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Preterm Infant Swallowing of Thin and Nectar-Thick Liquids: Changes in Lingual–Palatal Coordination and Relation to Bolus Transit

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Abstract

Tongue–soft palate coordination and bolus head pharyngeal transit were studied by means of postacquisition kinematic analysis of videofluoroscopic swallowing images of ten preterm infants referred from hospital NICUs due to poor oral feeding and suspicion of aspiration. Sequences of coordinated tongue–soft palate movements and bolus transits during swallows of thin-consistency and nectar-thick-consistency barium were digitized, and time series data were used to calculate continuous relative phase, a measure of coordination. During swallows of nectar-thick compared to thin barium, tongue–soft palate coordination was more likely to be antiphase, bolus head pharyngeal transit time was longer, and coordination was significantly correlated with bolus head pharyngeal transit. Analysis of successive swallows indicated that tongue–soft palate coordination variability decreased with nectar-thick but not with thin-consistency barium. Together, the results suggest that slower-moving bolus transits may promote greater opportunity for available sensory information to be used to modulate timing of tongue–soft palate movements so that they are more effective for pumping liquids.

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References

  1. Goldfield EC, et al. Coordination of sucking, swallowing, and breathing and oxygen saturation during early infant breast-feeding and bottle-feeding. Pediatr Res. 2006;60(4):450–5.

    Article  PubMed  Google Scholar 

  2. Rogers B, Arvedson J. Assessment of infant oral sensorimotor and swallowing function. Ment Retard Dev Disabil Res Rev. 2005;11(1):74–82.

    Article  PubMed  Google Scholar 

  3. Arvedson JC, Brodsky L. The airway and swallowing. In: Arvedson JC, Brodsky L, editors. Pediatric swallowing and feeding: assessment and management. Albany: Singular Publishing Group; 2002. p. 153–85.

    Google Scholar 

  4. Vazquez JL, Buonomo C. Feeding difficulties in the first days of life: findings on upper gastrointestinal series and the role of videofluoroscopic swallowing study. Pediatr Radiol. 1999;29:894–6.

    Article  PubMed  CAS  Google Scholar 

  5. Stuart S, Motz JM. Viscosity in infant dysphagia management: comparison of viscosity of thickened liquids used in assessment and thickened liquids used in treatment. Dysphagia. 2009;24:412–22.

    Article  PubMed  Google Scholar 

  6. Dengel D, Robbins J, Rosenbek J. Image processing in swallowing and speech research. Dysphagia. 1991;6:30–9.

    Article  PubMed  CAS  Google Scholar 

  7. Mercado-Deane MG, et al. Swallowing dysfunction in infants less than 1 year of age. Pediatr Radiol. 2001;31(6):423–8.

    Article  PubMed  CAS  Google Scholar 

  8. Bosma JF, et al. Ultrasound demonstration of tongue motions during suckle feeding. Dev Med Child Neurol. 1990;32(3):223–9.

    Article  PubMed  CAS  Google Scholar 

  9. Bu’Lock F, Woolridge MW, Baum JD. Development of co-ordination of sucking, swallowing and breathing: ultrasound study of term and preterm infants. Dev Med Child Neurol. 1990;32(8):669–78.

    Article  PubMed  Google Scholar 

  10. Miller JL, Kang SM. Preliminary ultrasound observation of lingual movement patterns during nutritive versus non-nutritive sucking in a premature infant. Dysphagia. 2007;22(2):150–60.

    Article  PubMed  Google Scholar 

  11. Pouderoux PK, Kahrilas PJ. Deglutitive tongue force modulation by volition, volume, and viscosity in humans. Gastroenterology. 1995;108:1418–26.

    Article  PubMed  CAS  Google Scholar 

  12. Miller JL, Watkin KL. The influence of bolus volume and viscosity on anterior lingual force during the oral stage of swallowing. Dysphagia. 1996;11:117–24.

    Article  PubMed  CAS  Google Scholar 

  13. Lazarus CL, et al. Effects of bolus volume, viscosity, and repeated swallows in nonstroke subjects and stroke patients. Arch Phys Med Rehabil. 1993;74(10):1066–70.

