Effect of lingual nerve injury on oromotor function

描述(申请人提供)：饮食在日常生活和保持生活质量中起着核心作用。安全饮食有赖于口腔感官信息的整合来管理食物。当口腔感觉因受伤或疾病而受到负面影响时，患者可能会面临没有为吞咽准备适当的固体食物的风险。舌神经的主要感觉神经，即舌神经，在常规牙科手术(如拔除第三颗磨牙)中经常受到压迫(“挤压”)或切断，因为它在口腔底部没有解剖学上的保护位置。舌神经损伤会导致疼痛， 感觉改变或减少，患者也报告进食困难。然而，这种运动功能障碍的潜在生物力学和功能基础尚不清楚。此应用程序的目的是了解舌神经损伤如何影响进食行为以及进食过程中舌头和下巴的神经控制和协调。中心假设是，舌神经压迫和横断损伤对口腔结构的感觉运动整合以及口腔食物管理产生了负面影响，但它们以不同的方式做到了这一点。单侧舌神经损伤的影响将在ig中进行研究，ig是一种公认的人类喂养生物力学和口腔功能的动物模型。具体目标1将使用双平面透视和一种新的运动分析方法--X射线运动形态重建(XROMM)--来确定这些损伤对运动行为的影响。《特定目标2》将结合颌部、口腔和舌部肌肉的运动分析和肌电图学，以了解这些损伤后相关运动的神经生理控制。这两个目标都将确定舌头和下巴在语言感觉障碍后的功能变化和补偿机制。这项研究具有创新性，因为它集中在1)两种不同类型的感觉障碍对运动输出和控制的影响，以及2)吞咽前阶段而不是口咽吞咽的影响，这是大多数喂养康复研究的重点。与吞咽不同，进食的口腔阶段需要两侧不对称的运动和运动控制。该项目在使用XROMM方面具有方法创新，它允许高分辨率3D舌头和下巴运动与控制这些运动的肌肉的肌电同步。预计这将导致对舌头在进食过程中的作用以及由于感觉障碍而导致的功能变化的新见解。这项拟议的研究意义重大，因为舌神经损伤令人惊讶地常见，了解它们对口腔运动输出的影响有助于设计恢复口腔功能的康复策略。

DESCRIPTION (provided by applicant): Eating plays a central role in everyday living and maintaining quality of life. Safe eating depends upon the integration of sensory information from the oral cavity to manage food. When oral sensation is negatively affected due to injury or disease, patients are at risk for not properly preparing solid foods for the swallow. The main sensory nerve of the tongue, the lingual nerve, is frequently compressed ("crushed") or transected during routine dental procedures (e.g., third molar removal) because of its anatomically unprotected location in the floor of the mouth. Lingual nerve injuries result in pain, altered or reduced sensation, and patients also report difficulties with feeding. However, the underlying biomechanical and functional basis of this oromotor dysfunction is unknown. The objective of this application is to understand how trauma to the lingual nerve impacts feeding behavior and the neural control and coordination of the tongue and jaw during feeding. The central hypothesis is that lingual nerve compression and transection injuries negatively impact sensorimotor integration of oral structures and, by extension, oral food management, but they do so in distinct ways. The effect of unilateral lingual nerve lesions will be investigated in the ig, an accepted animal model for human feeding biomechanics and oral function. Specific Aim 1 will use biplanar fluoroscopy and a novel motion analysis method, X-ray Reconstruction of Moving Morphology (XROMM), to determine the impact of these injuries on oromotor behavior. Specific Aim 2 will combine motion analysis with electromyography from jaw, oral and tongue muscles to understand the neurophysiological control of associated movements following these injuries. Both aims will identify functional changes and compensatory mechanisms in the tongue and jaw following lingual sensory disturbances. This research is innovative because it focuses on 1) the effect of two distinct types of sensory disturbances on motor output and control and 2) the pre-swallowing feeding stages rather than on the oropharyngeal swallow, the focus of most feeding rehabilitation research. Unlike swallowing, the oral stages of feeding require bilaterally asymmetrical movements and motor control. This project is methodologically innovative in its use of XROMM, which allows the synchronization of high resolution 3D tongue and jaw movements with electromyograms from muscles controlling these movements. This is expected to lead to new insights into the role of the tongue during the oral stages of feeding and changes in its function resulting from sensory disturbances. The proposed research is significant because lingual nerve injuries are surprisingly common, and understanding their impact on oromotor output can benefit the design of rehabilitation strategies to restore oral function.