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Dysphagia

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05.05.2023 | Review

Brain and Pharyngeal Responses Associated with Pharmacological Treatments for Oropharyngeal Dysphagia in Older Patients

verfasst von: Pere Clavé, Omar Ortega, Laia Rofes, Daniel Alvarez-Berdugo, Noemí Tomsen

Erschienen in: Dysphagia | Ausgabe 6/2023

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Abstract

Impaired pharyngo-laryngeal sensory function is a critical mechanism for oropharyngeal dysphagia (OD). Discovery of the TRP family in sensory nerves opens a window for new active treatments for OD. To summarize our experience of the action mechanism and therapeutic effects of pharyngeal sensory stimulation by TRPV1, TRPA1 and TRPM8 agonists in older patients with OD. Summary of our studies on location and expression of TRP in the human oropharynx and larynx, and clinical trials with acute and after 2 weeks of treatment with TRP agonists in older patients with OD. (1) TRP receptors are widely expressed in the human oropharynx and larynx: TRPV1 was localized in epithelial cells and TRPV1, TRPA1 and TRPM8 in sensory fibers mainly below the basal lamina. (2) Older people present a decline in pharyngeal sensory function, more severe in patients with OD associated with delayed swallow response, impaired airway protection and reduced spontaneous swallowing frequency. (3) Acute stimulation with TRP agonists improved the biomechanics and neurophysiology of swallowing in older patients with OD TRPV1 = TRPA1 > TRPM8. (4) After 2 weeks of treatment, TRPV1 agonists induced cortical changes that correlated with improvements in swallowing biomechanics. TRP agonists are well tolerated and do not induce any major adverse events. TRP receptors are widely expressed in the human oropharynx and larynx with specific patterns. Acute oropharyngeal sensory stimulation with TRP agonists improved neurophysiology, biomechanics of swallow response, and safety of swallowing. Subacute stimulation promotes brain plasticity further improving swallow function in older people with OD.

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Titel: Brain and Pharyngeal Responses Associated with Pharmacological Treatments for Oropharyngeal Dysphagia in Older Patients
verfasst von: Pere Clavé
Omar Ortega
Laia Rofes
Daniel Alvarez-Berdugo
Noemí Tomsen
Publikationsdatum: 05.05.2023
Verlag: Springer US
Erschienen in: Dysphagia / Ausgabe 6/2023
Print ISSN: 0179-051X
Elektronische ISSN: 1432-0460
DOI: https://doi.org/10.1007/s00455-023-10578-x

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Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

29.05.2024 Hörstörungen Nachrichten

Hört jemand im Alter schlecht, nimmt das Hirn- und Hippocampusvolumen besonders schnell ab, was auch mit einem beschleunigten kognitiven Abbau einhergeht. Und diese Prozesse scheinen sich unabhängig von der Amyloidablagerung zu ereignen.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Brain and Pharyngeal Responses Associated with Pharmacological Treatments for Oropharyngeal Dysphagia in Older Patients

Abstract

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Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

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Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

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Weitere Artikel der Ausgabe 6/2023

Comprehensive Manometric Evaluation of Dysphagia in Patients with Down Syndrome

Impact of Quantitative Videofluoroscopic Swallowing Measures on Clinical Interpretation and Recommendations by Speech-Language Pathologists

Effects of Head and Neck Alignment and Pharyngeal Anatomy on Epiglottic Inversion During Swallowing in Dysphagic Patients

Assessing Prevalence and Characteristics of Oro-bulbar Involvement in Children and Adults with SMA Type 2 and 3 Using a Multimodal Approach

The Role of Bolus Residue and Its Relation with Respiratory Problems in Children with Esophageal Atresia

The Hyoid Bone Kinematics in Dysphagic Stroke Patients: Instantaneous Velocity, Acceleration and Temporal Sequence Matters

Neu im Fachgebiet HNO

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

Update HNO