The Role of the Cerebellum in Control of Swallow: Evidence of Inspiratory Activity During Swallow

Reed, Mitchell; English, Mason; English, Connor; Huff, Alyssa; Poliaček, Ivan; Musselwhite, M Nicholas; Howland, Dena R.; Bolser, Donald C.; Pitts, Teresa

doi:10.1007/s00408-018-00192-2

Cited by 14 publications

(14 citation statements)

References 20 publications

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“…Afferent projections from the larynx are represented in the cerebellum [ 16 ], and perhaps this feedback regulates motor output to maintain a set point for laryngeal stiffness during cough. Interestingly, we observed the opposite effect of cerebellectomy on thyroarytenoid activity during swallow reported in Reed and colleagues [ 51 ]. These data in combination with what is previously understood about breathing demonstrate a clear need for research on all pattern generators important for airway protection, as the effects on a single behavior are not translated to others.…”

Section: Discussioncontrasting

confidence: 74%

“…Williams et al [ 50 ] similarly reported a prolonged T TOT and T E (in addition to a slightly prolonged T I ) and a reduced respiratory frequency post-cerebellectomy in vagal intact animals. However, several other publications reported no change in eupneic breathing values in vagally intact animals [ 40 , 51 – 53 ]. At least one study did report increased respiratory frequency, but this sample included some vagotomized animals [ 49 ].…”

Section: Discussionmentioning

confidence: 98%

“…This increased range for gain modulation in this preparation may underlie disparate reported effects of cerebellectomy. For example, cerebellectomy has been variously reported to increase [49], decrease [50], or have no effect [40,[51][52][53] on respiration. These discrepancies are between studies rather than within one data set as presented here.…”

Section: Plos Onementioning

confidence: 99%

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Differential effects of acute cerebellectomy on cough in spontaneously breathing cats

et al. 2021

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The role of the cerebellum in controlling the cough motor pattern is not well understood. We hypothesized that cerebellectomy would disinhibit motor drive to respiratory muscles during cough. Cough was induced by mechanical stimulation of the tracheobronchial airways in anesthetized, spontaneously breathing adult cats (8 male, 1 female), and electromyograms (EMGs) were recorded from upper airway, chest wall, and abdominal respiratory muscles. Cough trials were performed before and at two time points after total cerebellectomy (10 minutes and >1 hour). Unlike a prior report in paralyzed, decerebrated, and artificially ventilated animals, we observed that cerebellectomy had no effect on cough frequency. After cerebellectomy, thoracic inspiratory muscle EMG magnitudes increased during cough (diaphragm EMG increased by 14% at 10 minutes, p = 0.04; parasternal by 34% at 10 minutes and by 32% at >1 hour, p = 0.001 and 0.03 respectively). During cough at 10 minutes after cerebellectomy, inspiratory esophageal pressure was increased by 44% (p = 0.004), thyroarytenoid (laryngeal adductor) muscle EMG amplitude increased 13% (p = 0.04), and no change was observed in the posterior cricoarytenoid (laryngeal abductor) EMG. Cough phase durations did not change. Blood pressure and heart rate were reduced after cerebellectomy, and respiratory rate also decreased due to an increase in duration of the expiratory phase of breathing. Changes in cough-related EMG magnitudes of respiratory muscles suggest that the cerebellum exerts inhibitory control of cough motor drive, but not cough number or phase timing in response to mechanical stimuli in this model early after cerebellectomy. However, results varied widely at >1 hour after cerebellectomy, with some animals exhibiting enhancement or suppression of one or more components of the cough motor behavior. These results suggest that, while the cerebellum and behavior-related sensory feedback regulate cough, it may be difficult to predict the nature of the modulation based on total cerebellectomy.

