Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening

The swallowing muscles that influence upper esophageal sphincter (UES) opening are centrally controlled and modulated by sensory information. Activation of neural inputs to these muscles, the intrinsic cricopharyngeus muscle and extrinsic suprahyoid muscles, results in their contraction or relaxatio...

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Main Authors: Taher eOmari, Lukasz eWiklendt, Philip eDinning, Marcello eCosta, Nathalie eRommel, Charles eCock
Format: Article
Language:English
Published: Frontiers Media S.A. 2015-01-01
Series:Frontiers in Systems Neuroscience
Subjects:
Online Access:http://journal.frontiersin.org/Journal/10.3389/fnsys.2014.00241/full
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author Taher eOmari
Taher eOmari
Taher eOmari
Lukasz eWiklendt
Philip eDinning
Philip eDinning
Marcello eCosta
Nathalie eRommel
Charles eCock
author_facet Taher eOmari
Taher eOmari
Taher eOmari
Lukasz eWiklendt
Philip eDinning
Philip eDinning
Marcello eCosta
Nathalie eRommel
Charles eCock
author_sort Taher eOmari
collection DOAJ
description The swallowing muscles that influence upper esophageal sphincter (UES) opening are centrally controlled and modulated by sensory information. Activation of neural inputs to these muscles, the intrinsic cricopharyngeus muscle and extrinsic suprahyoid muscles, results in their contraction or relaxation, which changes the diameter of the lumen, alters the intraluminal pressure and ultimately inhibits or promotes flow of content. This relationship that exists between the changes in diameter and concurrent changes in intraluminal pressure has been used previously to calculate the ‘mechanical states’ of the muscle; that is when the muscles are passively or actively, relaxing or contracting. Diseases that alter the neural pathways to these muscles can result in weakening the muscle contractility and/or decreasing the muscle compliance, all of which can cause dysphagia. Detecting these changes in the mechanical state of the muscle is difficult and as the current interpretation of UES motility is based largely upon pressure measurement (manometry), subtle changes in the muscle function during swallow can be missed. We hypothesised that quantification of mechanical states of the UES and the pressure-diameter properties that define them, would allow objective characterisation of the mechanisms that govern the timing and extent of UES opening during swallowing. To achieve this we initially analysed swallows captured by simultaneous videofluoroscopy and UES pressure with impedance recording. From these data we demonstrated that intraluminal impedance measurements could be used to determine changes in the internal diameter of the lumen when compared to videofluoroscopy. Then using a database of pressure-impedance studies, recorded from young and aged healthy controls and patients with motor neuron disease, we calculated the UES mechanical states in relation to a standardised swallowed bolus volume, normal aging and dysphagia pathology. Our results indicated that eight
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spelling doaj.art-d9d4b0b94986447f8dd5bafab9ed85ee2022-12-21T23:24:59ZengFrontiers Media S.A.Frontiers in Systems Neuroscience1662-51372015-01-01810.3389/fnsys.2014.00241120590Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and openingTaher eOmari0Taher eOmari1Taher eOmari2Lukasz eWiklendt3Philip eDinning4Philip eDinning5Marcello eCosta6Nathalie eRommel7Charles eCock8Flinders UniversityFlinders Medical CentreUniversity of LeuvenFlinders UniversityFlinders UniversityFlinders Medical CentreFlinders UniversityUniversity of LeuvenFlinders Medical CentreThe swallowing muscles that influence upper esophageal sphincter (UES) opening are centrally controlled and modulated by sensory information. Activation of neural inputs to these muscles, the intrinsic cricopharyngeus muscle and extrinsic suprahyoid muscles, results in their contraction or relaxation, which changes the diameter of the lumen, alters the intraluminal pressure and ultimately inhibits or promotes flow of content. This relationship that exists between the changes in diameter and concurrent changes in intraluminal pressure has been used previously to calculate the ‘mechanical states’ of the muscle; that is when the muscles are passively or actively, relaxing or contracting. Diseases that alter the neural pathways to these muscles can result in weakening the muscle contractility and/or decreasing the muscle compliance, all of which can cause dysphagia. Detecting these changes in the mechanical state of the muscle is difficult and as the current interpretation of UES motility is based largely upon pressure measurement (manometry), subtle changes in the muscle function during swallow can be missed. We hypothesised that quantification of mechanical states of the UES and the pressure-diameter properties that define them, would allow objective characterisation of the mechanisms that govern the timing and extent of UES opening during swallowing. To achieve this we initially analysed swallows captured by simultaneous videofluoroscopy and UES pressure with impedance recording. From these data we demonstrated that intraluminal impedance measurements could be used to determine changes in the internal diameter of the lumen when compared to videofluoroscopy. Then using a database of pressure-impedance studies, recorded from young and aged healthy controls and patients with motor neuron disease, we calculated the UES mechanical states in relation to a standardised swallowed bolus volume, normal aging and dysphagia pathology. Our results indicated that eighthttp://journal.frontiersin.org/Journal/10.3389/fnsys.2014.00241/fullNeural PathwaysPressuredysphagiaimpedanceSwallowupper esophageal sphincter
spellingShingle Taher eOmari
Taher eOmari
Taher eOmari
Lukasz eWiklendt
Philip eDinning
Philip eDinning
Marcello eCosta
Nathalie eRommel
Charles eCock
Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening
Frontiers in Systems Neuroscience
Neural Pathways
Pressure
dysphagia
impedance
Swallow
upper esophageal sphincter
title Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening
title_full Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening
title_fullStr Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening
title_full_unstemmed Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening
title_short Upper esophageal sphincter mechanical states analysis: A novel methodology to describe UES relaxation and opening
title_sort upper esophageal sphincter mechanical states analysis a novel methodology to describe ues relaxation and opening
topic Neural Pathways
Pressure
dysphagia
impedance
Swallow
upper esophageal sphincter
url http://journal.frontiersin.org/Journal/10.3389/fnsys.2014.00241/full
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