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巴氯芬对吞咽运动模式的影响。

Effects of baclofen on swallow motor pattern.

作者信息

Fielder Nathan W, Frazure Michael, Poliacek Ivan, Bolser Donald C, Iceman Kimberly E, Pitts Teresa

机构信息

School of Medicine, University of Louisville, Louisville, KY, United States.

Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ, United States.

出版信息

Front Neurol. 2025 Feb 25;16:1526453. doi: 10.3389/fneur.2025.1526453. eCollection 2025.

Abstract

Baclofen is a GABA receptor agonist used clinically to manage spasticity. It has also been associated with increased duration of mechanical ventilation and rates of aspiration pneumonitis. We hypothesized that baclofen would impair pharyngeal swallow, a vital airway protective reflex. Electromyography (EMG) activity was recorded in four spontaneously breathing, sodium pentobarbital-anesthetized cats. Swallow was stimulated by oral water infusion before and after administration of 3 μg/kg and 10 μg/kg (±)baclofen doses. Swallow-related thyrohyoid EMG amplitude increased after 3 μg/kg and 10 μg/kg (±)baclofen, while parasternal EMG amplitude decreased after 3 μg/kg (±)baclofen. Geniohyoid, thyroarytenoid, and thyropharyngeus EMG amplitudes increased on average, but did not reach significance. Clinically, increased thyrohyoid activation may extend duration of laryngeal abduction. Decreased parasternal activation could impair development of the negative intrathoracic pressure that aids bolus propulsion during swallow. These changes may reflect increased risk of aspiration, and more work is needed to study the effects of baclofen on airway protection.

摘要

巴氯芬是一种临床上用于治疗痉挛的γ-氨基丁酸(GABA)受体激动剂。它还与机械通气时间延长和吸入性肺炎发生率增加有关。我们假设巴氯芬会损害咽吞咽,这是一种重要的气道保护反射。在四只戊巴比妥钠麻醉、自主呼吸的猫身上记录了肌电图(EMG)活动。在给予3μg/kg和10μg/kg(±)巴氯芬剂量前后,通过口服注水刺激吞咽。3μg/kg和10μg/kg(±)巴氯芬给药后,与吞咽相关的甲状舌骨肌EMG振幅增加,而3μg/kg(±)巴氯芬给药后,胸骨旁肌EMG振幅降低。颏舌骨肌、甲杓肌和咽下缩肌的EMG振幅平均增加,但未达到显著水平。临床上,甲状舌骨肌激活增加可能会延长喉部外展的持续时间。胸骨旁肌激活减少可能会损害吞咽过程中有助于食团推进的胸内负压的形成。这些变化可能反映了误吸风险增加,需要更多的研究来探讨巴氯芬对气道保护的影响。

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