Modulation of human swallowing behaviour by thermal and chemical stimulation in health and after brain injury

Hall, N; Hamdy, S; Jilani, S; Price, V; Parker, C; Power, ML

Abstract

Few data support thermal or chemical stimulation as therapy for neurogenic dysphagia. Our aims were to explore the behavioural effects of thermal (cold) and chemical (citrus) modalities on water swallowing in healthy subjects (n=65; mean age, 45 years; 44 females) and acute stroke patients (n=22; mean age, 67 years; 8 females) [UK]. Multiple randomized timed 50-ml swallowing tests were performed for each of 4 water conditions: (1) room temperature (RT), (2) cold (CD), (3) citrus (CT) and (4) combined cold and citrus (CD + CT). The inter-swallow interval (ISI), swallowing volume velocity (speed) and volume per swallow (capacity) were measured. In healthy subjects, only CD + CT, as compared to RT, slowed the speed (12.3±0.5 vs. 10.3±0.5 ml/s, P<0.03) and decreased the capacity (16.4±0.9 vs. 14.6±0.7 ml per swallow, P<0.02) of swallowing. ISI was unaffected, except by CD + CT in healthy young subjects (<60 years) where it was reduced (1.44±0.02 vs. 1.30±0.02 s, P<0.02). Despite smaller volumes ingested by stroke patients, CD + CT, compared to RT, slowed both the speed (3.8±0.4 vs. 4.5±0.5 ml/s, P<0.03) and capacity (7.6±0.7 vs. 8.5±0.7 ml per swallow, P<0.03) of swallowing but had no effect on ISI. We concluded that combined thermal and chemical modification of water consistently alters swallowing behaviour in healthy and acute stroke patients. These findings have relevance in the management of neurogenic swallowing problems.

Citation

Hall, N., Hamdy, S., Jilani, S., Price, V., Parker, C., & Power, M. (2003). Modulation of human swallowing behaviour by thermal and chemical stimulation in health and after brain injury. Neurogastroenterology and Motility, 15(1), 69-77. https://doi.org/10.1046/j.1365-2982.2003.00390.x

• Journal Article Type: Article
• Publication Date: Feb 1, 2003
• Deposit Date: Aug 10, 2007
• Journal: Neurogastroenterology and Motility
• Print ISSN: 1350-1925
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 15
• Issue: 1
• Pages: 69-77
• DOI: https://doi.org/10.1046/j.1365-2982.2003.00390.x
• Publisher URL: http://www3.interscience.wiley.com/journal/118895303/abstract?CRETRY=1&SRETRY=0