Welby Lauren, Caudill Hailey, Yitsege Gelila, Hamad Ali, Bunyak Filiz, Zohn Irene E, Maynard Thomas, LaMantia Anthony-Samuel, Mendelowitz David, Lever Teresa E
Department of Otolaryngology Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, MO, United States.
Department of Pharmacology and Physiology, School of Medicine and Health Sciences, The George Washington University, Washington, DC, United States.
Front Neurol. 2020 Jan 31;11:4. doi: 10.3389/fneur.2020.00004. eCollection 2020.
Disrupted development of oropharyngeal structures as well as cranial nerve and brainstem circuits may lead to feeding and swallowing difficulties in children with 22q11. 2 deletion syndrome (22q11DS). We previously demonstrated aspiration-based dysphagia during early postnatal life in the mouse model of 22q11DS along with disrupted oropharyngeal morphogenesis and divergent differentiation and function of cranial motor and sensory nerves. We now ask whether feeding and swallowing deficits persist in adult mice using methods analogous to those used in human patients to evaluate feeding and swallowing dysfunction. Compared to wild-type mice, videofluoroscopic swallow study revealed that mice have altered feeding and swallowing behaviors, including slower lick rates, longer inter-lick intervals, and longer pharyngeal transit times with liquid consistency. Transoral endoscopic assessment identified minor structural anomalies of the palate and larynx in one-third of the mice examined. Video surveillance of feeding-related behaviors showed that mice eat and drink more frequently. Furthermore, animals engage in another oromotor behavior, grooming, more frequently, implying that divergent craniofacial and cranial nerve structure and function result in altered oromotor coordination. Finally, mice have significantly increased lung inflammation, a potential sign of aspiration-based dysphagia, consistent with results from our previous studies of early postnatal animals showing aspiration-related lung inflammation. Thus, oromotor dysfunction, feeding, and swallowing difficulties and their consequences persist in the 22q11DS mouse model. Apparently, postnatal growth and/or neural plasticity does not fully resolve deficits due to anomalous hindbrain, craniofacial, and cranial nerve development that prefigure perinatal dysphagia in 22q11DS. This new recognition of persistent challenges with feeding and swallowing may provide opportunities for improved therapeutic intervention for adolescents and adults with 22q11DS, as well as others with a history of perinatal feeding and swallowing disorders.
口咽结构以及颅神经和脑干回路的发育中断可能导致22q11.2缺失综合征(22q11DS)患儿出现进食和吞咽困难。我们之前在22q11DS小鼠模型中证明,出生后早期存在基于误吸的吞咽困难,同时伴有口咽形态发生中断以及颅运动和感觉神经的分化和功能异常。我们现在使用类似于人类患者评估进食和吞咽功能障碍的方法,来探究成年小鼠是否存在进食和吞咽缺陷。与野生型小鼠相比,视频荧光吞咽研究显示,小鼠的进食和吞咽行为发生了改变,包括舔舐频率降低、舔舐间隔时间延长以及液体食物的咽部通过时间延长。经口内镜评估发现,在三分之一接受检查的小鼠中,腭和喉部存在轻微结构异常。对进食相关行为的视频监测表明,小鼠更频繁地进食和饮水。此外,这些动物更频繁地进行另一种口面部运动行为——梳理毛发,这意味着颅面部和颅神经结构及功能的异常导致了口面部运动协调的改变。最后,小鼠的肺部炎症显著增加,这是基于误吸的吞咽困难的一个潜在迹象,与我们之前对出生后早期动物的研究结果一致,即显示存在与误吸相关的肺部炎症。因此,口面部运动功能障碍、进食和吞咽困难及其后果在22q11DS小鼠模型中持续存在。显然,出生后的生长和/或神经可塑性并不能完全解决由于后脑、颅面部和颅神经发育异常所导致的缺陷,这些异常在围产期预示着22q11DS患者会出现吞咽困难。对进食和吞咽持续挑战的这一新认识,可能为改善22q11DS青少年和成年人以及其他有围产期进食和吞咽障碍病史者的治疗干预提供机会。