What variables in the neuromuscular properties of the human pharynx make some patients more susceptible to aspiration, obstructive sleep apnea (OSA), acid reflux, cricopharyngeal spasm and other disorders of the pharyngeal region? In most mammals (and neonatal humans) the respiratory system is protected by overlapping the epiglottis and soft palate, however with separation of these structures the human at risk of aspiration, and this is often the cause of death in the elderly and neurologically impaired. At present the basic neuromuscular specializations of the human pharynx are poorly understood. In preliminary work numerous novel observations were made, one example is that of the human cricopharyngeus (CP) muscle; That the CP receives its innervation from multiple nerves, each of which supplies a distinct region within the muscle, and that it contains specialized muscle fibers. One of these, slow tonic muscle fibers (STMF) has a unique physiology. STMF are extremely rare in mammals but preliminary work has shown that they are widespread in human upper airway structures including the tongue and larynx. Moreover the particular distribution of these fiber suggests that they are directly related to distinct biomechanics. The proposed work will focus on clarifying the peripheral organization patterns of the human pharyngeal plexus and characterizing the intrinsic properties of the CP and the muscles surrounding the pharynx to answer the questions: what anatomic specializations are present that appear specific to humans and possibly speech and swallowing related? What variations in these specializations correlate with certain ethnic (black males OSA), genders (males reflux, OSA) and especially geriatric (CP spasm and aspiration) susceptibility to specific disorders? All studies will be done in human post-mortem tissue. The motor and sensory nerve supply to the pharyngeal region will be studied using Sihler's stain. An additional hypothesis to be tested is that the human glossopharyngeal nerve (IX) provides motor innervation not only to the traditionally described stylopharyngeus, but also to the CP and pharyngeal constrictor muscles as demonstrated by our preliminary studies. This will be studied by triple approaches: Sihler's stain whole-mount acetylcholinesterase (AChE) and silver stain, and Karnovsky-Roots' method. Another hypothesis to be tested is that most swallowing-related muscles are specialized and composed of neuromuscular compartments (NMC) as functional requirements. Our preliminary studies provided evidence for the existence of the NMC within the human CP inferior constrictor and geniohyoid muscles. In addition, the human CP appears to be a specialized skeletal muscle as it contains slow tonic and a-cardiac myosin heavy chain isoforms that are not normally present in limb muscles. The muscular specializations of the upper esophageal sphincter, pharyngeal constrictor and suprahyoid muscles will be explored using a wide variety of histochemical, immunohistochemical, electrophoretic and immunoblotting techniques The muscle fiber architecture, distribution of the fiber types and the major and unusual myosin heavy chain isoforms will be studied.

Agency
National Institute of Health (NIH)
Institute
National Institute on Deafness and Other Communication Disorders (NIDCD)
Type
Research Project (R01)
Project #
5R01DC004728-03
Application #
6628405
Study Section
Respiratory and Applied Physiology Study Section (RAP)
Program Officer
Shekim, Lana O
Project Start
2001-02-01
Project End
2005-01-31
Budget Start
2003-02-01
Budget End
2004-01-31
Support Year
3
Fiscal Year
2003
Total Cost
$254,250
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Otolaryngology
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Mu, Liancai; Chen, Jingming; Sobotka, Stanislaw et al. (2015) Alpha-Synuclein Pathology in Sensory Nerve Terminals of the Upper Aerodigestive Tract of Parkinson's Disease Patients. Dysphagia 30:404-17
Sanders, Ira; Mu, Liancai (2013) A three-dimensional atlas of human tongue muscles. Anat Rec (Hoboken) 296:1102-14
Sanders, Ira; Mu, Liancai; Amirali, Asif et al. (2013) The human tongue slows down to speak: muscle fibers of the human tongue. Anat Rec (Hoboken) 296:1615-27
Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming et al. (2013) Alpha-synuclein pathology and axonal degeneration of the peripheral motor nerves innervating pharyngeal muscles in Parkinson disease. J Neuropathol Exp Neurol 72:119-29
Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming et al. (2013) Parkinson disease affects peripheral sensory nerves in the pharynx. J Neuropathol Exp Neurol 72:614-23
Mu, Liancai; Sobotka, Stanislaw; Chen, Jingming et al. (2012) Altered pharyngeal muscles in Parkinson disease. J Neuropathol Exp Neurol 71:520-30
Mu, Liancai; Sanders, Ira (2010) Human tongue neuroanatomy: Nerve supply and motor endplates. Clin Anat 23:777-91
Mu, L; Sanders, I (2010) Sihler's whole mount nerve staining technique: a review. Biotech Histochem 85:19-42
Mu, Liancai; Sanders, Ira (2008) Newly revealed cricothyropharyngeus muscle in the human laryngopharynx. Anat Rec (Hoboken) 291:927-38
Mu, Liancai; Sanders, Ira (2007) Neuromuscular specializations within human pharyngeal constrictor muscles. Ann Otol Rhinol Laryngol 116:604-17

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