2024/03/29 更新

写真a

マガラ ジン
真柄 仁
MAGARA Jin
所属
医歯学総合病院 摂食嚥下機能回復部 講師
職名
講師
外部リンク

学位

  • 歯学博士 ( 2012年3月   新潟大学 )

研究キーワード

  • 口腔機能

  • 摂食嚥下障害

  • 経頭蓋磁気刺激

  • リハビリテーション

研究分野

  • ライフサイエンス / 常態系口腔科学

  • ライフサイエンス / 補綴系歯学

経歴(researchmap)

  • 新潟大学 医歯学総合病院   摂食嚥下機能回復部   講師

    2015年4月 - 現在

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  • University of Manchester   Neurogastroenterology, Faculty of Biology, Medicine and Health,   Research fellow

    2014年6月 - 2015年5月

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  • 新潟大学 医歯学総合病院   摂食嚥下機能回復部   助教

    2012年4月 - 2015年3月

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経歴

  • 新潟大学   医歯学総合病院 摂食嚥下機能回復部   講師

    2015年4月 - 現在

  • 新潟大学   医歯学総合研究科 口腔生命科学専攻   助教

    2012年4月 - 2015年3月

  • 新潟大学   医歯学総合病院 摂食嚥下機能回復部   助教

    2012年4月 - 2015年3月

学歴

  • 新潟大学   大学院 医歯学総合研究科

    2008年4月 - 2012年3月

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  • 新潟大学   歯学部

    2000年4月 - 2006年3月

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所属学協会

  • 日本摂食嚥下リハビリテーション学会

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  • 日本補綴歯科学会

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  • 日本顎口腔機能学会

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  • European Society for Swallowing Disorders

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  • 日本老年歯科医学会

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委員歴

  • 日本顎口腔機能学会   理事,評議員  

    2022年4月 - 現在   

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    団体区分:学協会

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  • 日本摂食嚥下リハビリテーション学会   評議員  

    2017年9月 - 現在   

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    団体区分:学協会

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留学歴

  • マンチェスター大学   Research Associate

    2015年6月 - 2016年5月

 

論文

  • Use of suction electrodes for measurement of intrinsic tongue muscular endurance during lingual pressure generation. 査読 国際誌

    Reiko Ita, Jin Magara, Yuto Ochiai, Takanori Tsujimura, Makoto Inoue

    Journal of oral rehabilitation   51 ( 3 )   566 - 573   2023年10月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Lingual pressure (LP) generation is cooperatively controlled not only by the intrinsic tongue (I-ton) muscles but also by hyoid muscle activation. However, the measurement of endurance and fatigue properties of I-ton muscles is difficult due to the instability of electrodes. OBJECTIVE: The purpose of this study was to apply suction electrodes to measure electromyograms (EMGs) of I-ton muscle and to evaluate integrated EMG amplitude (iEMG) and mean power frequency (MPF) of EMG in the I-ton and hyoid muscles performing continuous LP. METHODS: Twenty healthy adult volunteers (10 males, 10 females, mean age 28.8 years) were instructed to perform 10-s LP generation tasks at 25%, 50%, 75% and 100% of maximum LP in randomised order with visual feedback. During each task, EMGs of the I-ton, suprahyoid (S-hyo), infrahyoid (I-hyo) and masseter (Mass) muscles were simultaneously recorded. The iEMG and MPF of EMG burst during 10-s LP tasks were compared. The recording period was divided into three substages to analyse temporal changes with the Friedman test. RESULTS: During the 10-s task, the iEMG significantly increased as the LP strength increased (p < .001). There was no time-dependent change in the I-ton iEMG; however, the MPF of the I-ton EMG burst decreased in all tasks (p < .05). The S-hyo and I-hyo iEMGs gradually increased, especially with strong LP (p < .01). CONCLUSION: While I-ton muscles may easily fatigue during 10-s LP generation, S-hyo and I-hyo muscles may help compensate for the weakened I-ton muscle activity by increasing their activity to maintain LP.

