学龄期吞咽和运动言语发育的共同和独立神经肌肉基础。
Shared and Separate Neuromuscular Underpinnings of Swallowing and Motor Speech Development in the School-Age Years.
机构信息
Department of Speech, Language, and Hearing Sciences, Purdue University, West Lafayette, IN.
Department of Statistics, Purdue University, West Lafayette, IN.
出版信息
J Speech Lang Hear Res. 2023 Sep 13;66(9):3260-3275. doi: 10.1044/2023_JSLHR-23-00059. Epub 2023 Aug 7.
PURPOSE
Despite co-occurrence of swallowing and speech disorders in childhood, there is limited research on shared and separate neuromuscular underpinnings of these functions. The purpose of this study was to (a) compare neuromuscular control of swallowing and speech between younger and older children and (b) determine similarities and differences in neuromuscular control of swallowing and speech.
METHOD
Twenty-six typically developing children (thirteen 7- to 8-year-olds and thirteen 11- to 12-year-olds) completed this cross-sectional study. Neuromuscular control was evaluated using surface electromyography of submental muscles and superior and inferior orbicularis oris muscles during parallel tasks of swallowing and speech. Outcome measures included normalized mean amplitude, burst duration, time to peak amplitude, and bilateral synchrony, which were examined using mixed-effects models.
RESULTS
For normalized mean amplitude, burst duration, and time to peak amplitude, there were significant two- and three-way interactions between muscle group, task, and age group, indicating that older and younger children demonstrated different muscle activation patterns, and these patterns varied by muscle and task. No differences were noted between groups for bilateral synchrony. For parallel tasks, children demonstrated different magnitudes of normalized mean amplitude and time to peak amplitude of speech and swallowing. However, they demonstrated a similar pattern: increases in magnitude as task complexity increased.
CONCLUSIONS
Children continue to demonstrate refinement of their neuromuscular control of swallowing and speech between 7-8 and 11-12 years of age, and there are both shared and separate elements of neuromuscular control between these two vital functions. To improve generalizability of findings, future research should include longitudinal analysis of swallowing and speech development, as well as measures of central neurophysiology.
SUPPLEMENTAL MATERIAL
目的
尽管儿童期吞咽和言语障碍同时存在，但对于这些功能的共同和独立神经肌肉基础的研究有限。本研究的目的是：(a) 比较年轻和年长儿童在吞咽和言语方面的神经肌肉控制；(b) 确定吞咽和言语的神经肌肉控制的相似性和差异性。
方法
26 名发育正常的儿童（13 名 7-8 岁儿童和 13 名 11-12 岁儿童）完成了这项横断面研究。在吞咽和言语的平行任务中，使用颏下肌和上下口轮匝肌的表面肌电图评估神经肌肉控制。使用混合效应模型检查了包括标准化平均振幅、爆发持续时间、峰值时间和双侧同步性等结果指标。
结果
在标准化平均振幅、爆发持续时间和峰值时间方面，肌肉群、任务和年龄组之间存在显著的二因素和三因素交互作用，表明年长和年幼的儿童表现出不同的肌肉激活模式，这些模式因肌肉和任务而异。双侧同步性在组间无差异。对于平行任务，儿童表现出言语和吞咽的标准化平均振幅和峰值时间的不同幅度。然而，他们表现出相似的模式：随着任务复杂性的增加，幅度增加。
结论
7-8 岁至 11-12 岁儿童的吞咽和言语神经肌肉控制继续得到改善，这两种重要功能的神经肌肉控制既有共同的部分，也有独立的部分。为了提高研究结果的可推广性，未来的研究应包括吞咽和言语发展的纵向分析，以及中枢神经生理学的测量。
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