. However, the neural mechanisms of age-related decline in swallowing function and its association with lingual strength are not well understood. Using an established rat model of aging and tongue exercise, we hypothesized that the motor cortex of aged rats would have a smaller lingual motor map area than young adult rats and would increase in size as a function of tongue exercise. Over 8 weeks, rats either underwent a progressive resistance tongue exercise program (TE), learned the task but did not exercise (trained controls, TC), or were naïve untrained controls (UC). Cortical motor map areas for tongue and jaw were determined using intracortical microstimulation (ICMS). Rats in the TE and TC groups had a significantly larger motor cortex region for the tongue than the UC group. Lingual cortical motor area was not correlated with protrusive tongue force gains and did not differ significantly with age. These results suggest that learning a novel tongue force skill was sufficient to induce plasticity of the lingual motor cortex yet increasing tongue strength with progressive resistance exercise did not significantly expand the lingual motor area beyond the gains that occurred through the skilled learning component.
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Affiliation(s)
- Miranda J. Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
- *Correspondence: Miranda J. Cullins,
| | - Julie M. Wenninger
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Jared S. Cullen
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - John A. Russell
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
| | - Jeffrey A. Kleim
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ, United States
| | - Nadine P. Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, WI, United States
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22
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Lin HY, Su PL, Lin CY, Hung CH. Models of anatomically based oropharyngeal rehabilitation with a multilevel approach for patients with obstructive sleep apnea: a meta-synthesis and meta-analysis. Sleep Breath 2019; 24:1279-1291. [PMID: 31836993 DOI: 10.1007/s11325-019-01971-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/17/2019] [Accepted: 11/02/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) is a sleep-related breathing disorder associated with dysfunction of oropharyngeal muscles to maintain upper airway patency during sleep. Oropharyngeal rehabilitation (OPR) was developed to restore, reconstruct, and reeducate oropharyngeal muscle function, but current protocols and effectiveness of OPR have been inconsistent. The purpose of this study was to review (1) indications of OPR, (2) protocols of OPR, and (3) effectiveness of OPR. METHODS We searched MEDLINE, EMBASE, and the Cochrane Library and then conducted both meta-synthesis and meta-analysis according to the statement of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). RESULTS A total of eight studies with 203 patients were included. By means of meta-synthesis, the patients with middle age, BMI < 40 kg/m2, mild-to-moderate OSA, and non-severe upper airway anatomical abnormality were found to benefit from OPR. The protocol of OPR was summarized to be an anatomically based, multilevel approach, including the retropalatal, retroglossal, hypopharyngeal, TMJ, and facial levels. By using meta-analysis, overall outcomes were presented as apnea hypopnea index (AHI) with significant improvement from 25.2 ± 7.8/h to 16.1 ± 6.6/h (mean difference [MD] - 9.8 [95% CI - 11.0 to - 8.6], p < 0.0001); the lowest oxygen saturation (LSAT) improved from 80.2 ± 4.7 to 83.8 ± 2.9% (MD 3.0% [95% CI 2.0 to 4.0], p < 0.0001); Epworth sleepiness scale (ESS) improved from 11.8 ± 1.9 to 6.3 ± 1.6 (MD - 5.9 [95% CI - 7.5 to - 4.2], p < 0.001), neck circumference (NC) from 35.2 ± 1.1 to 34.7 ± 0.9 cm (MD - 0.6 [95% CI - 0.9 to - 0.2], p = 0.002), BMI from 24.8 ± 3.7 to 24.8 ± 4.1 kg/m2 (MD - 0.0; 95% CI - 0.5 to 0.5, p = 0.95). All outcomes except BMI demonstrated significant improvement from OPR. CONCLUSIONS Meta-analysis of previous OPR reports shows an improvement in AHI of 39%, compared with the usual surgical definition of success at 50%. Only mild and moderate cases of OSA were referred for OPR in the prior studies. In order to improve outcomes with OPR, a comprehensive approach to rehabilitation should be emphasized.
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Affiliation(s)
- Hsin-Yu Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, East District, Tainan City, 701, Taiwan
| | - Po-Lan Su
- Department of Internal Medicine, Division of Pulmonary, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Road, North District, Tainan City, 704, Taiwan
| | - Cheng-Yu Lin
- Department of Otolaryngology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Road, North District, Tainan City, 704, Taiwan.,Department of Environmental and Occupational Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Road, North District, Tainan City, 704, Taiwan.,Sleep Medicine Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138, Sheng-Li Road, North District, Tainan City, 704, Taiwan
| | - Ching-Hsia Hung
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, East District, Tainan City, 701, Taiwan. .,Department of Physical Therapy, College of Medicine, National Cheng Kung University, No. 1 Ta-Hsueh Road, East District, Tainan City, 701, Taiwan.
