Coordination of Swallowing and Breathing: How Is the Respiratory Control System Connected to the Swallowing System?

Oku, Yoshitaka

doi:10.1007/978-981-15-5596-1_3

Cited by 5 publications

(4 citation statements)

References 69 publications

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“…Coordination between swallowing and breathing is regulated by the interaction of central pattern generators (CPGs) within the brainstem [ 50 – 53 ]. Swallowing can be regarded as an external stimulation and natural disturbance of the respiratory CPG.…”

Section: Discussionmentioning

confidence: 99%

Breathing–Swallowing discoordination after definitive chemoradiotherapy for head and neck cancers is associated with aspiration pneumonia

Yoshida,

Yagi,

Ogawa

et al. 2024

PLoS ONE

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Purpose Swallowing dysfunction and the risk of aspiration pneumonia are frequent clinical problems in the treatment of head and neck squamous cell carcinomas (HNSCCs). Breathing–swallowing coordination is an important factor in evaluating the risk of aspiration pneumonia. To investigate breathing–swallowing discoordination after chemoradiotherapy (CRT), we monitored respiration and swallowing activity before and after CRT in patients with HNSCCs. Methods Non-invasive swallowing monitoring was prospectively performed in 25 patients with HNSCCs treated with CRT and grade 1 or lower radiation-induced dermatitis. Videoendoscopy, videofluoroscopy, Food Intake LEVEL Scale, and patient-reported swallowing difficulties were assessed. Results Of the 25 patients selected for this study, four dropped out due to radiation-induced dermatitis. The remaining 21 patients were analyzed using a monitoring system before and after CRT. For each of the 21 patients, 405 swallows were analyzed. Swallowing latency and pause duration after the CRT were significantly extended compared to those before the CRT. In the analysis of each swallowing pattern, swallowing immediately followed by inspiration (SW-I pattern), reflecting breathing–swallowing discoordination, was observed more frequently after CRT (p = 0.0001). In 11 patients, the SW-I pattern was observed more frequently compared to that before the CRT (p = 0.00139). One patient developed aspiration pneumonia at 12 and 23 months after the CRT. Conclusion The results of this preliminary study indicate that breathing–swallowing discoordination tends to increase after CRT and could be involved in aspiration pneumonia. This non-invasive method may be useful for screening swallowing dysfunction and its potential risks.

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Section: Discussionmentioning

confidence: 99%

Breathing–Swallowing discoordination after definitive chemoradiotherapy for head and neck cancers is associated with aspiration pneumonia

Yoshida,

Yagi,

Ogawa

et al. 2024

PLoS ONE

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“…Swallowing is a physiological perturbation of the respiratory rhythm [ 105 , 106 ]. In humans, swallowing during inspiration terminates the inspiratory phase, and respiration resumes with expiration, with a shorter duration than that of the control [ 107 ].…”

Section: Sources Of Respiratory Variabilitymentioning

confidence: 99%

Temporal variations in the pattern of breathing: techniques, sources, and applications to translational sciences

Oku¹

2022

J Physiol Sci

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The breathing process possesses a complex variability caused in part by the respiratory central pattern generator in the brainstem; however, it also arises from chemical and mechanical feedback control loops, network reorganization and network sharing with nonrespiratory motor acts, as well as inputs from cortical and subcortical systems. The notion that respiratory fluctuations contain hidden information has prompted scientists to decipher respiratory signals to better understand the fundamental mechanisms of respiratory pattern generation, interactions with emotion, influences on the cortical neuronal networks associated with cognition, and changes in variability in healthy and disease-carrying individuals. Respiration can be used to express and control emotion. Furthermore, respiration appears to organize brain-wide network oscillations via cross-frequency coupling, optimizing cognitive performance. With the aid of information theory-based techniques and machine learning, the hidden information can be translated into a form usable in clinical practice for diagnosis, emotion recognition, and mental conditioning.

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“…On the other hand, inspiration before swallowing is associated with longer swallowing apnea [4], and an increased frequency of inspiration before swallowing is associated with fewer exacerbations in patients with COPD [5]. Therefore, inspiration before swallowing may be an airway protective behavior to compensate for the delayed onset of swallowing [6].…”

Section: Introductionmentioning

confidence: 99%

Swallowing Dynamics and Breathing-Swallowing Coordination Are Altered in Patients with Mild Cognitive Impairment

Oku

Yagi

Nishino

et al. 2021

Dement Geriatr Cogn Disord

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Introduction: Postinspiratory activity, which is essential for laryngeal closure during swallowing to prevent aspiration of food into the airways, is reduced in a mouse model of tauopathy. Therefore, we hypothesized that patients at the stage of mild cognitive impairment (MCI) exhibit alterations in swallowing dynamics and coordination between swallowing and breathing. Methods: We examined breathing-swallowing coordination in patients with MCI. Patients who scored ≥24 on the Mini-Mental State Examination and <26 on the Japanese version of the Montreal Cognitive Assessment were recruited at Sumoto Itsuki Hospital. Parameters associated with breathing-swallowing coordination were assessed using a combination of two sensors: a respiratory flow sensor and a piezoelectric sensor attached to the skin surface of the anterior neck. Results: Nineteen patients met the criteria for MCI; 16 of these patients (79.5 ± 9.1 years old) scored <3 on the 10-item Eating Assessment Tool and were enrolled in the study. Their data were compared with those of an age-matched elderly cohort (79.9 ± 2.9 years old). The frequencies of swallowing during inspiration and swallowing immediately followed by inspiration in patients with MCI were 6.9% and 9.6%, respectively; these frequencies were not significantly different from those of the age-matched elderly cohort. However, the timing of swallowing in the respiratory cycle was significantly delayed in the MCI patients, and both time from the onset to the peak of laryngeal elevation and the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the resting position were significantly lengthened in this group. Conclusion: At the stage of MCI, breathing-swallowing coordination has already started to decline.

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Coordination of Swallowing and Breathing: How Is the Respiratory Control System Connected to the Swallowing System?

Cited by 5 publications

References 69 publications

Breathing–Swallowing discoordination after definitive chemoradiotherapy for head and neck cancers is associated with aspiration pneumonia

Breathing–Swallowing discoordination after definitive chemoradiotherapy for head and neck cancers is associated with aspiration pneumonia

Temporal variations in the pattern of breathing: techniques, sources, and applications to translational sciences

Swallowing Dynamics and Breathing-Swallowing Coordination Are Altered in Patients with Mild Cognitive Impairment

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