The Influence of Sour Taste on Dysphagia in Brain Injury: Blind Study

다국어 초록 (Multilingual Abstract)

Objective To verify the infl uence of sour taste on swallowing and the presence of refl ex cough when sour material was swallowed in patients with dysphagia secondary to brain injury.
Method Fifty dysphagic brain injury patients who underwent videofl uoroscopic swallowing study (VFSS) were recruited. Th e patients who had shown severe aspiration at 2 ml of liquid were excluded. Th e dysphagic patients were given 5 ml each of a sour tasting liquid (SOUR) and a thin liquid barium (LIQUID) in random order. An expert analyzed the result of VFSS by reviewing recorded videotapes. Analysis components consisted of the Penetration-Aspiration-Scale (PAS) score, oral transit time (OTT), pharyngeal transit time (PTT), pharyngeal delay time (PDT)and the refl ex cough presence.
Results The PAS score for SOUR was significantly lower than the one for LIQUID (p=0.03). The mean OTT for SOUR was significantly shortened compared to that for LIQUID (p=0.03). The mean PTT and PDT were also shortened in SOUR, although the diff erences were not statistically signifi cant (p=0.26 and p=0.32, respectively).
Th ere was no signifi cant diff erence between SOUR and LIQUID regarding the presence of refl ex cough (p=1.00).
Conclusion Th e sour taste could enhance sensorimotor feedback in the oropharynx, thus lowering the chances of penetration-aspiration caused by shortening of the oropharyngeal passage times. There was no significant diff erence in the presence of refl ex cough produced between LIQUID and SOUR.

참고문헌 (Reference)

1 Martin-Harris B, "The videofluorographic swallowing study" 19 : 769-785, 2008

2 Ozaki K, "The risk of penetration or aspiration during videofluoroscopic examination of swallowing varies depending on food types" 220 : 41-46, 2010

3 Chee C, "The influence of chemical gustatory stimuli and oral anaesthesia on healthy human pharyngeal swallowing" 30 : 393-400, 2005

4 Kaatzke-McDonald MN, "The effects of cold, touch, and chemical stimulation of the anterior faucial pillar on human swallowing" 11 : 198-206, 1996

5 Ding R, "The eff ects of taste and consistency on swallow physiology in younger and older healthy individuals: a surface electromyographic study" 46 : 977-989, 2003

6 Nilsson B, "Taste acuity of the human palate. I. Studies with electrogustometry and taste solutions on young adults" 35 : 51-62, 1977

7 Kajii Y, "Sour taste stimulation facilitates refl ex swallowing from the pharynx and larynx in the rat" 77 : 321-325, 2002

8 Sato K, "Sensitivity of three loci on the tongue and soft palate to four basic tastes in smokers and non-smokers" 546 : 74-82, 2002

9 Logemann JA., "Preswallow sensory input: its potential importance to dysphagic patients and normal individuals" 11 : 9-10, 1996

10 Davies AE, "Pharyngeal sensation and gag reflex in healthy subjects" 345 : 487-488, 1995

11 Hamdy S, "Long-term reorganization of human motor cortex driven by short-term sensory stimulation" 1 : 64-68, 1998

12 이주강, "Is Swallowing of All Mixed Consistencies Dangerous for Penetration-Aspiration?" LIPPINCOTT WILLIAMS WILKINS 91 (91): 187-192, 201203

13 Nakazato M, "Influence of aging on electrogustometry thresholds" 546 : 16-26, 2002

14 Ujiie Y, "Evidence for substance p as an endogenous substance causing cough in guinea pigs" 148 : 1628-1632, 1993

15 Palmer JB, "Evaluation and treatment of swallowing impairments" 61 : 2453-2462, 2000

16 Logemann JA, "Effects of a sour bolus on oropharyngeal swallowing measures in patients with neurogenic dysphagia" 38 : 556-563, 1995

17 Pelletier CA, "Effect of citric acid and citric acid-sucrose mixtures on swallowing in neurogenic oropharyngeal dysphagia" 18 : 231-241, 2003

18 Power ML, "Deglutitive laryngeal closure in stroke patients" 78 : 141-146, 2007

19 Jin Y, "Capsaicin desensitization inhibits swallowing refl ex in guinea pigs" 149 : 261-263, 1994

20 Stephen JR, "Bolus location at the initiation of the pharyngeal stage of swallowing in healthy older adults" 20 : 266-272, 2005

21 Gu Q, "Airway irritation and cough evoked by acid: from human to ion channel" 11 : 238-247, 2011

22 Logemann JA, "A screening procedure for oropharyngeal dysphagia" 14 : 44-51, 1999

23 Rosenbek JC, "A penetration-aspiration scale" 11 : 93-98, 1996