AGE AND AGE-RELATED DISEASE EFFECTS ON SWALLOWING

年龄和年龄相关疾病对吞咽的影响

• 批准号: 2265223
• 负责人: JOANNE ROBBINS
• 金额: $ 20.45万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-03-01 至 1999-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2265223
• 关键词: age difference; aging; biomechanics; body movement; gastrointestinal imaging /visualization; human subject; magnetic resonance imaging; medical complication; neuroanatomy; nutrition of aging; nutrition related tag; stroke; swallowing

Recent evidence suggests swallowing is affected by normal aging. Since age-specific change are not well-defined or understood, this limited knowledge complicates accurate dysphagia diagnosis in the elderly, in whom chronic debilitating diseases accompanied by swallowing problems occur with increased frequency. The long-term objective of this project is to increase understanding of the effects of normal aging on swallowing physiology in an effort to advance the diagnosis and treatment of oropharyngeal swallowing disorders in age-related disease. The proposed work will establish a normative data base of movement parameters comprising salient features of oropharyngeal swallowing in conjunction with structural brain quantification, obtained with magnetic resonance imaging, throughout the adult age interval of 45 to 95 years. One hypothesis to be tested is that oropharyngeal swallowing will differ with increasing age in terms of range, duration and direction of motion. In addressing this hypothesis, the quantification of various parameters will be expanded as will understanding of swallowing physiology and the effects of age on it. Little quantitative information on the specific parameters of oral movements during swallowing has been obtained using fluoroscopy. This is largely due to limitations inherent in fluoroscopic imaging of oropharyngeal soft tissue structures, particularly the tongue. Techniques to facilitate lingual point place tracking simultaneously with bolus tracking during fluoroscopic recording of swallowing have recently been established and a customized computer-based system has been developed to facilitate movement of soft tissue structures and provide a reliable source of kinematic measurement. These new methodologies will be used tin the proposed project. Also, the hypothesis that maximum tongue strength differs for young and old individuals and percent of maximum tongue strength used in swallowing increases with age will be tested. A pressure transducer, designed to measure tongue strength used in swallowing increases with age will be tested. A pressure transducer , designed to measure tongue strength during swallowing will be used to test the hypothesis that lingual pressure is predictive of pharyngeal kinematic parameters, bolus transit and pharyngeal kinematics in a test group of normals also will be studied. Comparison of normative data to swallowing profiles (bolus transit time, lingual pressure, and oropharyngeal kinematic measures and their interrelationships) and clinicoanatomic correlates of unilateral stroke patients with and without swallowing complaints will be studied. In this manner, another major objective, to distinguish changes in neuromotor processes and their relationship to anatomical changes in the brain that occur with normal aging from neuromotor deficiencies and clinicoanatomic correlates due to age-related disease, in this case stroke, will be addressed with specific regard to the swallowing mechanism. The relationship of aspects of swallowing physiology to nutritional parameters in normals of different ages and stroke patients also may contribute to diagnostic criteria for presence of dysphagia. The proposed examination of the interrelationships among physiologic parameters, nutritional parameters, and neurovascular correlates with normal and pathologic aging, will provide insights to the underlying mechanisms for differences found and will guide age-appropriate treatment development. Finally, soft tissue imaging and oral pressure measurement and analysis techniques will be substantially improved during the years of this project, providing better methodology and tools for future investigations of swallowing.

最近的证据表明，吞咽受到正常衰老的影响。自.以来 具体年龄的变化没有被很好地定义或理解，这是有限的 知识使老年人吞咽困难的准确诊断复杂化 伴随吞咽问题的慢性衰弱疾病发生在 增加了频率。这个项目的长期目标是 增加对正常衰老对吞咽的影响的了解 生理学在提高诊断和治疗方面的作用 年龄相关性疾病中的口咽吞咽障碍。建议数 工作将建立一个标准化的运动参数数据库，包括 口咽吞咽与结构性吞咽的显著特征 全程通过磁共振成像获得的大脑量化 成人年龄间隔为45岁至95岁。 一个需要检验的假设是，口咽吞咽会有所不同 随着年龄的增长，运动的范围、持续时间和方向都会增加。 在解决这一假设时，各种参数的量化 将会扩大对吞咽生理学和 年龄对它的影响。关于具体情况的定量信息很少 吞咽过程中的口腔运动参数通过以下方法获得 透视检查。这在很大程度上是由于透视检查固有的局限性。 口咽部软组织结构的成像，尤指舌头。 同时促进舌点位置跟踪的技术 最近，在透视记录吞咽过程中的团注跟踪 已建立并开发了定制的基于计算机的系统 为促进软组织结构的运动和提供可靠的 运动学测量源。这些新方法将用于 提议的项目。 此外，年轻人和老年人的最大舌力不同的假设 吞咽时使用的最大舌力的个数和百分比 随着年龄的增长，将进行测试。一种压力传感器，设计用于 测量吞咽时使用的舌力将随着年龄的增长而增加 测试过。一种压力传感器，设计用于测量舌头的强度 吞咽将被用来检验舌压是 咽部运动学参数、团注和咽部的预测 还将研究一组测试法线的运动学。 标准数据与吞咽轮廓的比较(推注传输时间， 舌压和口咽运动学测量及其临床意义 相互关系)和单侧卒中的临床解剖学相关性 有或没有吞咽主诉的患者将被研究。在这 方式，另一个主要目标，以区分神经运动的变化 过程及其与大脑的解剖学变化的关系 由于神经运动缺陷和临床解剖学原因而发生在正常年龄 由于年龄相关的疾病，在这种情况下，中风，将是 具体涉及吞咽机制。这个 吞咽生理各方面与营养参数的关系 在不同年龄的正常人和中风患者中也可能对 吞咽困难的诊断标准。建议进行的研究 生理参数、营养之间的相互关系 参数和神经血管与正常和病理性衰老相关， 将为发现差异的潜在机制提供洞察力 并将指导适合年龄的治疗发展。最后，软组织 成像和口腔压力测量和分析技术将 在该项目的几年中有了很大的改进，提供了更好的 未来吞咽研究的方法和工具。