    DOI: 10.1111/joor.13612

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  • Evaluating the effect of management on patients with oral hypofunction: A longitudinal study. 査読 国際誌

    Wakana Onuki, Jin Magara, Kayoko Ito, Reiko Ita, Satomi Kawada, Yuhei Tsutsui, Yuta Nakajima, Haruka Sakai, Takanori Tsujimura, Makoto Inoue

    Gerodontology   40 ( 3 )   308 - 316   2023年9月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    INTRODUCTION: Declining oral function may affect subsequent physical frailty in the older population. The aim of this longitudinal study was to summarise data on patients who underwent functional oral examination and evaluate the impact of management on patients with oral hypofunction (OHF). METHODS: Dental outpatients aged over 65 years at their initial visit to the Niigata University Hospital received detailed assessment of seven oral function items to diagnose oral hypofunction using diagnostic criteria defined by the Japanese Society of Gerodontology. Patients with OHF at the first assessment received management including oral health guidance for low function and dental treatment. They were re-evaluated approximately 6 months later and the two assessments were compared. According to the results of the second assessment, the patients were divided into two groups: OHF improved and OHF re-diagnosed. RESULTS: Of the 273 patients who underwent the first assessment, 86 (31.5%) were diagnosed with OHF and received management. Of those, 42 (48.8%) completed the second assessment. Comparing the first and second assessment, significant improvement was observed in oral hygiene, occlusal force, tongue-lip motor function of /pa/, mastication and swallowing. The change in values from the first assessment demonstrated a significant difference between the OHF improved and re-diagnosed groups only in occlusal force. CONCLUSION: Management for patients with OHF can contribute to the improvement of poor oral function, and an increase in occlusal force was notable in the recovery from OHF.

    DOI: 10.1111/ger.12655

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  • Chewing modulates the human cortical swallowing motor pathways. 査読 国際誌

    Jin Magara, Wakana Onuki, Reiko Ita, Takanori Tsujimura, Makoto Inoue

    Physiology & behavior   249   113763 - 113763   2022年5月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier BV  

    When eating, mastication is always followed by swallowing. The present study assessed the effect of mastication on swallowing-related neural pathways in humans. Twenty healthy volunteers participated and underwent baseline transcranial magnetic stimulation to evaluate cortico-pharyngeal and cortico-hand motor-evoked potentials (MEPs). Next, they performed a chewing task and a swallowing task. Repeated-measures ANOVA revealed that pharyngeal MEPs were significantly higher after the swallowing task than after the chewing task, even though the number of swallows across tasks was matched. This implies that chewing movements suppress swallowing-related activity in the pharyngeal motor circuit.

    DOI: 10.1016/j.physbeh.2022.113763

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  • Survey of oral hypofunction in older outpatients at a dental hospital. 査読 国際誌

    Wakana Onuki, Jin Magara, Takanori Tsujimura, Kayoko Ito, Haruka Sakai, Sirima Kulvanich, Yuta Nakajima, Nobuaki Saka, Makoto Inoue

    Journal of oral rehabilitation   48 ( 10 )   1173 - 1182.   2021年8月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Oral hypofunction is defined as the reversible stage preceding oral dysfunction. However, its assessment and management need further examination and consideration. OBJECTIVE: The present study aimed to examine the current state of oral hypofunction among outpatients at the university hospital. METHODS: New outpatients underwent medical interviews and detailed assessment of oral hypofunction at their initial visit to our dental department. Oral hypofunction was diagnosed if the results of three of the following seven assessment items were below cut-off values: poor oral hygiene, oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function and deterioration of swallowing function. The relationships between factors used to diagnose oral hypofunction as well as the distributions of assessment values were clarified. RESULTS: Seventy-five of 209 patients (35.9%) were finally diagnosed with oral hypofunction. Diagnosis of oral hypofunction was significantly related to patient age, Eichner index, a chief complaint of dental or periodontal disease or ill-fitting dentures and a history of neurodegenerative disease. The lowest quintile values for poor oral hygiene, oral dryness and decreased masticatory performance were all above current cut-off values. Reduced occlusal force contributed strongly to the diagnosis of oral hypofunction. CONCLUSION: Oral hypofunction in dental outpatients at a university hospital was associated with patient age, medical history and chief complaint at presentation. Diagnosis of oral hypofunction can be closely related to reduced occlusal force. The validity of cut-off values for assessments of oral hypofunction needs further consideration.