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23
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Cullins MJ, Connor NP. Reduced tongue force and functional swallowing changes in a rat model of post stroke dysphagia. Brain Res 2019; 1717:160-166. [PMID: 31022397 DOI: 10.1016/j.brainres.2019.04.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE Dysphagia is a common problem after stroke that is often associated with tongue weakness. However, the physiological mechanisms of post-stroke tongue muscle weakness and optimal treatments have not been established. To advance understanding of physiological mechanisms of post stroke dysphagia, we sought to validate the unilateral transient middle cerebral artery occlusion (MCAO) rat model of ischemic stroke as a translational model of post stroke dysphagia. Our goal was to establish clinically relevant measures and chronicity of functional deficits; criteria that increase the likelihood that findings will translate to the clinic. We hypothesized that MCAO would cause tongue weakness and functional swallowing changes. METHODS Maximum voluntary tongue forces and videofluoroscopic swallowing studies were collected in 8-week old male Sprague-Dawley rats prior to receiving either a left MCAO (N = 10) or sham (N = 10) surgery. Tongue forces and VFSS were reassessed at 1 and 8 weeks post-surgery. RESULTS Maximum voluntary tongue force, bolus area, and bolus speed were significantly reduced in the MCAO group at the 1 and 8-week timepoints. CONCLUSION Clinically relevant changes to swallowing and tongue force support the use of the MCAO rat model as a translational model of post stroke dysphagia. This model will allow for future studies to improve our understanding of the physiology contributing to these functional changes as well as the impact of therapeutic interventions on physiological targets and function.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, United States.
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, United States
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24
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Glass TJ, Kelm-Nelson CA, Russell JA, Szot JC, Lake JM, Connor NP, Ciucci MR. Laryngeal muscle biology in the Pink1-/- rat model of Parkinson disease. J Appl Physiol (1985) 2019; 126:1326-1334. [PMID: 30844333 DOI: 10.1152/japplphysiol.00557.2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Neuromuscular pathology is found in the larynx and pharynx in humans with Parkinson disease (PD); however, it is unknown when this pathology emerges. We hypothesized that pathology occurs in early (premanifest) stages. To address this, we used the Pink1-/- rat model of PD, which shows age-dependent dopaminergic neuron loss, locomotor deficits, and deficits related to laryngeal function. We report findings in the thyroarytenoid muscle (TA) in Pink1-/- rats compared with wild-type (WT) control rats at 4 and 6 mo of age. TAs were analyzed for force production, myosin heavy chain isoform (MyHC), centrally nucleated myofibers, neural cell adhesion molecule, myofiber size, and muscle section size. Compared with WT, Pink1-/- TA had reductions in force levels at 1-Hz stimulation and 20-Hz stimulation, increases in relative levels of MyHC 2L, increases in incidence of centrally nucleated myofibers in the external division of the TA, and reductions in myofiber size of the vocalis division of the TA at 6 mo of age. Alterations of laryngeal muscle biology occur in a rat model of premanifest PD. Although these alterations are statistically significant, their functional significance remains to be determined. NEW & NOTEWORTHY Pathology of peripheral nerves and muscle has been reported in the larynx and pharynx of humans diagnosed with Parkinson disease (PD); however, it is unknown whether differences of laryngeal muscle occur at premanifest stages. This study examined the thyroarytenoid muscles of the Pink1-/- rat model of PD for differences of muscle biology compared with control rats. Thyroarytenoid muscles of Pink1-/- rats at premanifest stages show differences in multiple measures of muscle biology.
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Affiliation(s)
- Tiffany J Glass
- Department of Surgery, University of Wisconsin , Madison, Wisconsin
| | | | - John A Russell
- Department of Surgery, University of Wisconsin , Madison, Wisconsin
| | - John C Szot
- Department of Surgery, University of Wisconsin , Madison, Wisconsin
| | - Jacob M Lake
- Department of Surgery, University of Wisconsin , Madison, Wisconsin
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin , Madison, Wisconsin.,Department of Communication Sciences and Disorders, University of Wisconsin , Madison, Wisconsin
| | - Michelle R Ciucci
- Department of Surgery, University of Wisconsin , Madison, Wisconsin.,Department of Communication Sciences and Disorders, University of Wisconsin , Madison, Wisconsin
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25
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Kletzien H, Cullins MJ, Connor NP. Age-related alterations in swallowing biomechanics. Exp Gerontol 2019; 118:45-50. [PMID: 30633957 DOI: 10.1016/j.exger.2019.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/14/2018] [Accepted: 01/06/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Aging rodent models allow for the discovery of underlying mechanisms of cranial muscle dysfunction. Methods are needed to allow quantification of complex, multivariate biomechanical movements during swallowing. Videofluoroscopic swallow studies (VSS) are the standard of care in assessment of swallowing disorders in patients and validated quantitative, kinematic, and morphometric analysis methods have been developed. Our purpose was to adapt validated morphometric techniques to the rodent to computationally analyze swallowing dysfunction in the aging rodent. METHODS VSS, quantitative analyses (bolus area, bolus velocity, mastication rate) and a rodent specific multivariate, morphometric computational analysis of swallowing biomechanics were performed on 20 swallows from 5 young adult and 5 old Fischer 344/Brown Norway rats. Eight anatomical landmarks were used to track the relative change in position of skeletal levers (cranial base, vertebral column, mandible) and soft tissue landmarks (upper esophageal sphincter, base of tongue). RESULTS Bolus area significantly increased and mastication rate significantly decreased with age. Aging accounted for 77.1% of the variance in swallow biomechanics, and 18.7% of the variance was associated with swallow phase (oral vs pharyngeal). Post hoc analyses identified age-related alterations in tongue base retraction, mastication, and head posture during the swallow. CONCLUSION Geometric morphometric analysis of rodent swallows suggests that swallow biomechanics are altered with age. When used in combination with biological assays of age-related adaptations in neuromuscular systems, this multivariate analysis may increase our understanding of underlying musculoskeletal dysfunction that contributes to swallowing disorders with aging.
