TONGUE JAW LINKAGES IN FEEDING

喂食时的舌颌连杆

• 批准号: 2903502
• 负责人: Jeffrey Bruce Palmer
• 金额: $ 31.34万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-05-01 至 2003-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2903502
• 关键词: barium; biomechanics; brain regulatory center; cinefluorography; clinical research; computer simulation; digital imaging; eating; electromyography; food; gastrointestinal imaging /visualization; human subject; image processing; jaw; jaw movement; mastication; neuroregulation; nutrition related tag; oral pharyngeal; palate; pulmonary respiration; swallowing; tongue; videotape /videodisc

The current paradigm for swallowing based on liquid command swallows does not apply to subjects eating solid foods. In normal adults, solid foods are processed in the oral cavity but the bolus is formed in the oropharynx. The accumulating bolus is carried forwards and backwards on the cycling surface of the tongue. There is no posterior oral seal as classically described. A Process Model for feeding on solid foods is proposed (Hiiemae and Palmer, 1999). We plan three experiments to validate the model by testing the following four hypotheses: a) there is a volume/consistency threshold which differs between hard and soft foods, and above which bolus formation normatively occurs in the oropharynx; b) the 'swallow on command' instruction will disrupt normal bolus formation, suggesting a cortical override of the hindbrain pattern generators; c) respiration will become slower and less regular during feeding, and high frequency oscillations in nasal air pressure will occur in chewing when the fauces are open; d) the soft palate will exhibit some intrinsic rhythmicity, but not make regular contact with the tongue except in early chewing cycles. The following techniques will be used: (a) lateral videofluorography (VFG) with radiopaque food in graduated initial bite sizes and consistencies (2-12 g banana, 1-8 g cookie), and with liquid swallows from 10-25 cc to assess the effect of bite size and consistency on feeding. Half of these subjects will have a soft palate marker or sniff barium to highlight the palatal surface and the posterior pharyngeal wall; radiopaque markers will also be glued to the tongue in a subset; (b) VFG (lateral and P-A) with subjects serving as their own controls to test the effect of the "command swallow" on sequence behavior. 8 VFG with simultaneous recording of respiratory rate (measured with a thoracic strain gauge and nasal pressure transducer), and masseter and suprahyoid EMG during feeding on natural bite sizes of banana (12 g) and cookie (6 g) to delineate the interactions between respiration, mastication, and swallowing in complete feeding sequences. Data will be analyzed visually, and by digitization and coordinate manipulation as appropriate. The linkages between events will be tested. The results will further delineate the circumstances in which oropharyngeal bolus formation occurs and have direct relevance to the evaluation of dysphagic patients, those with food processing problems and enhance our knowledge of CNS control of mastication and swallowing.

目前基于液体指令吞咽的范例并不适用于吃固体食物的受试者。在正常成年人中，固体食物在口腔中加工，但团状物在口咽部形成。累积的药丸在舌头的循环面上向前和向后移动。没有经典描述的后部口腔封口。提出了一个以固体食物为食的过程模型(Hiiemae和Palmer，1999)。我们计划进行三个实验，通过检验以下四个假设来验证模型：a)软硬食物之间存在一个不同的体积/浓度阈值，超过这个阈值，口咽部通常会形成团块；b)根据指令吞咽会扰乱正常的团团形成，这意味着后脑模式生成器的皮质优先；c)在进食过程中，呼吸将变得缓慢和不规律，当龙头打开时，鼻气压在咀嚼时会发生高频振荡；d)软掌将表现出一些内在的节律性，但除了早期的咀嚼周期外，不会经常与舌头接触。将使用以下技术：(A)横向视频透视(VFG)，以分级的初始咀嚼大小和稠度(2-12克香蕉，1-8克饼干)的不透射线食物，以及10-25毫升的液体燕子，以评估咀嚼大小和稠度对摄食的影响。这些受试者中有一半将有软腭标记或闻钡以突出腭面和咽后壁；不透射线的标记也将以子集的形式粘在舌头上；(B)VFG(侧向和P-A)，受试者作为自己的对照，以测试“命令吞咽”对序列行为的影响。8VFG，同时记录呼吸频率(用胸部应力计和鼻压传感器测量)，以及在进食自然大小的香蕉(12g)和饼干(6g)时的咬肌和舌骨上肌电，以描绘在整个进食序列中呼吸、咀嚼和吞咽之间的相互作用。将对数据进行可视化分析，并酌情进行数字化和坐标处理。将测试事件之间的联系。这一结果将进一步描述口咽团形成的环境，并与吞咽困难患者和有食物加工问题的患者的评估直接相关，并增强我们对中枢神经系统控制咀嚼和吞咽的了解。