A Comparison of Treatment Strategies for Recovery of Swallow and Swallow-Respiratory Coupling Following a Prolonged Liquid Diet in a Young Animal Model

项目摘要 健康婴儿从母乳喂养或奶瓶喂养到质地食品的成功过渡需要 复杂的神经肌肉控制的发展。这一转变也必须在快速发展的背景下进行。 生长发育和营养需求增加。为了启动这一过程，补充食品是 通常在4-6个月大时引入，并持续整个幼儿期。推迟采用 超过10个月大的补充食品会使原本健康的儿童面临持续喂养的风险 问题发展到学龄期。这表明长期的流质饮食从根本上 改变进食能力和潜在的口腔和咽部功能和协调。目前， 然而，如果这种情况发生， 口腔感觉运动发育的关键窗口已经过去。我们的理解有限，部分原因是 在检查吞咽时，为健康婴儿和儿童提供人类受试者研究保护 在喂养期间，它们的生长速度相对较慢，这使得纵向研究不可行。的 拟议的工作将确定是否喂养性能及其潜在的生理学和生物力学 在生长的关键时期长期使用质地改良的饮食后可以恢复， 口腔感觉运动成熟的动物模型。这个项目将比较喂养和吞咽呼吸 在早期成熟期间， 使用两种康复策略之一过渡到质地食品：直接过渡或渐进式 过渡这两种康复策略的结果将与正常断奶年龄进行比较- 匹配的对照动物（特定目标1）。该项目还将检查口腔（颌骨和 舌）和舌喉运动以及它们在每组进食期间的运动控制（直接过渡， 渐进过渡，对照）（具体目标2）。同步高速双平面透视， 将提供婴儿、幼年和亚成年动物4个月内的肌电图和呼吸数据， 跨关键发育阶段的序列和周期水平分析。结果将使我们能够区分 动物从一个生长发育阶段过渡到另一个生长发育阶段， 在口腔发育的关键窗口关闭后，将液体饮食转变为固体饮食。这项研究对以下方面至关重要： 为难以接受辅食的健康婴儿优化具体的康复策略。 这项研究也为治疗其他人群奠定了基础，如健康的早产儿， 存在影响口咽协调的潜在疾病并使断奶复杂化的儿童 以及向固体食物的成功过渡。

Project Summary Successful transition of healthy infants from breast- or bottle-feeding to textured foods requires the development of complex neuromuscular control. This transition must also occur within the context of rapid growth and development and increased nutritional demands. To initiate this process, complementary foods are typically introduced by 4-6 months of age and continue throughout early childhood. Delaying the introduction of complementary foods past 10 months of age places an otherwise healthy child at risk for persistent feeding problems to develop well into the school-age years. This suggests that prolonged liquid diets fundamentally alter feeding performance and the underlying oral and pharyngeal function and coordination. Currently, however, limited data is available on precisely what rehabilitation strategy would be best to implement if this critical window of oral sensorimotor development has passed. Our limited understanding is due, in part, to human subject research protections in place for healthy infants and children when examining the swallow during feeding and to their relatively slow growth rates which make longitudinal studies infeasible. The proposed work will determine whether feeding performance and its underlying physiology and biomechanics can be recovered following long-term use of a texture-modified diet during the critical periods of growth and oral sensorimotor maturation in an animal model. This project will compare feeding and swallow-respiratory coupling performance outcomes for animals reared on a texture-modified diet during early maturation and then transitioned to textured foods using one of two rehabilitation strategies: direct transition or progressive transition. The outcomes of these two rehabilitation strategies will be compared to normally-weaned age- matched control animals (Specific Aim 1). This project will also examine the coordination of oral (jaw and tongue) and hyolaryngeal movements and their motor control during feeding in each group (direct transition, progressive transition, controls) (Specific Aim 2). Synchronized high speed biplanar fluoroscopy, electromyography, and respiration data over 4 months in infant, juvenile, and subadult animals will provide sequence- and cycle-level analyses across critical developmental stages. Results will enable us to tease apart the relationship between growth and development, function, and performance as animals transition from a liquid to a solid diet after critical windows of oral development have closed. This research is essential for optimizing specific rehabilitation strategies for healthy infants who struggle to accept complementary foods. This research also lays the groundwork for treating other populations such as healthy preterm infants and children who present with underlying conditions affecting oropharyngeal coordination that complicate weaning and the successful transition to solid foods.