    DOI: 10.1111/joor.13237

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  • Lasting modulation of human cortical swallowing motor pathways following thermal tongue stimulation. 査読 国際誌

    Jin Magara, Masahiro Watanabe, Takanori Tsujimura, Shaheen Hamdy, Makoto Inoue

    Neurogastroenterology and motility   33 ( 1 )   e13938   2021年1月

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    担当区分:筆頭著者, 責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Thermal tactile oropharyngeal stimulation has been clinically used to facilitate swallowing initiation in dysphagic patients. We previously demonstrated that thermal stimulation applied to the oral cavity provokes an immediate excitability in pharyngeal motor cortex. The aim of the current study was to investigate whether thermal stimulation can produce longer lasting effects on the corticopharyngeal neural pathway. METHODS: Healthy volunteers (n = 8/12) underwent baseline pharyngeal motor evoked potential (PMEP) measurements evoked by transcranial magnetic stimulation. In the first experiment, subjects received thermal stimulation alternating 30 seconds of 15 and 36°C applied to the tongue surface for either 10 minutes, 5 minutes, or sham. In the second experiment, one of three intermittent thermal stimulus patterns was delivered: cold (alternating 30 seconds of 15 and 36°C), warm (continuous 36°C), or hot (alternating 30 seconds of 45 and 36°C) for 10 minutes. In both experiments, PMEP were remeasured every 15 minutes up to 60 minutes following thermal stimulation. KEY RESULTS: Repeated measures ANOVA for each stimulus time in the first experiment showed a significant increased change in PMEP amplitude at 30 minutes following only 10-minute stimulation compared with sham (P < .05). In the second experiment, we found that cold stimulation was more effective than the other stimulation (P < .05) at increasing PMEP amplitudes. CONCLUSIONS AND INFERENCES: Ten-minute cold stimulation on the tongue can induce a delayed (30 minutes) increase in pharyngeal cortical excitability, providing a clinically useful therapeutic window for its application in dysphagic patients.

    DOI: 10.1111/nmo.13938

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  • Endurance measurement of hyoid muscle activity and hyoid-laryngeal position during tongue lift movement. 査読 国際誌

    Yukako Sunada, Jin Magara, Takanori Tsujimura, Kazuhiro Ono, Makoto Inoue

    Journal of oral rehabilitation   47 ( 8 )   967 - 976   2020年8月

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    担当区分:責任著者   記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Tongue lift movement (TLM) is used as a therapy to improve tongue pressure against the hard palate for dysphagic patients. OBJECTIVE: The present study aimed to characterize the time-dependent endurance changes in hyoid muscle activity and hyoid-laryngeal displacement during TLM in different ways. METHODS: Sixteen young healthy volunteers were instructed to perform TLM at maximum effort (100%) against the anterior and posterior parts of the hard palate using a balloon-type tongue pressure instrument, followed by a 10-second recording during anterior 80% TLM, anterior 100% TLM, posterior 80% TLM and posterior 100% TLM with visual feedback. Electromyography (EMG) of suprahyoid (S-Hyo) and infrahyoid (I-Hyo) muscles and videofluorography were simultaneously recorded. To evaluate temporal changes, the recording period was divided into three substages: early, middle and late. Tongue pressure, integrated EMG (iEMG), power frequency of EMG burst and hyoid-laryngeal position were compared among the conditions (80% vs 100%, anterior vs posterior and early vs middle vs late). RESULTS: Tongue pressure was stably maintained for 10 seconds in all conditions. S-Hyo iEMG and I-Hyo iEMG were significantly greater at 100% than at 80%, while no significant difference was observed between positions. S-Hyo iEMG and I-Hyo iEMG significantly increased at the late stage, while power frequency of EMG burst gradually decreased. Significant temporal changes in laryngeal elevation were observed only in posterior 100% TLM. CONCLUSION: The current results suggested that isometric posterior TLM may be more useful compared with anterior TLM in clinical situations for dysphagic patients to elevate the hyolaryngeal complex.

