Early deficits in cortical control of swallowing in Alzheimer's disease

Ianessa A. Humbert, Donald G. McLaren, Kris Kosmatka, Michele Fitzgerald, Sterling Johnson, Eva Porcaro, Stephanie Kays, Eno Obong Umoh, Joanne Robbins

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

The goal of this study was to determine whether functional changes in cortical control of swallowing are evident in early Alzheimer's disease (AD), before dysphagia (swallowing impairment) is evident. Cortical function was compared between an early AD group and a group of age-matched controls during swallowing. Swallowing oropharyngeal biomechanics examined from videofluoroscopic recordings were also obtained to more comprehensively characterize changes in swallowing associated with early AD. Our neuroimaging results show that the AD group had significantly lower Blood-Oxygen-Level- Dependent (BOLD) response in many cortical areas that are traditionally involved in normal swallowing (i.e., pre and postcentral gyri, Rolandic and frontal opercula). There were no regions where the AD group showed more brain activity than the healthy controls during swallowing, and only 13% of all active voxels were unique to the AD group, even at this early stage. This suggests that the AD group is not recruiting new regions, nor are they compensating within regions that are active during swallowing. In videofluoroscopic measures, the AD group had significantly reduced hyo-laryngeal elevation than the controls. Although, swallowing impairment is usually noted in the late stages of AD, changes in cortical control of swallowing may begin long before dysphagia becomes apparent.

Original languageEnglish (US)
Pages (from-to)1185-1197
Number of pages13
JournalJournal of Alzheimer's Disease
Volume19
Issue number4
DOIs
StatePublished - 2010
Externally publishedYes

Keywords

  • Alzheimer's disease
  • Deglutition
  • Neuroimaging
  • Neurophysiology
  • Videofluoroscopy

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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