The hyoid bone and larynx elevate to protect the airway during swallowing. However, it is unknown whether hyolaryngeal movements during swallowing can adjust and adapt to predict the presence of a persistent perturbation in a feed-forward manner (adaptive motor learning). We investigated adaptive motor learning in nine healthy adults. Electrical stimulation was administered to the anterior neck to reduce hyolaryngeal elevation, requiring more strength to swallow during the perturbation period of this study. We assessed peak hyoid bone and laryngeal movements using videofluoroscopy across thirty-five 5-ml water swallows. Evidence of adaptive motor learning of hyolaryngeal movements was found when (1) participants showed systematic gradual increases in elevation against the force of electrical stimulation and (2) hyolaryngeal elevation overshot the baseline (preperturbation) range of motion, showing behavioral aftereffects, when the perturbation was unexpectedly removed. Hyolaryngeal kinematics demonstrates adaptive, error-reducing movements in the presence of changing and unexpected demands. This is significant because individuals with dysphagia often aspirate due to disordered hyolaryngeal movements. Thus, if rapid motor learning is accessible during swallowing in healthy adults, patients may be taught to predict the presence of perturbations and reduce errors in swallowing before they occur.
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This study was funded by The National Institutes of Health (NIDCD 1K23DC010776-01 to IH, NIDCD DC009980 to RZG, and R01 HD053793 to PC) and The National Institute of Child, Health and Development (NICHD) (PC).
Conflict of interest
There are no financial or other conflicts of interest related to this study by any author.
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Humbert, I.A., Christopherson, H., Lokhande, A. et al. Human Hyolaryngeal Movements Show Adaptive Motor Learning During Swallowing. Dysphagia 28, 139–145 (2013). https://doi.org/10.1007/s00455-012-9422-0