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Affiliation(s)
- Heidi Kletzien
- Division of Otolaryngology-Head and Neck Cancer, Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America; Department of Biomedical Engineering, University of Wisconsin-Madison, United States of America.
| | - Miranda J Cullins
- Division of Otolaryngology-Head and Neck Cancer, Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America
| | - Nadine P Connor
- Division of Otolaryngology-Head and Neck Cancer, Department of Surgery, University of Wisconsin School of Medicine and Public Health, United States of America; Department of Biomedical Engineering, University of Wisconsin-Madison, United States of America; Department of Communication Sciences and Disorders, University of Wisconsin-Madison, United States of America
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26
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Glass TJ, Twadell SL, Valmadrid LC, Connor NP. Early impacts of modified food consistency on oromotor outcomes in mouse models of Down syndrome. Physiol Behav 2018; 199:273-281. [PMID: 30496741 DOI: 10.1016/j.physbeh.2018.11.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/16/2018] [Accepted: 11/25/2018] [Indexed: 12/12/2022]
Abstract
Down syndrome (DS) in humans is associated with differences of the central nervous system and oromotor development. DS also increases risks for pediatric feeding challenges, which sometimes involve the use of altered food consistencies. Therefore, experimental food consistency paradigms are of interest to oromotor investigations in mouse models of Down syndrome (DS). The present work reports impacts of an altered food consistency paradigm on the Ts65Dn and Dp(16)1Yey mouse models of DS, and sibling control mice. At weaning, Ts65Dn, Dp(16)1Yey and respective controls were assigned to receive either a hard food or a soft food (eight experimental groups, n = 8-10 per group). Two weeks later, mice were assessed for mastication speeds and then euthanized for muscle analysis. Soft food conditions were associated with significantly smaller weight gain (p = .003), significantly less volitional water intake through licking (p = .0001), and significant reductions in size of anterior digastric myofibers positive for myosin heavy chain isoform (MyHC) 2b (p = .049). Genotype was associated with significant differences in weight gain (p = .004), significant differences in mastication rate (p = .001), significant differences in a measure of anterior digastric muscle size (p = .03), and significant reductions in size of anterior digastric myofibers positive for MyHC 2a (p = .04). In multiple measures, the Ts65Dn model of DS was more affected than other genotype groups. Findings indicate a soft food consistency condition in mice is associated with significant reductions in weight gain and oromotor activity, and may impact digastric muscle. This suggests extended periods of food consistency modifications may have impacts that extend beyond their immediate roles in facilitating deglutition.
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Affiliation(s)
- Tiffany J Glass
- Department of Surgery, University of Wisconsin, Madison, WI, USA.
| | - Sara L Twadell
- Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - Luke C Valmadrid
- Department of Surgery, University of Wisconsin, Madison, WI, USA
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin, Madison, WI, USA; Department of Communication Sciences and Disorders, University of Wisconsin, Madison, WI, USA
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27
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Relationship between swallowing muscles and trunk muscle mass in healthy elderly individuals: A cross-sectional study. Arch Gerontol Geriatr 2018; 79:21-26. [DOI: 10.1016/j.archger.2018.07.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 01/27/2023]
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28
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VanRavenhorst‐Bell HA, Coufal KL, Patterson JA, Mefferd AS. A comparative study: tongue muscle performance in weightlifters and runners. Physiol Rep 2018; 6:e13923. [PMID: 30460755 PMCID: PMC6246939 DOI: 10.14814/phy2.13923] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 10/19/2018] [Indexed: 12/05/2022] Open
Abstract
Exercise mode (i.e., resistance training, endurance training) is known to yield mode-specific effects on strength and endurance of muscles that are directly targeted during the exercise. Such mode-specific effects can also be observed in indirectly involved (i.e., nontargeted) muscles. Mode-specific muscle performance changes of nontargeted muscles, however, have only been investigated within the skeletal system. Therefore, as a first step, this study aimed to determine if bulbar muscle performance (tongue strength [TS], tongue endurance [TE]) differs between weightlifters and runners and if group differences are tongue region-specific. The Iowa Oral Performance Instrument (IOPI) was used to measure TS and TE of the anterior and posterior tongue regions in 21 weightlifters and 23 runners. In weightlifters anterior TS was significantly greater than posterior TS (P = 0.008), whereas in runners anterior and posterior TS were comparable. Furthermore, weightlifters produced significantly greater anterior TS than runners (P = 0.001). Finally, TE was overall significantly greater in runners than in weightlifters (P = 0.001). Findings suggest that exercise mode may differentially impact performance patterns of nontargeted bulbar muscles. More research is warranted to better understand the mechanisms underlying tongue muscle performance differences between weightlifters and runners.
