MECHANICALLY EVOKED REFLEXES & FUNCTIONAL OROMOTOR SKILLS IN PRE TERM

机械诱发的反射

• 批准号: 6265145
• 负责人: ANNA DUSICK
• 金额: $ 0.04万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-12-01 至 1999-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6265145
• 关键词: behavioral /social science research tag; child physical development; clinical research; developmental neurobiology; electromyography; human subject; neurophysiology; neuroregulation; nutrient intake activity; nutrition related tag; oral behavior; premature infant human; psychomotor function; reflex; sensorimotor system; stimulus /response

The neurophysiologic developmental sequence leading to successful oral feeding remains poorly delineated in the preterm infant largely because there are no objective measures of the sensorineural pathways involved in oromotor function. The long term goal of this research is to describe the maturation of perioral sensorimotor function of the preterm infant using a new methodology, which has the potential for application in the assessment of neurodevelopmental integrity of the preterm infant, as well as for the development of specific interventions. We propose to use the mechanically evoked perioral reflex responses combined with functional assessment of sucking to test the following hypotheses: 1) An organized ontologic sequence of neurophysiologic perioral reflexes and oromotor responses developed in the infant during nonnutritive sucking, dependent upon post conceptual maturation. 2) Delay or aberration in the developmental pattern of perioral reflexes will occur secondary to abnormal external perioral/intraoral stimuli and/or lack of normal stimuli. 3) Injury to the central nervous system in the developing neonate will result in delay or abnormality of the ontogeny of the perioral reflexes. To test these hypotheses electromyographic oromotor measurements will be prospectively obtained in three groups of preterm infants (28 weeks gestation): 1) healthy preterm infants; 2) preterm infants who have experienced prolonged intubation and 3) preterm infants with grades III and IV intraventricular hemorrhage. Functional assessment of sucking will be obtained by measuring the onset of suck, the suck pressure inside the oral cavity and the respiratory cycle in coordination with the suck. Preliminary studies of the oromotor reflexes in early infancy using the proposed methodology indicate highly significant changes in latency and specificity which correlate with maturation. However, perioral neurophysiologic function has not been measured previously using these techniques in the preterm infant. These proposed studies will provide objective, quantifiable information for the first time concerning the development of this critical functional ability. Furthermore, determining sensorimotor reflexes is a novel approach to neurodevelopmental assessment, and may ultimately form the basis for designing specific interventions.

导致成功的经口喂养的神经生理发育顺序在早产儿中仍然很难描述，这主要是因为没有客观的测量参与口腔功能的感觉神经通路。 本研究的长期目标是使用一种新的方法来描述早产儿口周感觉运动功能的成熟，该方法有可能应用于早产儿神经发育完整性的评估，以及特定干预措施的开发。我们建议使用机械诱发的口周反射反应结合功能评估的吸吮，以测试以下假设：1）一个有组织的本体序列的神经生理口周反射和oreprazole反应的婴儿在非营养性吸吮，依赖于概念成熟后。 2)口周反射发育模式的延迟或畸变将继发于异常的外部口周/口内刺激和/或缺乏正常刺激。 3)发育中的新生儿中枢神经系统损伤将导致口周反射的个体发育延迟或异常。 为了检验这些假设，将在三组早产儿（妊娠28周）中前瞻性获得肌电图或心电图测量值：1）健康早产儿; 2）经历长时间插管的早产儿和3）III级和IV级脑室内出血的早产儿。 通过测量吸吮的开始、口腔内的吸吮压力和与吸吮协调的呼吸周期，获得吸吮的功能评估。初步研究的orabulous反射在婴儿早期使用所提出的方法表明，非常显着的变化，与成熟的潜伏期和特异性。 然而，口周神经生理功能尚未被测量以前使用这些技术在早产儿。 这些拟议的研究将首次提供有关这一关键功能发展的客观、可量化的信息。 此外，确定感觉运动反射是神经发育评估的一种新方法，并可能最终形成设计特定干预措施的基础。