Changes in pharyngeal corticobulbar excitability and swallowing behavior after oral stimulation

Power, Maxine; Fraser, Christopher; Hobson, Anthony; Rothwell, John C.; Mistry, Satish; Nicholson, D A; Thompson, David G.; Hamdy, Shaheen

doi:10.1152/ajpgi.00114.2003

Cited by 83 publications

(76 citation statements)

References 31 publications

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“…However, it is not known if MEP changes in healthy subjects should be interpreted in the same way. Indeed, it was found in healthy subjects that changes to MEP magnitude did not directly translate to changes in swallowing function, following short intervention (Power et al 2004). This raises the question: Could larger swallowing-related MEPs be a positive outcome in one population (e.g., younger subjects) but not in another (e.g., older subjects)?…”

Section: Discussionmentioning

confidence: 99%

Age and gender effects on submental motor-evoked potentials

Sella

Jones

Huckabee

2014

AGE

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It is not known whether there are ageand/or gender-related differences in magnitude of motor-evoked potentials (MEPs) of the submental muscles. Knowledge of this is important in investigations of neurophysiological aspects of swallowing. Forty healthy participants (20 males, 20 females; 20 young [21-35 years], 20 old [53-88 years]) were recruited. Surface electromyography (EMG) electrodes were placed at midline underlying the submental muscle group. Age-and genderrelated differences were evaluated in two neurophysiologic measures of swallowing: MEPs stimulated by single-pulse transcranial magnetic stimulation (TMS) over the motor cortex and surface electromyography (sEMG) recorded from the same submental muscle group during non-stimulated swallows. The older participants had larger MEPs during saliva swallowing than the young participants (p = 0.04, d=0.86). Conversely, the older participants had lower amplitude submental EMG activity during nonstimulated swallows (p=0.045, d=0.67). Gender had no significant effect on MEP magnitude and on submental activity during saliva swallowing. There were no effects of age or gender on MEP latencies. These findings suggest deterioration in muscle function with age in a sample of healthy adults presenting with functional swallowing. We speculate that muscular decline is partially ameliorated by increased cortical activity-i.e., increased submental MEPs-so as to preserve swallowing function in healthy older subjects. These findings emphasize the need for different reference points for evaluation of submental MEPs of different age groups.

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Section: Discussionmentioning

confidence: 99%

Age and gender effects on submental motor-evoked potentials

Sella

Jones

Huckabee

2014

AGE

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“…During the videofluoroscopy swallow test, the patients remained seated and the images were taken from a lateral position, with upper and lower borders from the oral cavity to the esophagus with the lips in front view, the pharyngeal wall at the back, nasopharynx in upper view and the cervical esophagus at the bottom (5,30,31) .…”

Section: Methodsmentioning

confidence: 99%

The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

Cola

Gatto

Silva

et al. 2010

Arq. Gastroenterol.

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-Context -The effect of sour taste and food temperature variations in dysphagic patients has not been entirely clarified.Objective -To determine the effect of sour and cold food in the pharyngeal transit times of patients with stroke. Methods -Patients participating in this study were 30 right-handed adults, 16 of which were male and 14 were female, aged 41 to 88 (average age 62.3 years) with ictus varying from 1 to 30 days (median of 6 days). To analyze the pharyngeal transit time a videofluoroscopy swallow test was performed. Each patient was observed during swallow of a 5 mL paste bolus given by spoon, totaling four different stimuli (natural, cold, sour and cold sour), one at a time, room temperature (22°C) and cold (8°C) were used. Later, the tests were analyzed using specific software to measure bolus transit time during the pharyngeal phase. Results -The results showed that the pharyngeal transit time was significantly shorter during swallow of cold sour bolus when compared with other stimuli. Conclusion -Sour taste stimuli associated to cold temperature cause significant change in swallowing patterns, by shortening the pharyngeal transit time, which may lead to positive effects in patients with oropharyngeal dysphagia.

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“…Although surface electrical stimulation has received increased attention as an adjunct to swallowing therapy in dysphagia in recent years [1][2][3][4], little is known about the effects of transcutaneous stimulation on swallowing physiology. It has been hypothesized that electrical stimulation may assist swallowing either by augmenting hyo-laryngeal elevation [1,2] or by increasing sensory input to the central nervous system to enhance the elicitation of swallowing [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…It has been hypothesized that electrical stimulation may assist swallowing either by augmenting hyo-laryngeal elevation [1,2] or by increasing sensory input to the central nervous system to enhance the elicitation of swallowing [3,4].…”

Section: Introductionmentioning

confidence: 99%

Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia

et al. 2006

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We tested two hypotheses using surface electrical stimulation in chronic pharyngeal dysphagia: that stimulation 1) lowered the hyoid bone and/or larynx when applied at rest, and 2) increased aspiration, penetration or pharyngeal pooling during swallowing. Bipolar surface electrodes were placed on the skin overlying the submandibular and laryngeal regions. Maximum tolerated levels of stimulation were applied while patients held their mouth closed at rest. Videofluoroscopic recordings were used to measure hyoid movements in the superior-inferior (s-i) and anterior-posterior (a-p) dimensions and the subglottic air column (s-i) position while stimulation was on and off. Patients swallowed 5 ml liquid when stimulation was off, at low sensory stimulation levels, and at maximum tolerated levels (motor). Speech pathologists blinded to condition, tallied the frequency of aspiration, penetration, pooling and esophageal entry from videofluorographic recordings of swallows. Only significant (p=0.0175) hyoid depression occurred during stimulation at rest. Aspiration and pooling were significantly reduced only with low sensory threshold levels of stimulation (p=0.025) and not during maximum levels of surface electrical stimulation. Those patients who had reduced aspiration and penetration during swallowing with stimulation had greater hyoid depression during stimulation at rest (p= 0.006). Stimulation may have acted to resist patients' hyoid elevation during swallowing.

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Changes in pharyngeal corticobulbar excitability and swallowing behavior after oral stimulation

Cited by 83 publications

References 31 publications

Age and gender effects on submental motor-evoked potentials

Age and gender effects on submental motor-evoked potentials

The influence of sour taste and cold temperature in pharyngeal transit duration in patients with stroke

Effects of Surface Electrical Stimulation Both at Rest and During Swallowing in Chronic Pharyngeal Dysphagia

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