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Affiliation(s)
| | - Kathy L. Coufal
- Department of Special Education & Communication Disorders, EducationUniversity of NebraskaOmahaNE
| | | | - Antje S. Mefferd
- Department of Hearing and Speech SciencesVanderbilt UniversityNashvilleTN
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29
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Rogus-Pulia N, Wirth R, Sloane PD. Dysphagia in Frail Older Persons: Making the Most of Current Knowledge. J Am Med Dir Assoc 2018; 19:736-740. [DOI: 10.1016/j.jamda.2018.07.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 07/24/2018] [Indexed: 02/03/2023]
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Kletzien H, Russell JA, Leverson G, Connor NP. Effect of neuromuscular electrical stimulation frequency on muscles of the tongue. Muscle Nerve 2018; 58:441-448. [PMID: 29797723 DOI: 10.1002/mus.26173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 05/09/2018] [Accepted: 05/11/2018] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Neuromuscular electrical stimulation (NMES) for the treatment of swallowing disorders is delivered at a variety of stimulation frequencies. We examined the effects of stimulation frequency on tongue muscle plasticity in an aging rat model. METHODS Eighty-six young, middle-aged, and old rats were assigned to either bilateral hypoglossal nerve stimulation at 10 or 100 Hz (5 days/week, 8 weeks), sham, or no-implantation conditions. Muscle contractile properties and myosin heavy chain (MyHC) composition were determined for hyoglossus (HG) and styloglossus (SG) muscles. RESULTS Eight weeks of 100-Hz stimulation resulted in the greatest changes in muscle contractile function with significantly longer contraction and half-decay times, the greatest reduction in fatigue, and a transition toward slowly contracting, fatigue-resistant MyHC isoforms. DISCUSSION NMES at 100-Hz induced considerable changes in contractile and phenotypic profiles of HG and SG muscles, suggesting higher frequency NMES may yield a greater therapeutic effect. Muscle Nerve, 2018.
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Affiliation(s)
- Heidi Kletzien
- Department of Biomedical Engineering University of Wisconsin-Madison, 1300 University Avenue, Room 481, Madison, Wisconsin 53706, USA
| | - John A Russell
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Glen Leverson
- Department of Surgery, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Nadine P Connor
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, Wisconsin, USA
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31
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Valarelli LP, Corradi AMB, Grechi TH, Eckeli AL, Aragon DC, Küpper DS, Almeida LA, Sander HH, de Felício CM, Trawitzki LVV, Valera FCP. Cephalometric, muscular and swallowing changes in patients with OSAS. J Oral Rehabil 2018; 45:692-701. [DOI: 10.1111/joor.12666] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- L. P. Valarelli
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - A. M. B. Corradi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - T. H. Grechi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - A. L. Eckeli
- Division of Neurology; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - D. C. Aragon
- Department of Pediatrics; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - D. S. Küpper
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - L. A. Almeida
- Division of Neurology; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - H. H. Sander
- Division of Neurology; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - C. M. de Felício
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - L. V. V. Trawitzki
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
| | - F. C. P. Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery; Medical School of Ribeirão Preto; University of São Paulo; Ribeirão Preto Brazil
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Krekeler BN, Leverson G, Connor NP. Tongue exercise and ageing effects on morphological and biochemical properties of the posterior digastric and temporalis muscles in a Fischer 344 Brown Norway rat model. Arch Oral Biol 2018; 89:37-43. [PMID: 29438907 DOI: 10.1016/j.archoralbio.2018.02.002] [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] [Received: 04/24/2017] [Revised: 01/26/2018] [Accepted: 02/04/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study sought to examin effects of age and tongue exercise on the posterior digastric (opener) and the temporalis (closer). We hypothesized 1) age would result in differing morphological (cross sectional area) and biochemical (myosin heavy chain isoform) components of these muscles; 2) tongue exercise would result in coactivation of these muscles inducing a decrease in age-related differences between age groups. DESIGN Young adult (9 months) and old (32 months) Fischer 344 Brown Norway rats were randomized into a tongue exercise or control group. Post-training, posterior digastric and temporalis muscles were harvested and analyzed using: 1) Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) to assess percent myosin heavy chain (MyHC) content; 2) Immunohistochemical staining to determine cross sectional area (CSA). RESULTS A larger proportion of slowly contracting MyHC isoforms in the posterior digastric and temporalis muscles were found in old. No significant main effects for age or exercise in fiber size were found in posterior digastric muscle. An interaction between age and exercise for temporalis cross sectional area indicated the old exercise group had smaller average cross sectional area than all other groups. CONCLUSIONS FINDINGS: suggest that: 1) Increasing age induces biochemical changes in muscles of the jaw, specifically showing an increase the proportion of slower contracting MyHC isoforms; 2) Increasing age and tongue exercise induce a reduction in muscle fiber cross sectional area in the temporalis muscle only. However, continued study of these cranial muscle systems is warranted to better understand these changes that occur with age and exercise.
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Affiliation(s)
- Brittany N Krekeler
- Department of Communication Sciences and Disorders, Goodnight Hall, 1975 Willow Drive, Madison, WI, 53706, United States; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, K4/7 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792, United States.
