Document Detail

Central pattern generation involved in oral and respiratory control for feeding in the term infant.
MedLine Citation:
PMID:  19417662     Owner:  NLM     Status:  MEDLINE    
PURPOSE OF REVIEW: Drinking and eating are essential skills for survival and benefit from the coordination of several pattern generating networks and their musculoskeletal effectors to achieve safe swallows. Oralpharyngoesophageal motility develops during infancy and early childhood, and is influenced by various factors, including neuromuscular maturation, dietary and postural habits, arousal state, ongoing illnesses, congenital anomalies, and the effects of medical or surgical interventions. Gastroesophageal reflux is frequent in neonates and infants, and its role in neonatal morbidity including dysphagia, chronic lung disease, or apparent life-threatening events is not well understood. This review highlights recent studies aimed at understanding the development of oral feeding skills, and cross-system interactions among the brainstem, spinal, and cerebral networks involved in feeding.
RECENT FINDINGS: Functional linkages between suck-swallow and swallow-respiration manifest transitional forms during late gestation through the first year of life, which can be delayed or modified by sensory experience or disease processes, or both. Relevant central pattern generator (CPG) networks and their neuromuscular targets attain functional status at different rates, which ultimately influences cross-system CPG interactions. Entrainment of trigeminal primary afferents accelerates pattern genesis for the suck CPG and transition-to-oral feed in the RDS preterm infant.
SUMMARY: The genesis of within-system CPG control for rate and amplitude scaling matures differentially for suck, mastication, swallow, and respiration. Cross-system interactions among these CPGs represent targets of opportunity for new interventions, which optimize experience-dependent mechanisms to promote safe swallows among newborn and pediatric patients.
Steven M Barlow
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current opinion in otolaryngology & head and neck surgery     Volume:  17     ISSN:  1531-6998     ISO Abbreviation:  Curr Opin Otolaryngol Head Neck Surg     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-05-20     Completed Date:  2009-08-03     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  9417024     Medline TA:  Curr Opin Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-93     Citation Subset:  IM    
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MeSH Terms
Brain / physiopathology*
Brain Stem / physiopathology
Cerebral Cortex / physiopathology
Cranial Nerves / physiopathology
Deglutition / physiology*
Deglutition Disorders / etiology,  physiopathology*
Disease Models, Animal
Infant, Newborn
Infant, Newborn, Diseases / etiology,  physiopathology*
Mastication / physiology
Nerve Net / physiopathology
Pulmonary Ventilation / physiology*
Spinal Cord / physiopathology*
Sucking Behavior / physiology*
Grant Support
P30 DC005803/DC/NIDCD NIH HHS; P30 DC005803/DC/NIDCD NIH HHS; P30 DC005803-079003/DC/NIDCD NIH HHS; P30 HD02528/HD/NICHD NIH HHS; R01 DC003311/DC/NIDCD NIH HHS; R01 DC003311/DC/NIDCD NIH HHS; R01 DC003311-07/DC/NIDCD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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