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Sensorimotor Control of the Human Orofacial System

人类口面部系统的感觉运动控制

基本信息

批准号：
8828835
负责人：
STEVEN M BARLOW
金额：
$ 2.76万
依托单位：
UNIVERSITY OF NEBRASKA LINCOLN
依托单位国家：
美国
项目类别：
财政年份：
2002
资助国家：
美国
起止时间：
2002-01-15 至 2014-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8828835
关键词：
Sensorimotor Control Human Orofacial System

项目摘要

DESCRIPTION (provided by applicant): A new synthetic patterned orocutaneous stimulation technique (NTrainer) has been shown previously to entrain the suck central pattern generator (sCPG) in human infants. The effectiveness of the NTrainer will be tested in a randomized trial among four groups of preterm infants. Three of the clinical populations selected are especially at risk for significant oromotor dysfunction and feeding difficulties, including babies with (1) moderate-severe history of respiratory distress syndrome (RDS), (2) chronic lung disease and/or bronchopulmonary dysplasia (CLD/BPD), and (3) infants with Down syndrome (DS). Preterm infants distributed among these groups with birth gestational ages between 26 and 32 weeks will be randomly assigned to experimental (Treatment w/NTrainer) and control (No Treatment sham stimulation) subgroups. The fourth group will consist of HEALTHY preterm infants. It is hypothesized that premature infants with a significant history of RDS, CLD/BPD, and Down syndrome will demonstrate significant reorganization and activation of the sCPG following NTrainer treatment. Primary outcome variables include daily measures of non-nutritive suck dynamics (NeoSuck), spatiotemporal index of the non-nutritive suck (STI NNS), ororhythmic motor behavior, NNS cycle period analysis, early feeding skills assessment, transition time from tube-to-oral feed, feeding efficiency, and length of hospital stay. A second major objective will include a comprehensive assessment of neurodevelopmental outcome at 3 years of age. The Bayley III Developmental Scales and a battery of standardized articulation, vocabulary, grammar, and speech-language probes will provide vital information on production and reception. These measures will assess the potential link between oromotor status in prematurity, effects of NTrainer stimulation, and neurodevelopmental outcome. Prematurity is the leading cause of developmental disabilities in children, including cerebral palsy, mental retardation, blindness, chronic lung problems, attention deficit, and speech/language disorders. Feeding competency is another challenging hurdle facing many premature babies, especially for those who have an extensive oxygen history associated with respiratory disease, neurologic insult, or certain genetic defects which impair oromotor development. The lengthy intubation procedures cost the baby precious sensory and motor experiences during a critical period of brain development for oromotor pattern generation. Accelerated development of oromotor skills using a novel method for delivering patterned orocutaneous stimulation to the oral sensorium will directly benefit this growing population of fragile infants, leading to enhanced suck skills, decreased transition time from gavage tube-to-oral feed, decreased length of hospitalization, and promote a more positive neurodevelopmental outcome.

描述（由申请人提供）：一种新的合成模式口皮肤刺激技术（NTrainer）先前已被证明可以在人类婴儿中引入吸吮中枢模式发生器（sCPG）。 NTrainer 的有效性将通过四组早产儿的随机试验进行测试。所选的三个临床人群尤其面临严重的口部运动功能障碍和喂养困难的风险，包括患有（1）中重度呼吸窘迫综合征（RDS）病史的婴儿，（2）慢性肺病和/或支气管肺发育不良（CLD/BPD），以及（3）患有唐氏综合症（DS）的婴儿。分布在这些组中的出生胎龄在 26 至 32 周之间的早产儿将被随机分配到实验亚组（使用 NTrainer 进行治疗）和对照亚组（无治疗假刺激）。第四组将包括健康的早产儿。据推测，具有 RDS、CLD/BPD 和唐氏综合症病史的早产儿在 NTrainer 治疗后将表现出 sCPG 的显着重组和激活。主要结果变量包括每日非营养性吸吮动态测量（NeoSuck）、非营养性吸吮时空指数（STI NNS）、口律运动行为、NNS周期分析、早期喂养技能评估、从管饲到口服喂养的过渡时间、喂养效率和住院时间。第二个主要目标将包括对 3 岁时的神经发育结果进行全面评估。贝利 III 发展量表和一系列标准化发音、词汇、语法和言语语言探针将提供有关生产和接收的重要信息。这些措施将评估早产儿口腔运动状态、NTrainer 刺激的影响和神经发育结果之间的潜在联系。早产是儿童发育障碍的主要原因，包括脑瘫、智力低下、失明、慢性肺部问题、注意力缺陷和言语/语言障碍。喂养能力是许多早产儿面临的另一个具有挑战性的障碍，特别是对于那些因呼吸系统疾病、神经损伤或某些损害口部运动发育的遗传缺陷而有大量吸氧史的早产儿。在大脑发育的口部运动模式生成的关键时期，漫长的插管过程使婴儿失去了宝贵的感觉和运动经验。使用一种向口腔感觉中枢提供模式化口皮肤刺激的新方法来加速口部运动技能的发展将直接使不断增长的脆弱婴儿群体受益，从而增强吸吮技能，减少从管饲管到口腔喂养的过渡时间，缩短住院时间，并促进更积极的神经发育结果。