Sensory Input Pathways and Mechanisms in Swallowing: A Review

Steele, Catriona M.; Miller, Arthur J.

doi:10.1007/s00455-010-9301-5

Cited by 264 publications

(219 citation statements)

References 149 publications

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“…In humans, both regions have been implicated in swallowing and tongue movement (47), and, in primates, stimulation of the two regions has been shown to induce swallowing (48), along with tongue (49) and jaw (50) movements associated with mastication. These movements contribute to the oral preparatory phase of swallowing responsible for transporting liquid to the pharynx, where the sensory properties of the liquid can subsequently trigger initiation of swallowing (51). The increased BOLD signal in the two regions may thus represent an increase in the difficulty of manipulating the liquid to a position where swallowing can be instigated during the oral preparatory phase of swallowing.…”

Section: Discussionmentioning

confidence: 99%

Overdrinking, swallowing inhibition, and regional brain responses prior to swallowing

Saker

Farrell

Egan

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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In humans, drinking replenishes fluid loss and satiates the sensation of thirst that accompanies dehydration. Typically, the volume of water drunk in response to thirst matches the deficit. Exactly how this accurate metering is achieved is unknown; recent evidence implicates swallowing inhibition as a potential factor. Using fMRI, this study investigated whether swallowing inhibition is present after more water has been drunk than is necessary to restore fluid balance within the body. This proposal was tested using ratings of swallowing effort and measuring regional brain responses as participants prepared to swallow small volumes of liquid while they were thirsty and after they had overdrunk. Effort ratings provided unequivocal support for swallowing inhibition, with a threefold increase in effort after overdrinking, whereas addition of 8% (wt/vol) sucrose to water had minimal effect on effort before or after overdrinking. Regional brain responses when participants prepared to swallow showed increases in the motor cortex, prefrontal cortices, posterior parietal cortex, striatum, and thalamus after overdrinking, relative to thirst. Ratings of swallowing effort were correlated with activity in the right prefrontal cortex and pontine regions in the brainstem; no brain regions showed correlated activity with pleasantness ratings. These findings are all consistent with the presence of swallowing inhibition after excess water has been drunk. We conclude that swallowing inhibition is an important mechanism in the overall regulation of fluid intake in humans.thirst | drinking | swallowing | inhibition | fMRI F luid depletion leads to drinking, an important evolutionary behavior that satisfies the physiological need to replenish lost fluid. The motivation to begin drinking is normally provided, in humans at least, by the presence of a subjective state of thirst. At some point after drinking has commenced, the sensation of thirst disappears and is replaced by the experience of satiation, along with the cessation of drinking. Studies performed in humans and animals indicate the regulatory mechanisms that have evolved to govern the cessation of drinking appear to be tightly calibrated, with the amount of fluid ingested commensurate with the degree of fluid depletion, even though some variation occurs between species regarding the time taken to conclude drinking (1-3).Several factors have been implicated in the regulation of fluid intake, with the majority relating to thirst and the initiation of drinking. These include signals produced by osmoreceptors in the lamina terminalis (4-6), which respond to cellular dehydration and the resulting increase in sodium concentration within the cerebral spinal fluid (2), and signals produced in response to extracellular dehydration, such as those associated with the renin-angiotensin system, which is activated as a result of changes in vascular pressure and volume (7,8). In comparison, the mechanisms responsible for terminating drinking are less well understood. Oropharyngeal metering ...

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Section: Discussionmentioning

confidence: 99%

Overdrinking, swallowing inhibition, and regional brain responses prior to swallowing

Saker

Farrell

Egan

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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“…At the same time, the pharyngo-esophageal phases seem less likely to require, or be affected by, cognitive influences due to their non-volitionally controlled nature. 10,27 The relationship between motor dysfunction and swallowing functions is also not well defined. Indeed, the question of whether disease stage or severity is an indicator of dysphagia is a controversy in the field.…”

Section: Discussionmentioning

confidence: 99%

“…10 The pharyngo-esophageal swallowing sequence occurs via a brainstemdriven basic reflex, which utilizes sensory input from the oropharynx and esophagus. Because PD-related dysphagia is attributed to brainstem pathology, 11 research about swallowing dysfunction has focused mainly on the functions of brainstem swallowing centers, including the dorsal motor nucleus of the glossopharyngeus, the vagus nerves, and the nucleus of the solitary tract.…”

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confidence: 99%

Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

Kim

Youn

Suh

et al. 2015

Can. J. Neurol. Sci.

