TONGUE JAW LINKAGES IN FEEDING

喂食时的舌颌连杆

• 批准号: 6379327
• 负责人: Jeffrey Bruce Palmer
• 金额: $ 30.87万
• 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/6379327
• 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吞咽范例不适用于进食固体食物的受试者。 在正常成人中，固体食物在口腔中加工，但食团在口咽中形成。 积聚的药丸在舌头的循环表面上向前和向后携带。 没有经典描述的后口密封。 有人提出了一个固体食物喂养的过程模型（Hiiemae和Palmer，1999）。 我们计划了三个实验来验证模型，通过测试以下四个假设：a）存在硬食物和软食物之间不同的体积/稠度阈值，并且在该阈值以上，食团形成正常地发生在口咽部; B）“按命令吞咽”指令将破坏正常的食团形成，表明后脑模式发生器的皮质覆盖; c）在进食期间呼吸将变得更慢且更不规则，并且当鼻孔打开时，在咀嚼中将发生鼻空气压力的高频振荡; d）软腭将表现出一些内在的节律性，但除了在早期咀嚼周期之外，软腭不会与舌头有规律地接触。 将使用以下技术：（a）使用不透射线的食物进行侧向视频荧光造影（VFG），初始咬口大小逐渐变化，食物（2-12 g香蕉，1-8 g饼干），液体吞咽10-25 cc，以评估咬口大小和稠度对进食的影响。 这些受试者中的一半将具有软腭标记物或嗅钡剂以突出腭表面和咽后壁;不透射线标记物也将在子集中粘到舌头上;（B）VFG（侧面和P-A），受试者作为他们自己的对照，以测试“命令吞咽”对序列行为的影响。 8 VFG，同时记录呼吸率（用胸部应变计和鼻压传感器测量），以及在喂食自然咬合大小的香蕉（12 g）和饼干（6 g）期间的咬肌和舌骨上EMG，以描绘完整喂食序列中呼吸，咀嚼和吞咽之间的相互作用。 将对数据进行目视分析，并酌情进行数字化和坐标操作。将检验事件之间的联系。 这些结果将进一步描述口咽食团形成的情况，并与吞咽困难患者的评估直接相关，这些患者存在食物加工问题，并增强了我们对咀嚼和吞咽中枢神经系统控制的了解。