    Article  PubMed  CAS  Google Scholar 

  14. Bisch EM, Logemann JA, Rademaker AW, Kahrilas PJ. Pharyngeal effects of bolus volume, viscosity, and temperature in patients with dysphagia resulting from neurologic impairment and in normal subjects. J Speech Hear Res. 1994;37:1041–9.

    PubMed  CAS  Google Scholar 

  15. Perlman AL, Vandaele DJ, Otterbacher MS. Quantitative assessment of hyoid bone displacement from video images during swallowing. J Speech Hear Res. 1995;38:579–85.

    PubMed  CAS  Google Scholar 

  16. Ishida R, Palmer JB, Hiiemae KM. Hyoid motion during swallowing: Factors affecting forward and upward displacement. Dysphagia. 2002;17:262–72.

    Article  PubMed  Google Scholar 

  17. Kendall KA, et al. Timing of events in normal swallowing: a videofluoroscopic study. Dysphagia. 2000;15(2):74–83.

    PubMed  CAS  Google Scholar 

  18. Goldfield EC, et al. Premature infant swallowing: Patterns of tongue–soft palate coordination based upon videofluoroscopy. Infant Behav Dev. 2010;33:209–18.

    Article  PubMed  Google Scholar 

  19. Dantas RO, et al. The effect of high- vs low-density barium preparations on the quantitative features of swallowing. AJR Am J Roentgenol. 1989;153(6):1191–5.

    Article  PubMed  CAS  Google Scholar 

  20. Dantas RO, et al. Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing. Am J Physiol. 1990;258(5 Pt 1):G675–81.

    PubMed  CAS  Google Scholar 

  21. Steele CM. Searching for meaningful differences in viscosity. Dysphagia. 2005;20(4):336–8.

    Article  PubMed  Google Scholar 

  22. Jafari S, et al. Sensory regulation of swallowing and airway protection: a role for the internal superior laryngeal nerve in humans. J Physiol. 2003;550(Pt 1):287–304.

    Article  PubMed  CAS  Google Scholar 

  23. Bloch-Salisbury E, et al. Stabilizing immature breathing of preterm infants using stochastic mechanosensory stimulation. J Appl Physiol. 2009;107:1017–27.

    Article  PubMed  Google Scholar 

  24. Batschelet E. Circular statistics in biology (mathematics in biology). New York: Academic Press; 1981.

    Google Scholar 

  25. Hoon AH, et al. Sensory and motor deficits in children with cerebral palsy born pretermcorrelate with diffusion tensor imaging abnormalities in thalamocortical pathways. Dev Med Child Neurol. 2009;51:697–704.

    Article  PubMed  Google Scholar 

  26. Steele CM, Miller AJ. Sensory input pathways and mechanisms in swallowing. Dysphagia. 2010;25:323–333.

    Article  PubMed  Google Scholar 

  27. Ting LH, McKay JL. Neuromechanics of muscle synergies for posture and movement. Curr Opin Neurobiol. 2007;17(6):622–8.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This research was supported by NIH Grant R01 DC 007127 (to the first author) and by NIH Grant P01 HD18655 to the Children’s Hospital Intellectual and Developmental Disabilities Center. Thanks to Joan Arvedson, Rebecca German, and Jeff Palmer for encouragement and advice, and to Fuzz Crompton for the Fig. 1 line drawing.

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Authors and Affiliations

  1. Program in Behavioral Science, Harvard Medical School, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA, 02115, USA

    Eugene C. Goldfield

  2. Department of Neonatology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02115, USA

    Vincent Smith

  3. Department of Radiology, Children’s Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA

    Carlo Buonomo

  4. Department of Communication Enhancement, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA, 02115, USA

    Jennifer Perez & Kara Larson

Authors
  1. Eugene C. Goldfield
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  2. Vincent Smith
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  3. Carlo Buonomo
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  4. Jennifer Perez
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  5. Kara Larson
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Correspondence to Eugene C. Goldfield.

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Goldfield, E.C., Smith, V., Buonomo, C. et al. Preterm Infant Swallowing of Thin and Nectar-Thick Liquids: Changes in Lingual–Palatal Coordination and Relation to Bolus Transit. Dysphagia 28, 234–244 (2013). https://doi.org/10.1007/s00455-012-9440-y

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  • DOI: https://doi.org/10.1007/s00455-012-9440-y

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