| | - Glen Leverson
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, K4/7 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792, United States
| | - Nadine P Connor
- Department of Communication Sciences and Disorders, Goodnight Hall, 1975 Willow Drive, Madison, WI, 53706, United States; Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, K4/7 Clinical Sciences Center, 600 Highland Avenue, Madison, WI 53792, United States
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Cullins MJ, Krekeler BN, Connor NP. Differential impact of tongue exercise on intrinsic lingual muscles. Laryngoscope 2017; 128:2245-2251. [PMID: 29243257 DOI: 10.1002/lary.27044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/18/2017] [Accepted: 11/09/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Aging is associated with muscle fiber hypotrophy and decreased percentages of rapidly contracting myosin heavy chain (MyHC) type IIb muscle fibers. Tongue exercise programs used to treat dysphagia target age-related decline in tongue muscle function, but the impact of exercise on the intrinsic tongue muscles is unknown. We hypothesized that exercise would induce muscle fiber hypertrophy and increase the percentage of MyHC IIa fibers in the intrinsic tongue. STUDY DESIGN Animal model. METHODS Eight old and eight young-adult rats underwent 8 weeks of tongue exercise training, and 8 animals of each age group served as controls. Longitudinal, transverse, and verticalis muscle samples from the anterior, middle, and posterior regions of the tongue were sectioned and stained to determine muscle fiber diameter and MyHC composition. RESULTS MyHC fiber type distribution was altered by exercise, and the effects differed by muscle and region of the tongue. In the exercise groups, as compared to the control groups, the anterior transverse and middle superior longitudinal muscles had significantly reduced percentages of MyHC IIx positive fibers and higher percentages of rapidly contracting fatigable MyHC IIb positive muscle fibers, whereas the middle transverse and posterior longitudinal muscles had increased percentages of the less rapidly contracting and more fatigue-resistant MyHC IIa fibers. The impact of exercise did not differ with age, as there was no significant interaction between age and exercise. Tongue exercise had no significant effect on muscle fiber diameter. CONCLUSIONS The impact of exercise varied among the tongue muscles, which may indicate different functional contributions to the tongue exercise task. LEVEL OF EVIDENCE NA Laryngoscope, 128:2245-2251, 2018.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
| | - Brittany N Krekeler
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A
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34
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Van den Steen L, Schellen C, Verstraelen K, Beeckman AS, Vanderwegen J, De Bodt M, Van Nuffelen G. Tongue-Strengthening Exercises in Healthy Older Adults: Specificity of Bulb Position and Detraining Effects. Dysphagia 2017; 33:337-344. [PMID: 29052051 DOI: 10.1007/s00455-017-9858-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/12/2017] [Indexed: 10/18/2022]
Abstract
Clinical tongue-strengthening therapy programs are generally based on the principles of exercise and motor learning, including the specificity paradigm. The aim of this study was to investigate the specific effect of anterior and posterior tongue-strengthening exercises (TSE) on tongue strength (TS) in healthy older adults and to measure possible detraining effects. Sixteen healthy elderly completed 8 weeks of TSE by means of the Iowa Oral Performance Instrument (IOPI). They were distributed in two different treatment arms and performed either exclusively anterior or posterior TSE (ATSE, n = 9 or PTSE, n = 7) depending on the treatment arm. Anterior and posterior maximal isometric pressures (MIPA, MIPP) were measured at baseline, halfway, and after completion of the training sessions. Detraining was measured by repeating MIPA and MIPP measures 4 weeks after the last session of TSE. MIPA and MIPP increased significantly in both treatment arms. MIPA was significantly higher in the ATSE group compared to the PTSE group across all measures in time. No significant differences were observed in MIPP between the ATSE and PTSE groups. Regardless of treatment arm, there was no significant detraining effect measured 4 weeks after the last TSE session. This study suggests that TSE show partial specificity concerning bulb position. We conclude that especially anterior training results in higher anterior TS in comparison with posterior exercises. Furthermore, we found no detraining effects, independent of bulb location.
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Affiliation(s)
- Leen Van den Steen
- Department of Otolaryngology and Head & Neck Surgery - Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Wilrijkstraat 10 Edegem, 2650, Antwerp, Belgium. .,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1 Wilrijk, 2610, Antwerp, Belgium.
| | - Charlotte Schellen
- University College Arteveldehogeschool, Voetweg 66, 9000, Ghent, Belgium
| | - Katja Verstraelen
- University College Arteveldehogeschool, Voetweg 66, 9000, Ghent, Belgium
| | | | - Jan Vanderwegen
- University College Thomas More, Molenstraat 8, 2018, Antwerp, Belgium.,CHU Saint-Pierre, Hoogstraat 322, 1000, Brussels, Belgium
| | - Marc De Bodt
- Department of Otolaryngology and Head & Neck Surgery - Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Wilrijkstraat 10 Edegem, 2650, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1 Wilrijk, 2610, Antwerp, Belgium.,Faculty of Speech, Pathology and Audiology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Gwen Van Nuffelen
- Department of Otolaryngology and Head & Neck Surgery - Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Wilrijkstraat 10 Edegem, 2650, Antwerp, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1 Wilrijk, 2610, Antwerp, Belgium.,Faculty of Speech, Pathology and Audiology, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
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Kletzien H, Hare AJ, Leverson G, Connor NP. Age-related effect of cell death on fiber morphology and number in tongue muscle. Muscle Nerve 2017; 57:E29-E37. [PMID: 28440544 DOI: 10.1002/mus.25671] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/30/2017] [Accepted: 04/17/2017] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Multiple pathways may exist for age-related tongue muscle degeneration. Cell death is one mechanism contributing to muscle atrophy and decreased function. We hypothesized with aging, apoptosis, and apoptotic regulators would be increased, and muscle fiber size and number would be reduced in extrinsic tongue muscles. METHODS Cell death indices, expression of caspase-3 and Bcl-2, and measures of muscle morphology and number were determined in extrinsic tongue muscles of young and old rats. RESULTS Significant increases in cell death, caspase-3, and Bcl-2 were observed in all extrinsic tongue muscles along with reductions in muscle fiber number in old rats. DISCUSSION We demonstrated that apoptosis indices increase with age in lingual muscles and that alterations in apoptotic regulators may be associated with age-related degeneration in muscle fiber size and number. These observed apoptotic processes may be detrimental to muscle function, and may contribute to degradation of cranial functions with age. Muscle Nerve 57: E29-E37, 2018.
