The long-term goal of this project is to determine the role of tracheal and pharyngeal sensory feedback in the regulation of cough and swallow. Our central hypothesis is that an aspiration event produces a series of coughs and swallows which are expressed in various behavioral interaction patterns, and that there are decipherable rules that regulate the various patterns of expression. Cough and swallow are airway protective behaviors. The pharyngeal phase of swallow prevents aspiration of oral material (saliva, food and liquid), by epiglottal movement, laryngeal adduction, and clearing the mouth and pharynx. Cough is an aspiration-response behavior that clears material from the airway. Coordination of these behaviors is vital to protect the airway from further aspiration-promoting events, such as a swallow occurring during the inspiratory phase of cough. The peripheral inputs, operational characteristics, and primary strategies that coordinate cough and swallow are unknown. This lack of information impedes understanding of the deficits in airway protection, with co-occurrence of dystussia and dysphagia, which occurs with diseases such as Parkinson's disease and Alzheimer's disease.
The Specific Aims of the project are: 1) Develop a predictive computational distributed network model of the central influence of tracheal sensory pathways on the expression of cough and swallow; and 2) Identify the role of neurons in the reticular formation in processing tracheal and pharyngeal afferent feedback on cough and swallow. Our preliminary data demonstrates a modulatory effect of sensory feedback of the production of cough and swallow. Stimulation of tracheal afferents by an aspiration stimulus increases the magnitude of swallows, providing evidence of airway feedback-induced increased pharyngeal clearance.
In aim 2, we will: 1) record from neurons in the reticular formation using a multi-electrode array to obtain multiple-spike train data during: a) the selective stimulation of the trachea or pharynx to elicit cough or swallow; 2) test an acute model of dystussia and dysphagia induced by microinjection of the endogenous excitatory amino acid antagonist, kynurenic acid, into the medial reticular formation.

Public Health Relevance

This information will allow the testing of disease models with greater specificity and highlight therapeutic targets. This project will provide new fundamental information advancing the understanding of airway protection and the coordination of cough and swallow.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Transition Award (R00)
Project #
5R00HL111215-05
Application #
9266814
Study Section
Special Emphasis Panel (NSS)
Program Officer
Tigno, Xenia
Project Start
2013-02-23
Project End
2018-03-31
Budget Start
2017-04-01
Budget End
2018-03-31
Support Year
5
Fiscal Year
2017
Total Cost
$238,206
Indirect Cost
$79,402
Name
University of Louisville
Department
Neurosurgery
Type
Schools of Medicine
DUNS #
057588857
City
Louisville
State
KY
Country
United States
Zip Code
40208
Huff, Alyssa; Reed, Mitchell D; Smith, Barbara K et al. (2018) Strategies for the Integration of Cough and Swallow to Maintain Airway Protection in Humans. Lung :
Kotmanova, Z; Simera, M; Veternik, M et al. (2018) GABA-ergic neurotransmission in the nucleus of the solitary tract modulates cough in the cat. Respir Physiol Neurobiol 257:100-106
Pitts, Teresa; Poliacek, Ivan; Rose, Melanie J et al. (2018) Neurons in the dorsomedial medulla contribute to swallow pattern generation: Evidence of inspiratory activity during swallow. PLoS One 13:e0199903
Horton, Kofi-Kermit; Segers, Lauren S; Nuding, Sarah C et al. (2018) Central Respiration and Mechanical Ventilation in the Gating of Swallow With Breathing. Front Physiol 9:785
Huff, Alyssa; Day, Trevor A; English, Mason et al. (2018) Swallow-breathing coordination during incremental ascent to altitude. Respir Physiol Neurobiol :
Poliacek, Ivan; Pitts, Teresa; Rose, Melanie J et al. (2017) Microinjection of kynurenic acid in the rostral nucleus of the tractus solitarius disrupts spatiotemporal aspects of mechanically induced tracheobronchial cough. J Neurophysiol 117:2179-2187
King, Suzanne N; Dunlap, Neal E; Tennant, Paul A et al. (2016) Pathophysiology of Radiation-Induced Dysphagia in Head and Neck Cancer. Dysphagia 31:339-51
Mondal, Pritish; Abu-Hasan, Mutasim; Saha, Abhishek et al. (2016) Effect of laparotomy on respiratory muscle activation pattern. Physiol Rep 4:
Ovechkin, Alexander V; Sayenko, Dimitry G; Ovechkina, Elena N et al. (2016) Respiratory motor training and neuromuscular plasticity in patients with chronic obstructive pulmonary disease: A pilot study. Respir Physiol Neurobiol 229:59-64
Poliacek, Ivan; Simera, Michal; Veternik, Marcel et al. (2016) The course of lung inflation alters the central pattern of tracheobronchial cough in cat-The evidence for volume feedback during cough. Respir Physiol Neurobiol 229:43-50

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