A5035661638- Dysphagia Assessment and Management
- Voice and Speech Disorders
- Tracheal and airway disorders
- Child Nutrition and Feeding Issues
- Restless Legs Syndrome Research
- Esophageal and GI Pathology
- Transcranial Magnetic Stimulation Studies
- Obstructive Sleep Apnea Research
- Spinal Cord Injury Research
- Cervical and Thoracic Myelopathy
- Neurological disorders and treatments
- Gastroesophageal reflux and treatments
- Advanced MRI Techniques and Applications
- EEG and Brain-Computer Interfaces
- Stuttering Research and Treatment
- Neurobiology of Language and Bilingualism
- Advanced Neuroimaging Techniques and Applications
- Olfactory and Sensory Function Studies
- Infrared Thermography in Medicine
- Pain Management and Placebo Effect
- Gastrointestinal motility and disorders
- Apelin-related biomedical research
- Cognitive and developmental aspects of mathematical skills
- Electric and Hybrid Vehicle Technologies
- Myofascial pain diagnosis and treatment
Phagenesis (United Kingdom)
2016-2020
Stanford Medicine
2019
Castle Hill Hospital
2017
University of Manchester
2007-2016
Salford Royal NHS Foundation Trust
2008-2016
University of Salford
2007-2016
Salford Royal Hospital
2005-2015
Manchester Academic Health Science Centre
2011-2015
Health Sciences Centre
2011
Centre for Inflammation Research
2011
Inhibitory patterns of repetitive transcranial magnetic stimulation (rTMS) were applied to pharyngeal motor cortex in order establish its role modulating swallowing activity and provide evidence for functionally relevant hemispheric asymmetry. Healthy volunteers underwent single pulse TMS before 60 min after differing intensities 1 Hz rTMS (n = 9, 6 male, 3 female, mean age 34 +/- years) or theta burst (TBS) 37 4 years). Electromyographic responses recorded from pharynx hand used as a...
This study explored the effects of taste and oral anaesthesia on human sequential swallowing. Subjects were healthy adults (n = 42, mean age 28 years, 21 females), investigated by means a water swallow test. Taste stimuli comprised quinine, glucose, citrus saline solutions compared with neutral water. Oral topical lidocaine at doses 10, 20 40 mg placebo. Data collected swallowing speed (volume per second), inter-swallow interval capacity swallow). Compared water, reduced (10.94 +/- 0.89...
Swallowing problems following stroke may result in increased risk of aspiration pneumonia, malnutrition, and dehydration.Our hypothesis was that three neurostimulation techniques would produce beneficial effects on chronic dysphagia through a common brain mechanism predict behavioral response.In 18 dysphagic patients (mean age: 66 ± 3 years, female, time-post-stroke: 63 15 weeks [±SD]), pharyngeal electromyographic responses were recorded after single-pulse transcranial magnetic stimulation...
Background. Pharyngeal electrical stimulation (PES) appears to promote cortical plasticity and swallowing recovery poststroke. Objective. We aimed assess clinical effectiveness with longer follow-up. Methods. Dysphagic patients (n = 36; median 71 years; 61% male) recruited from 3 trial centers within 6 weeks of stroke, received active or sham PES in a single-blinded randomized design via an intraluminal pharyngeal catheter (10 minutes, for 3days). The primary outcome measure was the...
Faucial pillar (FP) stimulation is commonly used in swallowing rehabilitation, yet its physiological basis remains uncertain. We investigated the effects of intraoral FP on human corticobulbar excitability and behavior, to explore possibility a central mechanism for functional change. In 10 healthy subjects, projections pharynx were with transcranial magnetic stimulation, via intraluminal electrodes, before up 1 h after min electrical three frequencies (0.2, 1, 5 Hz) or sham peripheral...
Transcranial direct current stimulation (tDCS) is a novel intervention that can modulate brain excitability in health and disease; however, little known about its effects on bilaterally innervated systems such as pharyngeal motor cortex. Here, we assess the of differing doses tDCS physiology healthy human cortex prelude to designing therapeutic dysphagic patients. Healthy subjects (n = 17) underwent seven regimens (anodal 10 min 1 mA, cathodal anodal 1.5 20 Sham) separate days, double blind...