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Affiliation(s)
- Heidi Kletzien
- University of Wisconsin-Madison, Department of Biomedical Engineering, Madison, Wisconsin, USA
| | - Allison J Hare
- University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, Wisconsin, USA
| | - Glen Leverson
- University of Wisconsin School of Medicine and Public Health, Department of Surgery, Madison, Wisconsin, USA
| | - Nadine P Connor
- University of Wisconsin-Madison, Department of Communication Sciences and Disorders, Madison, Wisconsin, USA
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Cullins MJ, Connor NP. Alterations of intrinsic tongue muscle properties with aging. Muscle Nerve 2017; 56:E119-E125. [PMID: 28181263 DOI: 10.1002/mus.25605] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 01/27/2017] [Accepted: 02/03/2017] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Age-related decline in the intrinsic lingual musculature could contribute to swallowing disorders, yet the effects of age on these muscles is unknown. We hypothesized there is reduced muscle fiber size and shifts to slower myosin heavy chain (MyHC) fiber types with age. METHODS Intrinsic lingual muscles were sampled from 8 young adult (9 months) and 8 old (32 months) Fischer 344/Brown Norway rats. Fiber size and MyHC were determined by fluorescent immunohistochemistry. RESULTS Age was associated with a reduced number of rapidly contracting muscle fibers, and more slowly contracting fibers. Decreased fiber size was found only in the transverse and verticalis muscles. DISCUSSION Shifts in muscle composition from faster to slower MyHC fiber types may contribute to age-related changes in swallowing duration. Decreasing muscle fiber size in the protrusive transverse and verticalis muscles may contribute to reductions in maximum isometric tongue pressure found with age. Differences among regions and muscles may be associated with different functional demands. Muscle Nerve 56: E119-E125, 2017.
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Affiliation(s)
- Miranda J Cullins
- Department of Surgery, University of Wisconsin-Madison, 1300 University Avenue, Madison, Wisconsin, 53706, USA
| | - Nadine P Connor
- Department of Surgery, University of Wisconsin-Madison, 1300 University Avenue, Madison, Wisconsin, 53706, USA
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VanRavenhorst-Bell HA, Mefferd AS, Coufal KL, Scudder R, Patterson J. Tongue strength and endurance: Comparison in active and non-active young and older adults. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 19:77-86. [PMID: 27093223 DOI: 10.3109/17549507.2016.1154983] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE Tongue strength and endurance are important for swallowing and upper airway patency. Physical activity positively affects targeted and non-targeted skeletal muscles; however, little is known about the indirect effect of physical activity on tongue muscles. This study sought to determine if tongue muscle performance differs between highly active and non-active individuals and if such an effect varies with age. METHOD Forty-eight healthy adults were divided into two age groups (24 young, 20.96 ± 3.22 years; 24 older, 65 ± 3.72 years) and further divided into highly active and non-active based on The General Practice Physical Activity Questionnaire. Tongue strength (TS) and tongue endurance (TE) were obtained using the Iowa Oral Performance Instrument. RESULT A significant main effect of activity level on TS and TE was found. Although the main effect of age on TS and TE and age × activity level interactions were not significant, the effect of activity level on TS and TE was more pronounced in older adults than younger adults. CONCLUSION Findings suggest physical activity may affect TS and TE, particularly in older adults. Future research is warranted to understand the underlying mechanisms contributing to these group differences. Clinical implications of these findings are discussed.
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Affiliation(s)
| | - Antje S Mefferd
- b Hearing and Speech Sciences, Vanderbilt University Medical Center , Nashville , TN , USA , and
| | - Kathy L Coufal
- c Communication Sciences and Disorders, Wichita State University , Wichita , KS , USA
| | - Rosalind Scudder
- c Communication Sciences and Disorders, Wichita State University , Wichita , KS , USA
| | - Jeremy Patterson
- a Human Performance Studies, Wichita State University , Wichita , KS , USA
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Rogus-Pulia N, Connor NP. Muscle Strengthening Approaches to Dysphagia Rehabilitation. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2016. [DOI: 10.1007/s40141-016-0136-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Glass TJ, Connor NP. Digastric Muscle Phenotypes of the Ts65Dn Mouse Model of Down Syndrome. PLoS One 2016; 11:e0158008. [PMID: 27336944 PMCID: PMC4919106 DOI: 10.1371/journal.pone.0158008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/08/2016] [Indexed: 12/18/2022] Open
Abstract
Down syndrome is frequently associated with complex difficulties in oromotor development, feeding, and swallowing. However, the muscle phenotypes underlying these deficits are unclear. We tested the hypotheses that the Ts65Dn mouse model of DS has significantly altered myosin heavy chain (MyHC) isoform profiles of the muscles involved in feeding and swallowing, as well as reductions in the speed of these movements during behavioral assays. SDS-PAGE, immunofluorescence, and qRT-PCR were used to assess MyHC isoform expression in pertinent muscles, and functional feeding and swallowing performance were quantified through videofluoroscopy and mastication assays. We found that both the anterior digastric (ADG) and posterior digastric (PDG) muscles in 11-day old and 5–6 week old Ts65Dn groups showed significantly lower MyHC 2b protein levels than in age-matched euploid control groups. In videofluoroscopic and videotape assays used to quantify swallowing and mastication performance, 5–6 week old Ts65Dn and euploid controls showed similar swallow rates, inter-swallow intervals, and mastication rates. In analysis of adults, 10–11 week old Ts65Dn mice revealed significantly less MyHC 2b mRNA expression in the posterior digastric, but not the anterior digastric muscle as compared with euploid controls. Analysis of MyHC 2b protein levels across an adult age range (10–53 weeks of age) revealed lower levels of MyHC 2b protein in the PDG of Ts65Dn than in euploids, but similar levels of MyHC 2b in the ADG. Cumulatively, these results indicate biochemical differences in some, but not all, muscles involved in swallowing and jaw movement in Ts65Dn mice that manifest early in post-natal development, and persist into adulthood. These findings suggest potential utility of this model for future investigations of the mechanisms of oromotor difficulties associated with Down syndrome.
