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Sensory stimulation and dysphagia

Omar Ortega, Alberto Martín, Pere Clavé
Oropharyngeal dysphagia (OD) is a condition recognized by the World Health Organization and defined as the difficulty or inability to move a bolus safely and effectively from the oral cavity to the esophagus, and can include aspirations, choking, and residue. OD is pandemic among different phenotypes of older people, affecting between 27% and 91% of the population 70 years or older. Although OD can be diagnosed by well-defined clinical methods and complementary explorations, in the clinical setting OD is seldom systematically screened and treated, and awareness among the medical/geriatric community is scarce...
April 12, 2017: Journal of the American Medical Directors Association
Satoshi Hamada, Hirofumi Yamaguchi, Hiroyoshi Hara
Acute stroke patients with dysphagia are at risk of developing pulmonary infection, which increases the risk of death. Therefore, optimal management of dysphagia is essential; however, available evidence supporting the effectiveness of dysphagia treatments is limited. Surface electrical stimulation (e-stim) has been developed as a new treatment modality for dysphagia. In this study, we investigated the efficacy of surface sensory e-stim therapy in preventing pulmonary infection in 53 acute stroke patients with dysphagia...
March 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Omar Ortega, Laia Rofes, Alberto Martin, Viridiana Arreola, Irene López, Pere Clavé
Oropharyngeal dysphagia (OD) is a prevalent geriatric syndrome. Treatment is based on compensatory strategies to avoid complications. New treatments based on sensory stimulation to promote the recovery of the swallowing function have proved effective in acute studies but prolonged treatment needs further research. Our aim was to evaluate and compare the effect of two, longer-term sensory treatment strategies on older patients with OD. 38 older patients (≥70 years) were studied with videofluoroscopy (pre/posttreatment) and randomized into two 10-day treatment groups: Group A-transient receptor potential vanilloid 1 (TRPV1) agonist (capsaicin 1 × 10(-5) M) and Group B-transcutaneous sensory electrical stimulation (TSES) (Intelect VitalStim, biphasic pulses, 300 μs, 80 Hz)...
October 2016: Dysphagia
L Rofes, O Ortega, N Vilardell, L Mundet, P Clavé
BACKGROUND: Oropharyngeal dysphagia (OD) is a highly prevalent symptom in older people. Appropriate oropharyngeal sensory feedback is essential for safe and efficient swallowing. However, pharyngeal sensitivity decreases with advancing age and could play a fundamental role in the physiopathology of swallowing dysfunction associated with aging. We aimed to characterize pharyngeal sensitivity and cortical response to a pharyngeal electrical stimulus in healthy volunteers (HV) and older patients with and without OD...
February 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Daniel Alvarez-Berdugo, Laia Rofes, J Francesc Casamitjana, Andreína Padrón, Miquel Quer, Pere Clavé
Oropharyngeal dysphagia (OD) affects older and neurological patients, causing malnutrition and dehydration and increasing the risk for aspiration pneumonia. There is evidence that sensory deficits in those populations are closely related to swallowing disorders, and several research groups are developing new therapies based on sensory stimulation of this area. More information on the sensory innervation participating in the swallow response is needed to better understand the pathophysiology of OD and to develop new treatments...
September 2016: Annals of the New York Academy of Sciences
Christopher Cabib, Omar Ortega, Hatice Kumru, Ernest Palomeras, Natalia Vilardell, Daniel Alvarez-Berdugo, Desirée Muriana, Laia Rofes, Rosa Terré, Fermín Mearin, Pere Clavé
Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition...
July 11, 2016: Annals of the New York Academy of Sciences
Gabriela Dumitrita Stanciu, Gheorghe Solcan
BACKGROUND: Acute Idiopathic Polyradiculoneuritis, an animal model for the axonal form of the Guillain - Barre Syndrome in humans and the acquired myasthenia gravis are different autoimmune disorders affecting the peripheral nerves and the neuromuscular junction, respectively. Both lead to muscle weakness and possible respiratory failure. The coexistence of these two entities combined in the same patient is rare in humans and, to our knowledge, the present case is the first reported in dogs...
