Fundamental study for clarifying dysphagia : The role of upper brain in inducing swallowing

澄清吞咽困难的基础研究：上脑在诱导吞咽中的作用

• 批准号: 14207077
• 负责人: YAMADA Yoshiaki
• 金额: $ 23.96万
• 依托单位: Niigata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (A)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-14207077/
• 关键词: swallow induction area; masticatory sequence; tongue; face muscle; magnetoencephalogram; videofluorography; cingulate cortex; operculum; ヒト; ウサギ; 飲水; 嚥下; 青汁; 脳磁図; 摂食; 嚥下誘発; 急性動物; 島; 慢性動物

Mechanical stimulation to pharyngeal and/or laryngeal region has long been believed to elicit swallow reflexively irrespective of the cortical situation. However, videofluorographic (VF) study has revealed that some food may be transported to the pharynx during mastication. Interestingly, the bolus dropped in the pharynx does not elicit swallow till the chewing process is completed. The project was thus designed to seek possible cortical regions which could affect swallowing center, in which magneto-encephalogram and VF were applied for human subjects and kinesiological and electrophysiological methods for animals.In rabbits, the ingestive behavior, from food intake to swallowing, could be recorded and identified. The coordination between tongue and masticatory muscles and the role of facial (cheek and lip) muscles during mastication were clarified. To seek a possible cortical region for swallowing, rabbit's cortex was systematically stimulated. Then the region, where swallows were facilitated or inhibited during chewing, was identified. However, no concrete region where the swallow could be elicited solely was identified. We believe that in animals with crudely developed cortex, the region may be limited in a small area or even voluntary swallow itself may not be developed.Magneto-encephalogram showed that the cingulate cortex was active for short time about 2 sec preceding voluntary swallows and the insula and operculum were active for long period till swallows occurred. Since cingulate cortex is known as a region relating to emotion, it is concluded that the activation in this region may be related to a recognition process of food. Insula and operculum is known to have a direct connection with the swallowing center, thereafter, the region may be the main one for cortical elicitation of swallows. VF studies revealed that humans swallow two or three times when they clear the mouth of mouthful food as has been reported in animal studies.

长期以来，对咽部和/或喉部区域的机械刺激被认为引起反射性吞咽，而不管皮质情况如何。然而，视频荧光（VF）研究表明，一些食物可能会被运送到咽咀嚼。有趣的是，在咀嚼过程完成之前，落入咽部的食团不会引起吞咽。本研究采用脑磁图和VF技术对人进行研究，采用运动学和电生理学方法对动物进行研究，对家兔从摄食到吞咽的摄食行为进行记录和识别，以寻找可能影响吞咽中枢的脑皮层区域。阐明了咀嚼过程中舌与咀嚼肌之间的协调关系以及面（颊、唇）肌的作用。为了寻找一个可能的大脑皮层吞咽区域，系统地刺激了家兔的大脑皮层。然后，该地区，吞咽促进或抑制在咀嚼，被确定。然而，没有确定可以单独引起吞咽的具体区域。我们认为，在皮质发育不成熟的动物中，这一区域可能局限于一个小范围内，甚至自主吞咽本身也可能不发育，脑磁图显示，在自主吞咽前约2秒，扣带回皮质有短暂的活动，而前扣带回和鳃盖则有较长的活动，直至吞咽发生。由于扣带皮层被认为是一个与情绪有关的区域，因此可以得出结论，该区域的激活可能与食物的识别过程有关。岛盖与吞咽中枢有直接联系，可能是吞咽皮层诱发的主要部位。VF研究表明，人类在清理口腔中的食物时会吞咽两到三次，正如动物研究所报告的那样。

项目成果

咀嚼・嚥下運動とその神経機構

咀嚼和吞咽运动及其神经机制

• 发表时间: 2005
• 期刊: 日本全身咬合学会雑誌 11・2
• 作者: 市川智彦;山田 好秋
• 通讯作者: 山田 好秋

Understanding the Eating and Swallowing Mechanisms

了解进食和吞咽机制

• 发表时间: 2004
• 作者: Yamada;Y.
• 通讯作者: Y.

Kakizaki, Y.: "Coordination between the masticatory and tongue muscles as seen with different foods in consistency and in reflex activities during natural chewing"Brain Research. 929. 210-217 (2002)

Kakizaki, Y.：“在自然咀嚼过程中，不同食物的稠度和反射活动中咀嚼肌和舌头肌肉之间的协调”大脑研究。

Coordination of jaw and extrinsic tongue muscle activity during rhythmic jaw movements in anesthetized rabbits

• DOI: 10.1016/j.brainres.2004.05.005
• 发表时间: 2004-08-06
• 期刊: BRAIN RESEARCH
• 影响因子: 2.9
• 作者: Ariyashinghe, S;Inoue, M;Yamada, K
• 通讯作者: Yamada, K

Effects of functional training of dysphagia to prevent pneumonia for patients on tube feeding.

• DOI: 10.1111/j.1741-2358.2004.00016.x
• 发表时间: 2004-06-01
• 期刊: Gerodontology
• 影响因子: 2
• 作者: Ueda, Koichiro;Yamada, Y;Saitho, E
• 通讯作者: Saitho, E