    DOI: 10.1111/joor.12988

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  • Cold thermal oral stimulation produces immediate excitability in human pharyngeal motor cortex. 査読

    Jin Magara, Masahiro Watanabe, Takanori Tsujimura, Shaheen Hamdy, Makoto Inoue

    Neurogastroenterology and motility   e13384   2018年6月

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    担当区分:筆頭著者, 責任著者   記述言語:英語  

    DOI: 10.1111/nmo.13384

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  • Exploring the effects of synchronous pharyngeal electrical stimulation with swallowing carbonated water on cortical excitability in the human pharyngeal motor system 査読

    Jin Magara, Emilia Michou, Alicia Raginis-Zborowska, Makoto Inoue, Shaheen Hamdy

    Neurogastroenterology and motility   28 ( 9 )   1391 - 1400   2016年9月

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    担当区分:筆頭著者   記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    Background Previous reports have revealed that excitation of human pharyngeal motor cortex can be induced by pharyngeal electrical stimulation (PES) and swallowing carbonated water (CW). This study investigated whether combining PES with swallowing (of still water, SW or CW) can potentiate this excitation in either cortical and/or brain stem areas assessed with transcranial and transcutaneous magnetic stimulation (TMS). Methods Fourteen healthy volunteers participated and were intubated with an intraluminal catheter to record pharyngeal electromyography and deliver PES. Each participant underwent baseline corticopharyngeal, hand and craniobulbar motor-evoked potential (MEP) measurements. Subjects were then randomized to receive each of four 10-min interventions (PES only, ShamPES+CW, PES+CW, and PES+SW). Corticobulbar, craniobulbar and hand MEPs were then remeasured for up to 60 min and data analyzed using ANOVA and post hoc t-tests. Key Results A two-way rmANOVA for Interventions 9 Time-point showed a significant corticopharyngeal interaction (p = 0.010). One-way ANOVA with post hoc t-tests indicated significant cortical changes with PES only at 45 (p = 0.038) and 60 min (p = 0.023) and ShamPES+CW immediately (p = 0.008) but not with PES+CW or PES+SW. By contrast, there were immediate craniobulbar amplitude changes only with PES+CW (p = 0.020) which were not sustained. Conclusions & Inferences We conclude that only PES produced long-term changes in corticopharyngeal excitability whereas combination stimuli were less effective. Our data suggest that PES alone rather than in combination, may be better for the patients who have difficulty in performing voluntary swallows.

    DOI: 10.1111/nmo.12839

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  • Continuous electrical stimulation of superior laryngeal nerve inhibits initiation of swallowing in anesthetized rats. 国際誌