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Background: Dysphagia is a common symptom and an important prognostic factor in Parkinson's disease (PD). Although cognitive and motor dysfunctions may contribute to dysphagia in patients with PD, any specific association between such problems and swallowing functions is unclear. Here, we examined the potential relationship between cognitive/motor components and swallowing functions in PD. We evaluated the contributions of cognition and motor function to the components of swallowing via video fluoroscopic swallowing (VFS) experiments. Methods: We prospectively enrolled 56 patients without dementia having PD. Parkinson's disease severity was assessed by the Unified Parkinson's Disease Rating Scale (UPDRS). All participants received neuropsychological tests covering general mental status, visuospatial function, attention, language, learning and memory, and frontal executive function. The well-validated "modified barium swallow impairment profile" scoring system was applied during VFS studies to quantify swallowing impairments. Finally, correlations between neuropsychological or motor functions and impairment in swallowing components were calculated. Results: The most significant correlations were found between the frontal/executive or learning/memory domains and the oral phase of swallowing, though a minor component of the pharyngeal phase correlated with frontal function as well. Bradykinesia and the UPDRS total score were associated with both the pharyngeal and oral phases. Conclusions: Our findings suggest that cognitive dysfunctions are associated with the oral phase of swallowing in patients with early stage PD while the severity of motor symptoms may be associated with overall swallowing function.RÉSUMÉ: Aspects cognitifs et moteurs de la maladie de Parkinson qui sont associés à la dysphagie. Contexte : La dysphagie est un symptôme fréquent de la maladie de Parkinson (MP) et constitue un facteur de prédiction important dans cette maladie. Bien que les dysfonctions cognitives et motrices puissent contribuer à la dysphagie chez les patients atteints de la MP, une association spécifique entre ces problèmes et la déglutition demeure incertaine. Nous avons examiné une relation potentielle entre les composantes cognitives/motrices et la déglutition dans la MP. Nous avons évalué la contribution de la fonction cognitive et de la fonction motrice aux différentes composantes de la déglutition au moyen de la vidéofluoroscopie (DVF). Méthode : Nous avons recruté prospectivement 56 patients atteints de la MP, sans démence. La sévérité de la MP a été évaluée au moyen de la Unified Parkinson's Disease Rating Scale (UPDRS). Tous les participants ont subi des tests neuropsychologiques évaluant l'état mental général, la fonction visuospatiale, l'attention, le langage, l'apprentissage, la mémoire ainsi que les fonctions exécutives frontales. Le système « modified barium swallow impairment profile », un système d'évaluation validé, a été utilisé au cours des études de DVF pour quantifier l'atteinte de la fonction de d...

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“…João Rafael Sauzem Machado (1) , Eduardo Matias dos Santos Steidl (1) , Diego Fernando Dorneles Bilheri (1) , Mateus Trindade (2) , Guilherme Lopes Weis (2) , Paulo Roberto Oliveira de Jesus (3) , Marisa Bastos Pereira (4) , Renata Mancopes (5) (1) Universidade Federal de Santa Maria, RS -Brasil. 2) Serviço de Radiologia do Hospital Universitário de Santa Maria, RS -Brasil.…”

Section: Efeitos Do Exercício Muscular Respiratório Na Biomecânica Daunclassified

“…Steele et al 4 presented correlations between vertical and horizontal movement of this complex during swallowing and the predictive value for biomechanical of swallowing disorders. In this context, Troche et al 5 carried out a study in which they demonstrated the importance of respiratory muscle training, through the use of expiratory spirometry for the dysphagia rehabilitation in Parkinson patients.…”

Section: Introductionmentioning

confidence: 99%

Efeitos do exercício muscular respiratório na biomecânica da deglutição de indivíduos normais

et al. 2015

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RESUMO: Objetivo: analisar os efeitos do exercício respiratórios na biomecânica da deglutição de sujeitos normais. Métodos: o exercício muscular respiratório em sujeitos normais foi aplicado por sete dias consecutivos por meio de incentivador respiratório a fluxo (três séries de dez repetições para inspiração e expiração). A biomecânica da deglutição foi avaliada por videofluoroscopia, utilizando variáveis temporais (tempo de transição faríngea) e visuoperceptuais (número de deglutições, resíduos em seios piriformes e valéculas, penetração/aspiração). Para análise estatística foi aplicado o Teste de Wilcoxon, Igualdade de Duas Proporções e Kappa. Resultados: foram avaliadas 16 jovens do sexo feminino com média de idade de 21,2±3,4 anos. Nas variáveis visuoperceptuais observou-se concordância quase perfeita entre os avaliadores (p<0,001), bem como na temporal (p = 1,00). Após o período de treinamento houve redução no tempo de transição faríngea (p=0,02). Conclusão: o uso de incentivador respiratório a fluxo influenciou significantemente na biomecânica da deglutição, principalmente na redução do tempo de transição faríngea.

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Sensory Input Pathways and Mechanisms in Swallowing: A Review

Cited by 264 publications

References 149 publications

Overdrinking, swallowing inhibition, and regional brain responses prior to swallowing

Overdrinking, swallowing inhibition, and regional brain responses prior to swallowing

Cognitive and Motor Aspects of Parkinson’s Disease Associated with Dysphagia

Efeitos do exercício muscular respiratório na biomecânica da deglutição de indivíduos normais

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