Defining pharyngeal contractile integral during high-resolution manometry in neonates: a neuromotor marker of pharyngeal vigor

Jadcherla, Sudarshan R.; Prabhakar, Varsha; Hasenstab, Kathryn A.; Nawaz, Selina; Das, Jayajit; Kern, Mark; Balasubramanian, Gokulakrishnan; Shaker, Reza

doi:10.1038/s41390-018-0097-6

Cited by 18 publications

(23 citation statements)

References 38 publications

(78 reference statements)

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“…High‐resolution manometry data from the studies were imported in.CSV format from MMS analysis software (version 9.5, Laborie Medical Technologies) into Python (V 3.6.2). Swallow detection and analysis algorithms were used as previously published . User inputs to the algorithms included time windows of oral feeding and the identification of pharyngeal and UES regions on the pharyngo‐esophageal topography plots …”

Section: Methodsmentioning

confidence: 99%

“…Swallow detection and analysis algorithms were used as previously published . User inputs to the algorithms included time windows of oral feeding and the identification of pharyngeal and UES regions on the pharyngo‐esophageal topography plots …”

Section: Methodsmentioning

confidence: 99%

“…Constraint programming with hill climbing search was used to develop an algorithm to identify UES relaxation and UES nadir pressures. This was performed using pharyngeal contraction times identified by automatic swallow detection, UES length, and 50% UES relaxation thresholds as constraints. In addition to the variables obtained from HRM data, volumes (mL) consumed during the oral feeding session were also recorded.…”

Section: Methodsmentioning

confidence: 99%

“…In adults, high‐resolution manometry (HRM) techniques have made it possible to study both the regulatory and contractile functions in greater detail with the presence of multiple sensors in the pharyngeal region. Application of HRM in infants will further our understanding of their pharyngeal swallowing physiology . Contractility of the pharynx and its relationship with UES relaxation pressures is unknown in preterm and full‐term infants.…”

Section: Introductionmentioning

confidence: 99%

“…Application of HRM in infants will further our understanding of their pharyngeal swallowing physiology. 19 Contractility of the pharynx and its relationship with UES relaxation pressures is unknown in preterm and full-term infants. Discerning differences between these groups of infants will enable us to understand the significance of in utero maturation for successful nutritive swallowing abilities.…”

Section: Introductionmentioning

confidence: 99%

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Pharyngeal contractile and regulatory characteristics are distinct during nutritive oral stimulus in preterm‐born infants: Implications for clinical and research applications

Prabhakar

Hasenstab

Osborn

et al. 2019

Neurogastroenterology Motil

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Background Maturation of pharyngeal swallowing during neonatal oral feeding is unknown. Our objective was to evaluate pharyngeal functioning using high‐resolution manometry (HRM) during nutritive oral stimulus and test the hypothesis that pharyngeal contractility and regulation are distinct in preterm‐born infants. Methods High‐resolution manometry data during oral milk feeding were analyzed for pharyngeal contractile (PhCI, mm Hg cm s) and regulatory (number and frequency of pharyngeal contractions and bursts, pharyngeal activity‐to‐quiescence ratio, upper esophageal sphincter nadir pressure) characteristics in 23 preterm (<38 weeks’ gestation) and 18 full‐term‐born infants at term maturation. Mixed linear models and stepwise regression methods were used. Results Despite more oral feeding experiences (P < 0.05), preterm infants (vs full‐term), consumed less milk volume (P < 0.001), had lesser pharyngeal contractions within bursts (P = 0.04), lower pharyngeal contraction frequency (P < 0.01), and lower pharyngeal activity (P = 0.03), but higher PhCI per individual contraction (P = 0.01). PhCI is higher for longer PMA (P < 0.05), higher UES nadir pressures (P < 0.05), and lower pharyngeal contraction frequency (P < 0.05). Conclusions Nutritive oral milk stimulus provoked pharyngeal contractility characteristics is distinct in preterm‐born. Despite more oral nutritive experiences, preterm infants had underdeveloped excitatory and inhibitory rhythmic activity. Cranial nerve IX and X effects on sensory‐motor responses and feedback (excitation‐inhibitory rhythm regulation) remain immature among preterm‐born even at full‐term maturational status. We speculate the relationship between PhCI and UES regulatory activity contributes to the observed differences in preterm and full‐term infants.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pharyngeal contractile and regulatory characteristics are distinct during nutritive oral stimulus in preterm‐born infants: Implications for clinical and research applications

Prabhakar

Hasenstab

Osborn

et al. 2019

Neurogastroenterology Motil

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Characterization of pharyngeal contractile integral using pharyngeal manometry in children

Damrongmanee,

El‐Chammas,

Santucci

et al. 2024

J. pediatr. gastroenterol. nutr.

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ObjectivesPharyngeal contractile integral (PhCI) is the product of mean pharyngeal contractile amplitude, length, and duration, and provides a single metric for the vigor of entire pharyngeal contraction. A major limitation in children is lack of characterization of PhCI on high‐resolution pharyngeal manometry. We aimed to determine and compare the values of PhCI in children with the abnormal and normal videofluoroscopic study of swallow (VFSS).MethodsChildren who underwent high‐resolution pharyngeal and esophageal manometry (HRPM/HREM), as well as VFSS, were divided into two groups; “normal VFSS” and “abnormal VFSS” groups. PhCI was calculated from the pharyngo‐esophageal manometry analysis software (MMS, v9.5, Laborie Medical Technologies), and compared in these two groups.ResultsOf 67 children, 9 had abnormal VFSS (mean age 64 ± 50 months; 66.7% males), while 58 had normal VFSS (mean age 123 ± 55 months; 47% males). The mean PhCI in abnormal and normal VFSS groups was 82.00 ± 51.90 and 147.28 ± 53.89 mmHg.s.cm, respectively (p = 0.001). Subjects with abnormal VFSS were significantly younger than those with normal VFSS (p = 0.003). However, after adjusting for the VFSS result, age was no longer related to PhCI (p = 0.364). In subgroup analysis of children presenting with dysphagia, the mean PhCI in abnormal (9 subjects) and normal (36 subjects) VFSS groups was 82.00 ± 51.90 and 141.86 ± 50.39 mmHg.s.cm, respectively (p = 0.003).ConclusionsPhCI was significantly lower in children with abnormal VFSS than in those with normal VFSS. We did not find a significant impact of age on PhCI in our pediatric populations.

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Characterization of pharyngeal contractile integral using pharyngeal manometry in children

Kapavarapu

2024

J. pediatr. gastroenterol. nutr.

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Defining pharyngeal contractile integral during high-resolution manometry in neonates: a neuromotor marker of pharyngeal vigor

Cited by 18 publications

References 38 publications

Pharyngeal contractile and regulatory characteristics are distinct during nutritive oral stimulus in preterm‐born infants: Implications for clinical and research applications

Pharyngeal contractile and regulatory characteristics are distinct during nutritive oral stimulus in preterm‐born infants: Implications for clinical and research applications

Characterization of pharyngeal contractile integral using pharyngeal manometry in children

Characterization of pharyngeal contractile integral using pharyngeal manometry in children

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