June 14, 2016: BMC Veterinary Research
Sudarshan R Jadcherla, Kathryn A Hasenstab, Swetha Sitaram, Brian J Clouse, Jonathan L Slaughter, Reza Shaker
The pharynx is a locus of provocation among infants with aerodigestive morbidities manifesting as dysphagia, life-threatening events, aspiration-pneumonia, atelectasis, and reflux, and such infants often receive nasal respiratory support. We determined the impact of different oxygen delivery methods on pharyngeal stimulation-induced aerodigestive reflexes [room air (RA), nasal cannula (NC), and nasal continuous positive airway pressure (nCPAP)] while hypothesizing that the sensory motor characteristics of putative reflexes are distinct...
June 1, 2016: American Journal of Physiology. Gastrointestinal and Liver Physiology
Bronwyn Moorhouse, Caroline A Fisher
Dysphagia is a very common occurrence in Huntington's disease (HD). As such, many people with HD require texture modified diets. This commentary discusses the implications for individuals living long-term on modified diets, including the loss of sensory stimulation and dietary enjoyment. Clinical practice analyses of two interventions aimed at promoting dietary satisfaction and involvement in food preparation for those with HD are described and parameters for future research are discussed.
2016: Journal of Huntington's Disease
Eiji Kondo, Osamu Jinnouchi, Hiroki Ohnishi, Ikuji Kawata, Noriaki Takeda
Cough and swallowing reflexes are important airway-protective mechanisms against aspiration. Angiotensin-converting enzyme (ACE) inhibitors, one of the side effects of which is cough, have been reported to reduce the incidence of aspiration pneumonia in hypertensive patients with stroke. ACE inhibitors have also been reported to improve the swallowing function in post-stroke patients. On the other hand, stimulation of the Arnold nerve, the auricular branch of the vagus, triggers the cough reflex (Arnold's ear-cough reflex)...
November 2015: Nihon Jibiinkoka Gakkai Kaiho
Ming Zhang, Tao Tao, Zhao-Bo Zhang, Xiao Zhu, Wen-Guo Fan, Li-Jun Pu, Lei Chu, Shou-Wei Yue
OBJECTIVE: To evaluate and compare the effects of neuromuscular electrical stimulation (NMES) acting on the sensory input or motor muscle in treating patients with dysphagia with medullary infarction. DESIGN: Prospective randomized controlled study. SETTING: Department of physical medicine and rehabilitation. PARTICIPANTS: Patients with dysphagia with medullary infarction (N=82). INTERVENTIONS: Participants were randomized over 3 intervention groups: traditional swallowing therapy, sensory approach combined with traditional swallowing therapy, and motor approach combined with traditional swallowing therapy...
March 2016: Archives of Physical Medicine and Rehabilitation
K S Cakar Turhan, E A Salviz, S Beton, S T Timuroglu, S Catav, O Ozatamer
OBJECTIVE: Post-tonsillectomy pain is believed to be mediated by noxious stimulation of C-fiber afferents located in the peritonsillary space, and local anesthetic infiltration to this area may decrease pain by blocking the sensory pathways and thus preventing the nociceptive impulses. We aimed to compare the effects of different concentrations of preincisional peritonsillar levobupivacaine (0.25% and 0.5%) infiltration on postoperative pain and bleeding in a placebo-controlled design...
April 2015: European Review for Medical and Pharmacological Sciences
Philip Woodland, Rubina Aktar, Engelbert Mthunzi, Chung Lee, Madusha Peiris, Sean L Preston, L Ashley Blackshaw, Daniel Sifrim
Little is known about the mucosal phenotype of the proximal human esophagus. There is evidence to suggest that the proximal esophagus is more sensitive to chemical and mechanical stimulation compared with the distal. This may have physiological relevance (e.g., in prevention of aspiration of gastroesophageal refluxate), but also pathological relevance (e.g., in reflux perception or dysphagia). Reasons for this increased sensitivity are unclear but may include impairment in mucosal barrier integrity or changes in sensory innervation...
March 15, 2015: American Journal of Physiology. Gastrointestinal and Liver Physiology
Giédre Berretin-Felix, Isaac Sia, Ali Barikroo, Giselle D Carnaby, Michael A Crary
OBJECTIVE: This study compared the immediate impact of different transcutaneous electrical stimulation (TES) amplitudes on physiological swallowing effort in healthy older adults versus young adults. BACKGROUND: Swallowing physiology changes with age. Reduced physiological swallowing effort in older adults including lower lingua-palatal and pharyngeal pressures may increase risk for swallowing dysfunction (i.e. dysphagia). Transcutaneous electrical stimulation (TES) has been advocated as an adjunctive modality to enhance outcomes in exercise-based therapy for individuals with dysphagia...
