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Changes in the Excitability of Corticobulbar Projections Due to Intraoral Cooling with Ice

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Abstract

The aim of this study was to assess the effects of ice applied to the oral cavity on the excitability of corticobulbar projections to the swallowing muscles. The subjects were 8 healthy adult volunteers (mean age 29.0 ± 4.9 years). Motor-evoked potentials (MEPs) were recorded from the suprahyoid muscle complex using surface electrodes. Two blocks of 20 MEPs with a test stimulus intensity of 120% of the resting motor threshold were recorded at rest (baseline). Subjects then underwent 5-min thermal stimulation by either of 3 different types: (1) “ice-stick inside mouth,” (2) “ice-stick on neck,” and (3) “room temperature inside mouth.” Blocks of 20 MEPs were then recorded immediately and at 5-min intervals for the following 15 min. There was a significant difference in the effects of the 3 interventions on the amplitude of the MEPs following stimulation (two-way ANOVA: INTERVENTION × TIME; F8,84 = 3.76, p < 0.01). One-way ANOVA was used to evaluate the changes over time for each intervention type. Only “ice-stick inside mouth” caused an increase in the MEPs (one-way ANOVA main effect of TIME: F4,28 = 4.04, p = 0.010) with significant differences between baseline and P10 (mean difference 0.050; confidence interval (CI) 95% 0.019–0.079; p = 0.004). There were no significant effects of either “ice-stick on neck” or “room temperature inside mouth” (F4,28 = 1.13, p = 0.36; F4,28 = 1.36, p = 0.27, respectively). Ice stimulation within the oral cavity increases the excitability of the cortical swallowing motor pathway.

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Authors and Affiliations

  1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, London, UK

    Michiyuki Kawakami, Sara Simeoni, Sara Tremblay, Ricci Hannah & John C. Rothwell

  2. Department of Rehabilitation Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Michiyuki Kawakami

  3. Department of Physical Medicine and Rehabilitation, Juntendo University Graduate School of Medicine, Tokyo, Japan

    Toshiyuki Fujiwara

Authors
  1. Michiyuki Kawakami
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  2. Sara Simeoni
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  3. Sara Tremblay
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  4. Ricci Hannah
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  5. Toshiyuki Fujiwara
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  6. John C. Rothwell
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Contributions

MK and JCR contributed to the conception and study design, data acquisition, analysis and interpretation, and drafting of the manuscript. SS and RH contributed to data acquisition and analysis. ST and TF contributed to data acquisition, analysis and drafting of the manuscript. All authors revised the article critically and approved the final version for publication.

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Correspondence to Michiyuki Kawakami.

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Disclosure

JCR and RH were supported by a Medical Research Council Grant (MR/K01384X/1). The other authors declare no conflicts of interest.

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Informed consent was obtained from all participants.

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Kawakami, M., Simeoni, S., Tremblay, S. et al. Changes in the Excitability of Corticobulbar Projections Due to Intraoral Cooling with Ice. Dysphagia 34, 708–712 (2019). https://doi.org/10.1007/s00455-018-09975-4

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  • DOI: https://doi.org/10.1007/s00455-018-09975-4

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