Department of Physical Medicine and Rehabilitation, Johns Hopkins University, 98 North Broadway, Baltimore, MD 21231, USA.
Dysphagia. 2012 Sep;27(3):307-17. doi: 10.1007/s00455-011-9367-8. Epub 2011 Sep 4.
Swallowing impairments are treated mostly behaviorally. It is requisite to understand the relationship of cognition, specifically attention, with swallowing since so many swallowing impairments occur concomitantly with cognitive disorders. This study examined the hypothesis that attentional resources are required during swallowing. The approach involved a dual-task, reaction time (RT) paradigm in ten healthy, nonimpaired participants. Baseline measures were obtained of the duration of the anticipatory phase and of the oropharyngeal phase of swallowing and the RTs to nonword auditory stimuli. A dual-task then required participants to swallow 5 ml of water from an 8-oz. cup while listening for a target nonword presented auditorily during the anticipatory or the oropharyngeal phase. Target stimuli were randomized across baseline and dual-task trials. Duration of the anticipatory phase and of the oropharyngeal phase of swallowing and duration of the RT baseline trial and of the dual-task trial were determined. Results showed a statistically significant increase in speed of the anticipatory phase, relative to the oropharyngeal phase, for swallowing during the dual-task. RTs were slowed for both the anticipatory and the oropharyngeal phase during the dual-task, although neither of these was statistically significant. Clinical implications of these data suggest that disruptive stimuli in the environment to nonimpaired individuals may alter feeding but have little effect on the oropharyngeal swallow.
吞咽障碍主要通过行为治疗。由于吞咽障碍常与认知障碍同时发生，因此需要了解认知，特别是注意力与吞咽之间的关系。本研究检验了这样一个假设，即在吞咽过程中需要注意力资源。该方法涉及到一项双任务、反应时（RT）范式，在 10 名健康、无损伤的参与者中进行。首先获得了预备阶段和口咽阶段吞咽的持续时间以及对非词听觉刺激的 RT 的基线测量。然后，要求参与者在预备阶段或口咽阶段听目标非词时吞咽 5 毫升 8 盎司杯子里的水。目标刺激在基线和双任务试验中随机呈现。确定了吞咽时预备阶段和口咽阶段的持续时间、RT 基线试验和双任务试验的持续时间。结果显示，在双任务期间，吞咽时预备阶段的速度相对于口咽阶段呈统计学显著增加。在双任务期间，RT 对预备阶段和口咽阶段都有减缓作用，但均无统计学意义。这些数据的临床意义表明，环境中的干扰刺激可能会改变非损伤个体的进食方式，但对口咽吞咽几乎没有影响。
