Upper aerodigestive tract neurofunctional mechanisms: lifelong evolution and exercise

Abstract

The transformation of the upper aerodigestive tract--oral cavity, pharynx, and larynx--serves the functions of eating, speaking, and breathing during sleeping and waking hours. These life-sustaining functions may be produced by a central neural sensorimotor system that shares certain neuroanatomic networks while maintaining separate neural functional systems and network structures. Current understanding of development, maturation, underlying neural correlates, and integrative factors are discussed in light of currently available imaging modalities and recently emerging interventions. Exercise and an array of additional treatments together seem to provide promising translational pathways for evidence-based innovation, novel habilitation, and rehabilitation strategies and delay, or even prevent neuromuscular decline cross-cutting functions and supporting quality of life throughout increasingly enduring lifespans.

Copyright © 2011 Wiley Periodicals, Inc.

Figures

Figure 1

The upper aerodigestive tract has two primary functions: breathing and swallowing. (A) Upper aerodigestive tract valves positioned (open) for directing airflow through systems. (B) Upper aerodigestive tract valves positioned (closed) for safely directing bolus flow. (Adapted from Easy to Swallow, Easy to Chew Cookbook: Over 150 Tasty and Nutritious Recipes for People Who Have Difficulty Swallowing by Weihofen D, Robbins J, and Sullivan PA. 2002, with permission of John Wiley & Sons, Inc.)

Figure 2

The continuous and non-linear lifelong evolution of morphologic features represented by MRIs of distinct individuals of different ages.

Figure 3

Healthy young swallowing documented with videofluoroscopy. (A) Bolus in oral cavity, ready to be swallowed. (B) Bolus appears as a “column” of material swiftly moving through the pharynx. (C) Oropharynx cleared of material when the swallow is completed. Healthy old swallowing documented with videofluoroscopy. (D) Bolus in mouth ready for swallowing. (E) Bolus pooled in vallecula and pyriform sinus during delayed onset of pharyngeal response. (F) Bolus cleared of material when the swallow is completed. (Adapted with permission from Robbins JA. Normal swallowing and aging. Semin Neurol. 1996; 16(4):309.)

Figure 3

Healthy young swallowing documented with videofluoroscopy. (A) Bolus in oral cavity, ready to be swallowed. (B) Bolus appears as a “column” of material swiftly moving through the pharynx. (C) Oropharynx cleared of material when the swallow is completed. Healthy old swallowing documented with videofluoroscopy. (D) Bolus in mouth ready for swallowing. (E) Bolus pooled in vallecula and pyriform sinus during delayed onset of pharyngeal response. (F) Bolus cleared of material when the swallow is completed. (Adapted with permission from Robbins JA. Normal swallowing and aging. Semin Neurol. 1996; 16(4):309.)