September 2016: Gerodontology
Ling Chang, Peng-Lan He, Zhen-Zhong Zhou, Yan-Hua Li
OBJECTIVE: To observe the impacts on the recovery of swallowing function in patients of dysphagia after acute stroke treated with acupuncture and functional electric stimulation. METHODS: Seventy-four patients were randomized into an acupuncture plus electric stimulation group (38 cases) and an electric stimulation group (36 cases). The functional electric stimulator was used in the two groups. The electric pads were placed on the hyoid bone, the upper part of thyroid cartilage, the masseter muscle and the mandibular joint...
August 2014: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Joel V Gutiérrez, Lucy Norcliffe-Kaufmann, Horacio Kaufmann
OBJECTIVE: Several distinctive clinical features of patients with familial dysautonomia (FD) including dysarthria and dysphagia suggest a developmental defect in brainstem reflexes. Our aim was to characterize the neurophysiological profile of brainstem reflexes in these patients. METHODS: We studied the function of sensory and motor trigeminal tracts in 28 patients with FD. All were homozygous for the common mutation in the IKAP gene. Each underwent a battery of electrophysiological tests including; blink reflexes, jaw jerk reflex, masseter silent periods and direct stimulation of the facial nerve...
March 2015: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Youtian Hu, Zhenyu Liu, Xiaoyun Yu, Pankaj J Pasricha, Bradley J Undem, Shaoyong Yu
Eosinophilic esophagitis (EoE) is characterized with eosinophils and mast cells predominated allergic inflammation in the esophagus and present with esophageal dysfunctions such as dysphagia, food impaction, and heartburn. However, the underlying mechanism of esophageal dysfunctions is unclear. This study aims to determine whether neurons in the vagal sensory ganglia are modulated in a guinea pig model of EoE. Animals were actively sensitized by ovalbumin (OVA) and then challenged with aerosol OVA inhalation for 2 wk...
July 15, 2014: American Journal of Physiology. Gastrointestinal and Liver Physiology
Marziyeh Poorjavad, Saeed Talebian Moghadam, Noureddin Nakhostin Ansari, Mostafa Daemi
Neuromuscular electrical stimulation (NMES) for treating dysphagia is a relatively new therapeutic method. There is a paucity of evidence about the use of NMES in patients with dysphagia caused by stroke. The present review aimed to introduce and discuss studies that have evaluated the efficacy of this method amongst dysphagic patients following stroke with emphasis on the intensity of stimulation (sensory or motor level) and the method of electrode placement on the neck. The majority of the reviewed studies describe some positive effects of the NMES on the neck musculature in the swallowing performance of poststroke dysphagic patients, especially when the intensity of the stimulus is adjusted at the sensory level or when the motor electrical stimulation is applied on the infrahyoid muscles during swallowing...
2014: Stroke Research and Treatment
Remedios López-Liria, Melodie Fernández-Alonso, Francisco A Vega-Ramírez, M Ángeles Salido-Campos, David Padilla-Góngora
INTRODUCTION. Bronchopneumonia is a frequent complication in the first days after a cerebrovascular disease and is linked with a higher rate of mortality. It occurs in patients with an altered level of consciousness or tussigenic reflex, and could be prevented with an early dysphagia rehabilitation programme. AIMS. To review the scientific literature on the treatment and rehabilitation of patients with dysphagia after suffering a stroke, published between 2002 and 2012. DEVELOPMENT. A search conducted in the PubMed, Cochrane, PEDro, CINAHL and ENFISPO databases yielded 15 papers that fulfilled eligibility criteria and the initial aims of the study, providing information about 3,212 patients...
March 16, 2014: Revista de Neurologia
Bradley J Undem, Thomas Taylor-Clark
Persons with allergies present with symptoms that often are the result of alterations in the nervous system. Neuronally based symptoms depend on the organ in which the allergic reaction occurs but can include red itchy eyes, sneezing, nasal congestion, rhinorrhea, coughing, bronchoconstriction, airway mucus secretion, dysphagia, altered gastrointestinal motility, and itchy swollen skin. These symptoms occur because mediators released during an allergic reaction can interact with sensory nerves, change processing in the central nervous system, and alter transmission in sympathetic, parasympathetic, and enteric autonomic nerves...
June 2014: Journal of Allergy and Clinical Immunology
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