Sucking versus swallowing coordination, integration, and performance in preterm and term infants.
Sucking versus swallowing coordination, integration, and performance in preterm and term infants.
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早产儿和足月儿吸吮与吞咽的协调、整合和表现。
DOI：
10.1152/japplphysiol.00668.2020
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
German,RebeccaZ
中科院分区：
文献类型：
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作者：
Mayerl,ChristopherJ;Edmonds,ChloeE;Catchpole,EmilyA;Myrla,AlexisM;Gould,FrancoisDH;Bond,LauraE;Stricklen,BethanyM;German,RebeccaZ
哺乳动物婴儿必须能够整合食物的获取，运输和吞咽以有效喂养。了解这些过程是如何协调的是至关重要的，因为它们在神经控制和对扰动的敏感性方面存在差异。尽管如此，大多数婴儿喂养的研究集中在孤立的过程中，导致有限的理解的感觉运动整合在婴儿喂养的不同过程中的作用。这在早产儿的情况下尤其成问题，因为他们被认为具有病理生理学的大脑发育并且经常经历喂养困难。在这里，我们使用动物模型来研究如何不同的属性的食物获取，运输和吞咽之间的长期和早产儿纵向通过婴儿期的不同，以了解哪些过程是敏感的变化正在吞咽的丸剂。我们发现，足月儿比早产儿更容易获得乳汁，并且获得的特性与吞咽的丸剂的大小密切相关。相反，咽部吞咽期间发生的行为，如舌骨和软腭运动，与食团大小几乎没有相关性。这些结果突出了早产儿大脑的病理生理学性质，也表明在口腔运输过程中发生的行为比在“咽期”发生的行为更容易对感觉干预做出反应。婴儿喂养的生理成熟在临床和发育上都很重要，但很少作为一个整体功能进行研究。使用纵向高速视频透视数据，我们发现，性能的吸吮，如吸吮的长度，更敏感的吞咽生理比那些与咽吞咽本身，如舌骨偏移。早产影响了喂养系统的功能和成熟，导致断奶时的生理学与足月儿根本不同。
Mammalian infants must be able to integrate the acquisition, transport, and swallowing of food to effectively feed. Understanding how these processes are coordinated is critical, as they have differences in neural control and sensitivity to perturbation. Despite this, most studies of infant feeding focus on isolated processes, resulting in a limited understanding of the role of sensorimotor integration in the different processes involved in infant feeding. This is especially problematic in the context of preterm infants, as they are considered to have pathophysiological brain development and often experience feeding difficulties. Here, we use an animal model to study how the different properties of food acquisition, transport, and swallowing differ between term and preterm infants longitudinally through infancy to understand which processes are sensitive to variation in the bolus being swallowed. We found that term infants are better able to acquire milk than preterm infants, and that properties of acquisition are strongly correlated with the size of the bolus being swallowed. In contrast, behaviors occurring during the pharyngeal swallow, such as hyoid and soft palate movements, show little to no correlation with bolus size. These results highlight the pathophysiological nature of the preterm brain and also demonstrate that behaviors occurring during oral transport are much more likely to respond to sensory intervention than those occurring during the “pharyngeal phase.”NEW & NOTEWORTHYPhysiological maturation of infant feeding is clinically and developmentally significant, but seldom examined as an integrated function. Using longitudinal high-speed videofluoroscopic data, we found that properties of sucking, such as the length of the suck, are more sensitive to swallow physiology than those associated with the pharyngeal swallow itself, such as hyoid excursion. Prematurity impacted the function and maturation of the feeding system, resulting in a physiology that fundamentally differs from term infants by weaning.