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 98%

Section: Plos Onementioning

confidence: 99%

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Differential effects of acute cerebellectomy on cough in spontaneously breathing cats

et al. 2021

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“…Clinically, it has been assumed that swallow duration positively correlates with force production, as defined by swallow phase relationships in videofluoroscopy exams [13]. We have now established that swallow-related EMG amplitude and duration are not correlated in cats [13,46,73], humans [74,75], or rats (present study). The inability to assess this using visual metrics (videofluoroscopy and endoscopy) supports the need for development of "strength" related clinical metrics in order to better investigate this property of swallow pattern generation.…”

Section: Emg Amplitude and Duration Are Not Correlatedmentioning

confidence: 48%

Sex-specific vagal and spinal modulation of swallow and its coordination with breathing

et al. 2020

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Swallow-breathing coordination is influenced by changes in lung volume, which is modulated by feedback from both vagal and spinal sensory afferents. The purpose of this study was to manipulate feedback from these afferents, with and without a simultaneous mechanical challenge (chest compression), in order to assess the influence of each sensory pathway on swallow in rats. We hypothesized that manipulation of afferent feedback would shift the occurrence of swallow toward the inspiratory phase of breathing. Afferent feedback was perturbed by lidocaine nebulization, extra-thoracic vagotomy, or lidocaine administration to the pleural space in sodium pentobarbital anesthetized rats (N = 43). These different afferent perturbations were performed both in control conditions (no chest compression), and with chest compression. Manipulating pulmonary stretch receptor-mediated volume feedback in male animals decreased swallow occurrence. Female rats appear to rely more on spinal afferent feedback, as swallow occurrence shifted to late expiration with chest compression and vagotomy or lidocaine injections. Results suggest that sex-specific mechanisms modulate swallow-breathing coordination, and that vagal feedback is inhibitory to swallow-related muscles, while spinal feedback from pleural afferents has excitatory effects. This study supports the theory that a balance of vagal and spinal afferent feedback is necessary to maintain an optimal swallow pattern and swallow-breathing coordination.

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“…Furthermore, adults with CP have a greater risk of respiratory disease than adults in the general population [17,18]. The DIAm plays a critical role in reducing susceptibility to respiratory infections in two ways: 1) during the pharyngeal phase of swallowing, the DIAm generates a large negative intrathoracic pressure necessary to propel a food bolus through the pharynx and into the esophagus, with failure resulting in aspiration; and 2) coughing and sneezing, where the DIAm contributes to increased intraabdominal pressure necessary to expel aspirates and phlegm from the airway [11,[19][20][21]. Therefore, we propose that we should educate families of children with CP that their child may also have an impaired cough, which can increase their child's susceptibility to respiratory complications.…”

mentioning

confidence: 99%

Why individuals with cerebral palsy are at higher risk for respiratory complications from COVID-19

Brandenburg

Fogarty

Sieck

2020

PRM

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Respiratory dysfunction is a leading cause of morbidity and mortality in individuals with cerebral palsy (CP). In children and adults with CP, movement and physical function is always affected. Yet, many clinicians overlook potential for impaired movement and function of the diaphragm muscle (DIAm) in individuals with CP. Since individuals with pre-existing respiratory disorders are at greater risk for respiratory complications if they contract COVID-19, understanding potential risks to individuals with CP is important. In this review we present research on respiratory function and DIAm force generation in children with CP. We compare this clinical work to basic science research investigating phrenic motor neuron and DIAm motor unit dysfunction in an animal model with CP symptoms, the spa mouse. Finally, we integrate the clinical and basic science work in respiratory function in CP, discussing potential for individuals with CP to have severe respiratory symptoms from COVID-19.

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The Role of the Cerebellum in Control of Swallow: Evidence of Inspiratory Activity During Swallow

Cited by 14 publications

References 20 publications

Differential effects of acute cerebellectomy on cough in spontaneously breathing cats

Differential effects of acute cerebellectomy on cough in spontaneously breathing cats

Sex-specific vagal and spinal modulation of swallow and its coordination with breathing

Why individuals with cerebral palsy are at higher risk for respiratory complications from COVID-19

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