Journal
JOURNAL OF ALZHEIMERS DISEASE
Volume 19, Issue 4, Pages 1185-1197Publisher
IOS PRESS
DOI: 10.3233/JAD-2010-1316
Keywords
Alzheimer's disease; deglutition; neuroimaging; neurophysiology; videofluoroscopy
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Funding
- National Institutes of Health (NIH), NCRR [8K12RR023268-02]
- Wisconsin Comprehensive Memory Program [2006-2008]
- National Institutes of Health and National Institute on Aging [5T32AG000213-18]
- William S. Middleton Memorial VA Hospital Geriatric Research Education and Clinical Center (GRECC) [2009-12]
- NATIONAL CENTER FOR RESEARCH RESOURCES [K12RR023268] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [T32AG000213] Funding Source: NIH RePORTER
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The goal of this study was to determine whether functional changes in cortical control of swallowing are evident in early Alzheimer's disease (AD), before dysphagia (swallowing impairment) is evident. Cortical function was compared between an early AD group and a group of age-matched controls during swallowing. Swallowing oropharyngeal biomechanics examined from videofluoroscopic recordings were also obtained to more comprehensively characterize changes in swallowing associated with early AD. Our neuroimaging results show that the AD group had significantly lower Blood-Oxygen-Level-Dependent (BOLD) response in many cortical areas that are traditionally involved in normal swallowing (i.e., pre and postcentral gyri, Rolandic and frontal opercula). There were no regions where the AD group showed more brain activity than the healthy controls during swallowing, and only 13% of all active voxels were unique to the AD group, even at this early stage. This suggests that the AD group is not recruiting new regions, nor are they compensating within regions that are active during swallowing. In videofluoroscopic measures, the AD group had significantly reduced hyo-laryngeal elevation than the controls. Although, swallowing impairment is usually noted in the late stages of AD, changes in cortical control of swallowing may begin long before dysphagia becomes apparent.
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