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Affiliation(s)
- Tiffany J. Glass
- Department of Surgery, University of Wisconsin, Madison, Wisconsin, United States of America
- * E-mail:
| | - Nadine P. Connor
- Department of Surgery, University of Wisconsin, Madison, Wisconsin, United States of America
- Department of Communication Sciences and Disorders, University of Wisconsin, Madison, Wisconsin, United States of America
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Kletzien H, Russell JA, Connor NP. The effects of treadmill running on aging laryngeal muscle structure. Laryngoscope 2015; 126:672-7. [PMID: 26256100 DOI: 10.1002/lary.25520] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 05/06/2015] [Accepted: 06/25/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS Age-related changes in laryngeal muscle structure and function may contribute to deficits in voice and swallowing observed in elderly people. We hypothesized that treadmill running, an exercise that increases respiratory drive to upper airway muscles, would induce changes in thyroarytenoid muscle myosin heavy chain (MHC) isoforms that are consistent with a fast-to-slow transformation in muscle fiber type. STUDY DESIGN Randomized parallel group controlled trial. METHODS Fifteen young adult and 14 old Fischer 344/Brown Norway rats received either treadmill running or no exercise (5 days/week/8 weeks). Myosin heavy chain isoform composition in the thyroarytenoid muscle was examined at the end of 8 weeks. RESULTS Significant age and treatment effects were found. The young adult group had the greatest proportion of superfast-contracting MHCIIL isoform. The treadmill running group had the lowest proportion of MHCIIL and the greatest proportion of MHCIIx isoforms. CONCLUSION Thyroarytenoid muscle structure was affected both by age and treadmill running in a fast-to-slow transition that is characteristic of exercise manipulations in other skeletal muscles. LEVEL OF EVIDENCE NA. Laryngoscope, 126:672-677, 2016.
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Affiliation(s)
- Heidi Kletzien
- Department of Surgery, Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, Wisconsin, U.S.A.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, U.S.A
| | - John A Russell
- Department of Surgery, Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, Wisconsin, U.S.A.,Department of Communication Sciences and Disorders, University of Wisconsin, Madison, Wisconsin, U.S.A
| | - Nadine P Connor
- Department of Surgery, Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, Wisconsin, U.S.A.,Department of Biomedical Engineering, University of Wisconsin, Madison, Wisconsin, U.S.A.,Department of Communication Sciences and Disorders, University of Wisconsin, Madison, Wisconsin, U.S.A
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Becker BJ, Russell JA, Connor NP. Effects of aging on evoked retrusive tongue actions. Arch Oral Biol 2015; 60:966-71. [PMID: 25847069 DOI: 10.1016/j.archoralbio.2015.02.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 02/24/2015] [Accepted: 02/25/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Tongue strength, timing, and coordination deficits may underlie age-related swallowing function. Retrusive tongue actions are likely important in retrograde bolus transport. However, age-related changes in retrusive tongue muscle contractile properties have not been identified in animal studies. Because previous studies employed whole hypoglossal nerve stimulation that activated both protrusive and retrusive tongue muscles, co-contraction may have masked retrusive muscle force decrements. The hypotheses of this study were: (1) retrusive tongue muscle contraction forces would be diminished and temporal characteristics prolonged in old rats when lateral nerves were selectively activated, and (2) greater muscle contractile forces with selective lateral branch stimulation would be found relative to whole hypoglossal nerve stimulation. DESIGN Nineteen Fischer 344/Brown Norway rats (9 old, 10 young adult) underwent tongue muscle contractile property recording elicited by: (1) bilateral whole hypoglossal nerve stimulation, and (2) selective lateral branch stimulation. Twitch contraction time (CT), half-decay time, maximal twitch and tetanic forces, and a fatigue index were measured. RESULTS For whole nerve stimulation, CT was significantly longer in the old group. No significant age group differences were found with selective lateral nerve stimulation. Significantly reduced twitch forces (old group only), increased tetanic forces and significantly less fatigue were found with selective lateral nerve stimulation than with whole hypoglossal stimulation. CONCLUSIONS Retrusive tongue forces are not impaired in old rats. Deficits observed in swallowing with aging may be due to other factors such as inadequate bolus propulsive forces, mediated by protrusive tongue muscles, or timing/coordination of muscle actions.
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Affiliation(s)
- Benjamin J Becker
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, WI, United States
| | - John A Russell
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, WI, United States
| | - Nadine P Connor
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin, Madison, WI, United States; Department of Communication Sciences and Disorders, University of Wisconsin, Madison, WI, United States.
