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One note for everyone in attendance, next weeks talk by Adrianne Huxtable will not be recorded since she is presenting unpublished data. So please make all efforts to see it in real time for what will be a very interesting and informative talk!
Thank you all for coming today. Please feel free to use the chat feature to ask questions. Alyssa Huff Is on line to answer simple questions in real time. More complex or nuanced questions will be saved for a Q&A at mid-talk and at the end.
Does airway angle change as we age and does this lead to increased risk for aspiration in the elderly population?
Hi. Dr. Marlis Gonzalez-Fernandez is working on this at Johns Hopkins. It seems to be a more CNS/sensorimotor integration problem.
Is the diaphragmatic inspiratory activity documented in humans?
Ie during active swallowing?
Are all swallows “Schluckatmung” and involve diaphragmatic activity or is Schluckatmung a special form of swallowing?
Teresa it looks like the thyroarytenoid magnitude isnt changing much after an acute cervical injury, is that accurate?
Q: Are there changes in control of the tongue (hypoglossal motor control)?
How much negative pressure do you need to facilitate swallowing? Should it be complete loss of the diaphragm function?
Do you know of any studies in humans that have looked at the impact of phrenic nerve stimulation on the swallow?
[Q} Does the tone to the epiglottis have any impact on the risk for aspiration?
Following on from John, that loss of diaphragmatic activity would decrease distal tethering of the trachea and thus may well be (yet another) potential contributor to the increased rate of sleep apnoea in tetraplegia. And certainly there is a paper from Sankari’s group associating swallow and SBD events in humans with tetraplegia.
How do opioids affect swallowing?
Thanks for this great talk with new insight in swallowing function in SCI. If diaphragm muscle activity is important in swallowing in SCI, does body position has any influence? For instance in the supine position, the diaphragm is optimized due to the abdominal visceral content that acts as a fulcrum. So could it be that supine position is better for the swallowing function, although this is contra intuitive.
Have you considered measuring other laryngeal muscles aside from thryoarytenoid? It struck me when you compared the relationship between thyroarytenoid and thyropharyngeus muscles because there are other key muscles responsible for laryngeal vestibule closure that may be compensating to achieve timely LVC and not appreciated if only considering thyroarytenoid.. just curious!
Just jumping in - we looked at two young people and there experience of phrenic nerve pacing (high spinal, one-way valve in situ) - both challenged in different ways with the pacing. One young person refused to eat with pacing.
Excellent work Teresa, it's great to see the clear physiological link between SCI and swallowing impairment. In humans, there are additional factors that add to complexity of dysphagia and clinical management
Q] Does improvement in ipsilateral diaphragm function at 4 wks correlate with less aspiration at this stage?
Q} 8OH DPAT is a potent 5HT7 agonist as well. Does your WAY inhibitor have appropriate selectivity for 1A versus 7?
Are you analyzing the swallowing physiology (timing and kinematics) during videofluoroscopy to help better explain the differences in PAS scores?
Hi Teresa, fantastic work and presentation. I think that variability you see is probably a limitation of using the PAS scale to quantify swallowing function, which I think is problematic in the speech pathology literature. Do you think that you might see less variability by focusing on swallowing biomechanisms?
Alicia Vose you got there before me!
Gordon, Teresa can answer your question too but I believe the WAY- drug is specific to 1A
Gordon, in agreement with Alyssa, I believe that WAY100635 doesn’t have activity at 5HT7, so you have a very good point.
Fantastic talk Dr. Pitts! You always give fantastic talks on your research!
Thanks for a fantastic talk! I really enjoyed it :) For healthy and awake cats, is there normal variability across PAS scores, timing & kinematic measures?
Thank you for a wonderful talk! Quite intrigued with your amazing work!
Great talk, Teresa!!
Thanks Dr. Pitts for such an informative session!
Thanks Teresa, Great talk!
Thank you for such a great talk!
Thank you for a wonderful talk. Very interesting
great talk! Thank you!