Various therapeutic approaches for dysphagia management are based on modifications of bolus properties to change swallowing biomechanics and increase safety. Limited evidence exists the effects carbonation temperature behavior. Here, we investigated behavior using a novel automated complex reaction time task via pressure signal recordings in hypopharynx. Healthy participants (n = 39, 27.7±5 years old) were randomized two different experiments asked perform 10 normal-paced swallows,...
Neurostimulation is a rapidly emerging approach to swallowing rehabilitation, but cerebellar stimulation has not been explored as treatment. Such proposed therapies for post-stroke dysphagia have required confirmation of physiological effects and optimisation parameters in healthy humans prior translational progression into patient groups. There strong evidence role the cerebellum physiology, this relationship under-explored. Recently, single pulses magnetic shown directly evoke responses...
Neurogenic dysphagia is common and has no definitive treatment. We assessed whether pharyngeal electrical stimulation (PES) associated with reduced dysphagia.The PHAryngeal for treatment of neurogenic Dysphagia European Registry (PHADER) was a prospective single-arm observational cohort study. Participants were recruited (comprising five groups - stroke not needing ventilation; ventilation acquired; traumatic brain injury; other neurological causes). PES administered once daily three days....
Key points Cortical control of swallowing exhibits functional asymmetry with brain lesions involving the strongest projection being implicated in pathophysiology dysphagia after unilateral stroke. Swallowing recovery is associated neuroplastic adaptation unlesioned hemisphere, a process which can be facilitated by excitatory neurostimulation techniques including transcranial direct current stimulation (tDCS). Unilateral suppression pharyngeal motor using 1 Hz repetitive magnetic (rTMS)...
Human swallowing involves the integration of sensorimotor information with complexities such as taste; however, interaction between taste food and its effects on control remains unknown. We assessed pleasant (sweet) aversive (bitter) tastes human cortical motor pathway excitability. Healthy adult male volunteers underwent a transcranial magnetic stimulation (TMS) mapping study (n = 9, mean age: 34 yr) to assess corticobulbar excitability before up 60 min after 10-min liquid infusions either...
Background. Several stimulation parameters can influence the neurophysiological and behavioral effects of paired associative (PAS), a neurostimulation paradigm that repeatedly pairs peripheral electrical with central cortical (transcranial magnetic [TMS]) stimulus. This also appears to be case when PAS is applied pharyngeal motor cortex (MI), some variability in excitatory responses, questioning its translation into useful therapy for patients brain injury. Objective. To investigate whether...
Intermittent theta burst stimulation (iTBS) is a novel, non-invasive form of brain capable facilitating excitability the human primary motor cortex with therapeutic potential in treatment neurological conditions, such as multiple sclerosis. The objectives this study were to evaluate effects iTBS on cortical properties pharyngeal system. Transcranial magnetic (TMS)-evoked responses recorded via swallowed intra-luminal catheter and used assess pathways pharynx both hemispheres before for up 90...
Rationale Ongoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway aspiration. In a recently reported single-centre pilot study, significantly larger proportion (75%) of tracheotomized dysphagic regained sufficient control management allowing tube removal (decannulation) 24–72 h after pharyngeal electrical stimulation (PES) compared controls who received standard therapy over same time period (20%). Aim To assess...
Abstract Background Recent evidence implicates brain‐derived neurotrophic factor (BDNF) in visceral hypersensitivity and pain functional gastrointestinal disorders. We hypothesized that presence of the val66met polymorphism BDNF gene would be linked to increased esophageal sensitivity electrical stimulation. Methods A total 39 healthy volunteers (20 males, mean age 30) compliant with inclusion criteria after screening procedures were genotyped for polymorphisms completed an Hospital Anxiety...
Abstract Objective: We discuss the use of balloon dilatation to relieve supraglottic stenosis caused by mucous membrane plasmacytosis. Case report: A 54-year-old man with a known diagnosis plasmacytosis presented dysphonia and worsening airway obstruction which required tracheostomy. He underwent larynx using an angioplasty within sequentially sized endotracheal tubes. This enabled successful decannulation, minimal re-stenosis at eight-month follow up. Conclusion: To our knowledge, this is...
Abstract Introduction: Post-extubation dysphagia is commonly observed in ICU patients and associated with increased aspiration rates, delayed resumption of oral intake/ malnutrition, prolonged hospital length stay, decreased quality life, mortality. Conventional therapeutic approaches are limited. Pharyngeal electrical stimulation (PES) was previously shown to improve swallowing function airway safety severely dysphagic tracheostomised stroke patients. Methods: In a multi-center,...