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Russell JA, Connor NP. Effects of age and radiation treatment on function of extrinsic tongue muscles. Radiat Oncol 2014; 9:254. [PMID: 25472556 PMCID: PMC4269095 DOI: 10.1186/s13014-014-0254-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 11/05/2014] [Indexed: 11/10/2022] Open
Abstract
Background Radiation treatment for head and neck cancer often results in difficulty swallowing. Muscle weakness and fibrosis have been identified clinically as possible etiologies for swallowing problems following radiation. Aging may compound the effects of radiation on swallowing because radiation-induced damage to muscles and other tissues critical for the oropharyngeal swallow is overlaid on a declining sensorimotor system. However, there have been no investigations of the manner in which aging and radiation treatment effects combine to impact tongue muscles, which are critical effectors of the oropharyngeal swallow. Methods Thirty-seven male Fisher 344/Brown Norway rats were divided into four groups; young adults (9 month old), old (32 months old), young radiation (9 months), and old radiation (32 months old). Two fractions of 11 Gy on consecutive days was delivered by external beam radiation to the ventral side of the rat’s body over the anterior portion (20 X 30 mm area) of the anterior digastric muscle. Two-way analysis of variance (ANOVA) was used to examine the effects of age and radiation and their interaction on muscle contractile properties. Post-hoc testing was completed using Fisher’s least significant differences (LSD). Results Radiation was associated with a significant decrease in tongue force production and reduced speed of tongue muscle contraction. However, radiation treatment did not lead to muscle atrophy and fibrosis formation in the GG muscle. Radiation treatment did not exacerbate atrophic changes observed with aging, or lead to additional fibrosis formation in the GG muscle from that observed in the other groups. Conclusions The purpose of this research was to determine the effect of radiation on muscles of the tongue and to determine whether aging altered the extent of radiation injury to tongue muscles. Radiation was associated with a significant decrease in tongue force production and reduced speed of tongue muscle contraction, and the reduction in the speed of tongue muscle contraction was exacerbated in the aged-rat tongue. This work provides a foundation for future investigations of treatments for concurrent effects of aging and radiation on muscles of the tongue and swallowing.
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Affiliation(s)
- John A Russell
- University of Wisconsin School of Medicine and Public Health, Otolaryngology Head and Neck Surgery, Madison, WI, 53706, USA.
| | - Nadine P Connor
- University of Wisconsin School of Medicine and Public Health, Otolaryngology Head and Neck Surgery, Madison, WI, 53706, USA. .,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, 53706, USA.
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Ulrich Sommer J, Birk R, Hörmann K, Stuck BA. Evaluation of the maximum isometric tongue force of healthy volunteers. Eur Arch Otorhinolaryngol 2014; 271:3077-84. [DOI: 10.1007/s00405-014-3103-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2014] [Accepted: 05/13/2014] [Indexed: 11/29/2022]
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Seo DY, Lee SR, Kim N, Ko KS, Rhee BD, Han J. Humanized animal exercise model for clinical implication. Pflugers Arch 2014; 466:1673-87. [PMID: 24647666 DOI: 10.1007/s00424-014-1496-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/03/2014] [Accepted: 03/05/2014] [Indexed: 01/20/2023]
Abstract
Exercise and physical activity function as a patho-physiological process that can prevent, manage, and regulate numerous chronic conditions, including metabolic syndrome and age-related sarcopenia. Because of research ethics and technical difficulties in humans, exercise models using animals are requisite for the future development of exercise mimetics to treat such abnormalities. Moreover, the beneficial or adverse outcomes of a new regime or exercise intervention in the treatment of a specific condition should be tested prior to implementation in a clinical setting. In rodents, treadmill running (or swimming) and ladder climbing are widely used as aerobic and anaerobic exercise models, respectively. However, exercise models are not limited to these types. Indeed, there are no golden standard exercise modes or protocols for managing or improving health status since the types (aerobic vs. anaerobic), time (morning vs. evening), and duration (continuous vs. acute bouts) of exercise are the critical determinants for achieving expected beneficial effects. To provide insight into the understanding of exercise and exercise physiology, we have summarized current animal exercise models largely based on aerobic and anaerobic criteria. Additionally, specialized exercise models that have been developed for testing the effect of exercise on specific physiological conditions are presented. Finally, we provide suggestions and/or considerations for developing a new regime for an exercise model.
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Affiliation(s)
- Dae Yun Seo
- National Research Laboratory for Mitochondrial Signaling, Department of Physiology, College of Medicine, Department of Health Sciences and Technology, Cardiovascular and Metabolic Disease Center, Inje University, Bok Ji-Ro 75, Busanjin-Gu, Busan, 613-735, Republic of Korea
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Watts CR. Measurement of Hyolaryngeal Muscle Activation Using Surface Electromyography for Comparison of Two Rehabilitative Dysphagia Exercises. Arch Phys Med Rehabil 2013; 94:2542-2548. [DOI: 10.1016/j.apmr.2013.04.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022]
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Fregosi RF, Ludlow CL. Activation of upper airway muscles during breathing and swallowing. J Appl Physiol (1985) 2013; 116:291-301. [PMID: 24092695 DOI: 10.1152/japplphysiol.00670.2013] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The upper airway is a complex muscular tube that is used by the respiratory and digestive systems. The upper airway is invested with several small and anatomically peculiar muscles. The muscle fiber orientations and their nervous innervation are both extremely complex, and how the activity of the muscles is initiated and adjusted during complex behaviors is poorly understood. The bulk of the evidence suggests that the entire assembly of tongue and laryngeal muscles operate together but differently during breathing and swallowing, like a ballet rather than a solo performance. Here we review the functional anatomy of the tongue and laryngeal muscles, and their neural innervation. We also consider how muscular activity is altered as respiratory drive changes, and briefly address upper airway muscle control during swallowing.
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Affiliation(s)
- Ralph F Fregosi
- Department of Physiology, University of Arizona, Tucson, Arizona
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