AGE AND AGE-RELATED DISEASE EFFECTS ON SWALLOWING

年龄和年龄相关疾病对吞咽的影响

• 批准号: 2265223
• 负责人: JOANNE ROBBINS
• 金额: $ 20.45万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 1987
• 资助国家: 美国
• 起止时间: 1987-03-01 至 1999-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2265223
• 关键词: age difference; aging; biomechanics; body movement; gastrointestinal imaging /visualization; human subject; magnetic resonance imaging; medical complication; neuroanatomy; nutrition of aging; nutrition related tag; stroke; swallowing

Recent evidence suggests swallowing is affected by normal aging. Since age-specific change are not well-defined or understood, this limited knowledge complicates accurate dysphagia diagnosis in the elderly, in whom chronic debilitating diseases accompanied by swallowing problems occur with increased frequency. The long-term objective of this project is to increase understanding of the effects of normal aging on swallowing physiology in an effort to advance the diagnosis and treatment of oropharyngeal swallowing disorders in age-related disease. The proposed work will establish a normative data base of movement parameters comprising salient features of oropharyngeal swallowing in conjunction with structural brain quantification, obtained with magnetic resonance imaging, throughout the adult age interval of 45 to 95 years. One hypothesis to be tested is that oropharyngeal swallowing will differ with increasing age in terms of range, duration and direction of motion. In addressing this hypothesis, the quantification of various parameters will be expanded as will understanding of swallowing physiology and the effects of age on it. Little quantitative information on the specific parameters of oral movements during swallowing has been obtained using fluoroscopy. This is largely due to limitations inherent in fluoroscopic imaging of oropharyngeal soft tissue structures, particularly the tongue. Techniques to facilitate lingual point place tracking simultaneously with bolus tracking during fluoroscopic recording of swallowing have recently been established and a customized computer-based system has been developed to facilitate movement of soft tissue structures and provide a reliable source of kinematic measurement. These new methodologies will be used tin the proposed project. Also, the hypothesis that maximum tongue strength differs for young and old individuals and percent of maximum tongue strength used in swallowing increases with age will be tested. A pressure transducer, designed to measure tongue strength used in swallowing increases with age will be tested. A pressure transducer , designed to measure tongue strength during swallowing will be used to test the hypothesis that lingual pressure is predictive of pharyngeal kinematic parameters, bolus transit and pharyngeal kinematics in a test group of normals also will be studied. Comparison of normative data to swallowing profiles (bolus transit time, lingual pressure, and oropharyngeal kinematic measures and their interrelationships) and clinicoanatomic correlates of unilateral stroke patients with and without swallowing complaints will be studied. In this manner, another major objective, to distinguish changes in neuromotor processes and their relationship to anatomical changes in the brain that occur with normal aging from neuromotor deficiencies and clinicoanatomic correlates due to age-related disease, in this case stroke, will be addressed with specific regard to the swallowing mechanism. The relationship of aspects of swallowing physiology to nutritional parameters in normals of different ages and stroke patients also may contribute to diagnostic criteria for presence of dysphagia. The proposed examination of the interrelationships among physiologic parameters, nutritional parameters, and neurovascular correlates with normal and pathologic aging, will provide insights to the underlying mechanisms for differences found and will guide age-appropriate treatment development. Finally, soft tissue imaging and oral pressure measurement and analysis techniques will be substantially improved during the years of this project, providing better methodology and tools for future investigations of swallowing.

最近的证据表明，吞咽受正常衰老的影响。 自从 特定年龄的变化不是明确或理解的，这是有限的 知识使老年人的准确吞咽困难诊断复杂，其中 长期衰弱的疾病伴随着吞咽问题 频率增加。 该项目的长期目标是 增加对正常衰老对吞咽影响的影响 生理学，以提高诊断和治疗 口咽吞咽疾病与年龄有关的疾病。 提议 工作将建立包括运动参数的规范数据库 口咽吞咽的显着特征与结构 大脑定量，通过磁共振成像获得 成人年龄间隔为45至95岁。 要检验的一个假设是口咽吞咽会有所不同 随着年龄的增长，范围，持续时间和运动方向。 在解决这一假设时，对各种参数的量化 将扩展，对吞咽生理学和 年龄的影响。 关于特定的几乎没有定量信息 使用吞咽过程中口服运动的参数已获得 透视。 这主要是由于荧光镜固有的局限性 口咽软组织结构的成像，尤其是舌头。 同时促进舌点位置跟踪的技术 吞咽的荧光镜记录期间的推注跟踪已有 已建立并开发了基于计算机的定制系统 促进软组织结构的运动并提供可靠的 运动学测量的来源。 这些新方法将用于锡 拟议的项目。 同样，最大舌强度在年轻人和老年人方面有所不同的假设 吞咽中使用的个人和最大舌头力量的百分比 随着年龄的增长将进行测试。 压力传感器，设计为 测量用于吞咽时使用的舌头力量随着年龄的增长而增加 测试。 压力传感器，旨在测量舌头强度 吞咽将用于测试舌压为 预测咽运动参数，推注和咽 还将研究一组正常测试组中的运动学。 比较规范性数据与吞咽概况（推注转运时间， 舌压，口咽运动量及其 相互关系）和单侧中风的临床解剖学相关性 将研究有或没有吞咽投诉的患者。 在这个 方式，是另一个主要目标，以区分神经运动的变化 过程及其与大脑解剖学变化的关系 发生因神经运动缺陷和临床解剖学的正常老化而发生 由于年龄相关疾病而引起的相关性，在这种情况下是中风的 针对吞咽机制的特定方面解决。 这 吞咽生理学与营养参数的各个方面的关系 在不同年龄和中风患者的正常情况下，也可能有助于 存在吞咽困难的诊断标准。 提议的检查 生理参数之间的相互关系，营养 参数和神经血管与正常和病理老化相关， 将为发现的差异提供有关基础机制的见解 并将指导适合年龄的治疗发展。 最后，软组织 成像和口服压力测量和分析技术将是 在该项目的几年中，大大改善了，提供更好的 方法和工具，用于吞咽的未来研究。