Spatiotemporal characteristics of the pharyngeal event‐related potential in healthy subjects and older patients with oropharyngeal dysfunction

Abstract

Older people present a decline in pharyngeal sensory function, more severe in older patients with OD. This sensory impairment might be a critical pathophysiological element and a potential target for treatment of swallowing dysfunction in older patients.

Chronic post‐stroke oropharyngeal dysphagia is associated with impaired cortical activation to pharyngeal sensory inputs

“…Aviv et al [7] found a positive correlation between impaired laryngopharyngeal sensitivity and aspiration in patients with stroke. In contrast, we found no significant differences in pharyngeal sensory thresholds between PSD and PSnD, similar to previous findings using the same technique in an elderly population [6]. In addition to methodological differences (depending on distinct receptor activation in pharyngeal mucosa due to air puff vs. electrical stimulation), discrepancies may be explained by the fact that, in the study of Aviv et al [7], patients were in the acute phase of stroke, the majority located in the brainstem (66.7%), whereas we recruited chronic post-stroke patients, over 80% of whom were total anterior circulation infarct/partial anterior circulation infarct.…”

“…Although delay of earlier pSEP peaks (N1/P1) is probably related to conduction slowing through the afferent pathway at the stroke site, delay of later peaks (N2/P2) also suggests impaired integration of sensory inputs. ERP studies have reported an altered pharyngeal sensory pathway in dysphagic elderly people and in Parkinson's disease [6,19]. The inverse correlation that we found between N2/P2 amplitude and LV closure time indicates that impaired sensory integration of pharyngeal inputs is associated with impaired safety of swallowing.…”

A comparative study on the therapeutic effect of TRPV1, TRPA1, and TRPM8 agonists on swallowing dysfunction associated with aging and neurological diseases

“…Older people and patients with neurological diseases suffering from OD present decreased oropharyngeal sensitivity . Reduced sensory input contributes to impaired motor response .…”

“…While TRP stimulants increased bolus velocity and reduced swallow response times, Older people and patients with neurological diseases suffering from OD present decreased oropharyngeal sensitivity. 16 Reduced sensory input contributes to impaired motor response. 17,18 Thus, sensory impairment is a potential target for treatment of swallowing dysfunction in older patients.…”

“…[13][14][15] We have recently found that this impaired pharyngeal sensory function is due to disturbances in the pharyngo-cortical connection together with a disrupted pattern of cortical activation. 16 Studies have also found a close relationship between sensory deficits and impaired swallow response, which might imply that reduced sensory input contributes to impaired motor response. 17,18 This sensory impairment might be a critical pathophysiological element and a potential target for treatment of swallowing dysfunction in older patients.…”