Variation in the Timing and Frequency of Sucking and Swallowing over an Entire Feeding Session in the Infant Pig Sus scrofa

Gierbolini-Norat, Estela M.; Holman, Shaina Devi; Ding, Peng; Bakshi, Shubham; German, Rebecca Z.

doi:10.1007/s00455-014-9532-y

Cited by 17 publications

(13 citation statements)

References 33 publications

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“…Muscle recordings with inadequate EMG signal were excluded from analysis. Data from the beginning (high swallow frequency) and the end (low swallow frequency) of each feeding sequence were also avoided (20). A set of 10 -25 swallows, from muscles showing EMG activity, were selected from each feeding sequence and used for analysis.…”

Section: Methodsmentioning

confidence: 99%

Impact of recurrent laryngeal nerve lesion on oropharyngeal muscle activity and sensorimotor integration in an infant pig model

DeLozier

Gould

Ohlemacher

et al. 2018

Journal of Applied Physiology

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The successful performance of a swallow requires dynamic integration between a wide range of sensory inputs and muscle activities to produce the coordinated kinematics of oropharyngeal structures. Damage to the recurrent laryngeal nerve (RLN) produces dysphagia in infants, with food or liquid entering the airway despite this nerve having minimal direct sensory or motor connections to the act of swallowing, apart from vocal fold closure. Previous results have demonstrated that a complete RLN lesion disrupts both performance and kinematics before initiation of the pharyngeal swallow in infants. We tested the hypothesis that a RLN lesion produces changes in the normal activity of oral floor, tongue, and infrahyoid muscles during a swallow. We recorded swallowing in our validated infant pig model, with synchronous high-speed imaging and fine-wire, chronic electromyography. We found changes in the timing, duration, and amplitude of the motor pattern in an array of muscles that are supplied by several different cranial and cervical nerves. Some of these changes in muscle activity are associated with the preparatory aspects of bolus aggregation or movement and so occur before the pharyngeal swallow. Taken with previous biomechanical results, these patterns suggest an intricate brain stem sensorimotor integration that occurs as part of a swallow. In particular, the execution of oral motor function is changed as a result of this simple lesion. NEW & NOTEWORTHY Damage to the recurrent laryngeal nerve compromises swallowing despite an absent or minimal contribution to either the motor or sensory aspects of this function. This study documents EMG changes, following RLN lesion, to non-RLN innervated muscles that are active during swallowing in an infant model. Some of these muscles fire before the pharyngeal swallow and are associated with the preparatory aspects of bolus aggregation and movement, suggesting important sensorimotor integration at a brain stem level.

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Section: Methodsmentioning

confidence: 99%

Impact of recurrent laryngeal nerve lesion on oropharyngeal muscle activity and sensorimotor integration in an infant pig model

DeLozier

Gould

Ohlemacher

et al. 2018

Journal of Applied Physiology

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“…For each feeding sequence, we identified the first set of swallows that occurred without break following the first 5 seconds of feeding, which occurs at a faster rate than the rest of a feeding sequence (24). Swallows were identified by the frame at which the bolus was accumulated in the supraglottic space prior to passing the epiglottis (19).…”

Section: Data Processingmentioning

confidence: 99%

Premature birth impacts bolus size and shape through nursing in infant pigs

et al. 2019

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Background-The formation of a bolus of food is critical for proper feeding function, and there is substantial variation in the size and shape of a bolus prior to a swallow. Preterm infants exhibit decreased abilities to acquire and process food, but how that relates to their bolus size and shape is unknown. Here, we test two hypotheses: (1) that bolus size and shape will differ between term and preterm infants, and (2) bolus size and shape will change longitudinally through development in both term and preterm infants. Methods-To test these hypotheses, we measured bolus size and shape in preterm and term infant pigs longitudinally through nursing using high-speed videofluoroscopy. Results-Preterm infant pigs swallowed smaller volumes of milk. Although term infants increased the amount of milk per swallow as they aged, preterm infants did not. These changes in bolus volume were also correlated with changes in bolus shape; larger boluses became more elongate as they better filled the available anatomical space of the valleculae. Conclusion-These results suggest that preterm birth reduces the ability of preterm pigs to increase bolus size as they grow, affecting development in this fragile population. These results highlight that studies on term infant feeding may not translate to preterm infants.

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“…The change in these waveform patterns may be due to one or several factors: brainstem maturation, sensory and motor maturation of afferent and efferent pathway responses, or changes in central pattern generator functions. Owing to the clinical nature of this study, precise mechanisms are uncertain and developmental animal studies are needed (1, 6, 16, 30, 33).…”

Section: Discussionmentioning

confidence: 99%

“…Analytical methods were adapted from previous non-nutritive sucking, nutritive sucking-swallowing, and pharyngo-esophageal analysis (3–5, 14, 16, 19, 30) to characterize pharyngeal provocation induced rhythms. Based on our previous pharyngo-esophageal studies (3, 19), the following definitions were applied utilizing pharyngo-esophageal manometry waveforms to all pharyngeal stimuli administered.…”

Section: Methodsmentioning

confidence: 99%

Maturation Modulates Pharyngeal-Stimulus Provoked Pharyngeal and Respiratory Rhythms in Human Infants

et al. 2017

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Pharyngeal-provocation induced aerodigestive symptoms in infants remain an enigma. Sources of pharyngeal provocation can be anterograde as with feeding, and retrograde as in gastroesophageal reflux. We determined maturational and dose-response effects of targeted pharyngeal-stimulus on frequency, stability, and magnitude of pharyngeal and respiratory waveforms during multiple pharyngeal swallowing responses in preterm-born infants when they were of full-term postmenstrual age (PMA). Eighteen infants (11 male) were studied longitudinally at 39.8 ± 4.8 weeks PMA (time-1) and 44.1 ± 5.8 weeks PMA (time-2). Infants underwent concurrent pharyngo-esophageal manometry, respiratory inductance plethysmography, and nasal airflow thermistor methods to test sensory-motor interactions between the pharynx, esophagus, and airway. Linear mixed models were used and data presented as mean ± SEM or %. Overall, responses to 250 stimuli were analyzed. Of the multiple pharyngeal swallowing responses (n = 160), with maturation (a) deglutition apnea duration decreases (p < 0.01), (b) number of pharyngeal waveform peaks and duration decreases for initial responses (p < 0.01), and subsequent responses have lesser variation and greater stability (p < 0.01). With increment in stimulus volumes we noted (a) increased prevalence (%) of pharyngeal responses (p < 0.05), (b) increased number of pharyngeal peaks (p < 0.05), yet pharyngeal frequency (Hz), variability, and stability remain unaffected (p > 0.05), and (c) respiratory changes were unaffected (p > 0.05). Initial and subsequent pharyngeal responses and respiratory rhythm interactions become more distinct with maturation. Interval oromotor experiences and volume-dependent increase in adaptive responses may be contributory. These mechanisms may be important in modulating and restoring respiratory rhythm normalcy.

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Variation in the Timing and Frequency of Sucking and Swallowing over an Entire Feeding Session in the Infant Pig Sus scrofa

Cited by 17 publications

References 33 publications

Impact of recurrent laryngeal nerve lesion on oropharyngeal muscle activity and sensorimotor integration in an infant pig model

Impact of recurrent laryngeal nerve lesion on oropharyngeal muscle activity and sensorimotor integration in an infant pig model

Premature birth impacts bolus size and shape through nursing in infant pigs

Maturation Modulates Pharyngeal-Stimulus Provoked Pharyngeal and Respiratory Rhythms in Human Infants

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