    Yuta Nakajima, Takanori Tsujimura, Kojun Tsuji, Jin Magara, Makoto Inoue

    Neuroscience letters   825   137672 - 137672   2024年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pharyngeal electrical stimulation (PES) applies electrical stimulation to pharyngeal mucosa (PhM) and represents a useful approach to improve swallowing function in patients with dysphagia. To determine the optimal PES modality to treat dysphagia, the mechanism underlying the effects of PES on swallowing function must be elucidated. In this study, we evaluated how PES and electrical stimulation of the superior laryngeal nerve (SLN) modulate the initiation of swallowing in anesthetized rats. A swallow was evoked by electrical stimulation of the PhM, SLN, and nucleus of the solitary tract (nTS) and pharyngeal mechanical stimulation using a von Frey filament. A swallow was identified by electromyographic bursts in mylohyoid and thyrohyoid muscles. Bilateral SLN transection abolished the swallows evoked by PhM electrical stimulation. PhM and SLN electrical stimulation decreased swallowing frequency in a similar time-dependent manner. Intravenous administration of the GABAA receptor antagonist bicuculine did not affect the time-dependent change in swallowing frequency during SLN electrical stimulation. Continuous SLN electrical stimulation significantly inhibited pharyngeal mechanically and nTS-electrically evoked swallows compared with before and 5 min after stimulation. The present findings suggest that the SLN plays a primary role in PES-evoked swallows. Additionally, continuous SLN electrical stimulation inhibits the initiation of swallowing, and the modulation of central network associated with swallowing might be partially involved in this inhibition.

    DOI: 10.1016/j.neulet.2024.137672

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  • Short-term and long-term effects of unilateral external carotid artery ligation on orofacial functions in rats. 国際誌

    Titi Chotirungsan, Yuhei Tsutsui, Nobuaki Saka, Satomi Kawada, Nozomi Dewa, Jin Magara, Takanori Tsujimura, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   326 ( 3 )   G318-G329   2024年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The external carotid artery (ECA) plays a major role in supplying blood to the head and neck. Although impeded blood flow in the ECA is expected to affect orofacial functions, few studies have shown how blood flow obstruction in the ECA contributes to impairment of these functions, including chewing and swallowing. This study was performed to investigate the effects of ECA ligation (ECAL) on immediate and long-term changes in masticatory and swallowing functions as well as the jaw-opening reflex evoked in the digastric muscle. The experiments were carried out using male Sprague-Dawley rats. In the acute experiment, the digastric reflex evoked by low-threshold electrical stimulation of the inferior alveolar nerve and the swallow reflex, identified by digastric and thyrohyoid electromyographic (EMG) bursts, were compared between before and 1 h after ECAL. The chronic experiment was conducted on freely moving rats. EMGs of the masseter, digastric, and thyrohyoid muscles were chronically recorded. The long-term effects of ECAL on behavior and muscle histology were compared between rats with an intact ECA and rats with ECAL. In the acute experiment, the peak amplitude of the digastric reflex on the ECAL side was significantly decreased 1 h after ECAL. In the chronic experiment, although most parameters of the masticatory and swallowing EMGs were not significantly different between the groups, the results suggest wide variation of the effect of ECAL on the muscles. Blood supply compensation from collaterals of the internal carotid artery may be permanent in some animals.NEW & NOTEWORTHY The inhibitory effect of unilateral external carotid artery ligation (ECAL) on the ipsilateral digastric reflex was small but evident. Most parameters of masticatory and swallowing muscle activity were not significantly different after ECAL. Wide variation was noted in the effect of ECAL on the ipsilateral muscle activity. Blood supply compensation from collaterals of the internal carotid artery may occur in response to the impaired blood flow.

    DOI: 10.1152/ajpgi.00226.2023

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  • Modulation of reflex responses of the anterior and posterior bellies of the digastric muscle in freely moving rats. 査読 国際誌

    Titi Chotirungsan, Yuhei Tsutsui, Nobuaki Saka, Satomi Kawada, Nozomi Dewa, Taku Suzuki, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Journal of oral rehabilitation   50 ( 11 )   1270 - 1278   2023年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Chewing and licking are primarily activated by central pattern generator (CPG) neuronal circuits in the brainstem and when activated trigger repetitive rhythmic orofacial movements such as chewing, licking and swallowing. These CPGs are reported to modulate orofacial reflex responses in functions such as chewing. OBJECTIVE: This study explored the modulation of reflex responses in the anterior and posterior bellies (ant-Dig and post-Dig, respectively) of the digastric muscle evoked by low-intensity trigeminal stimulation in conscious rats. METHODS: The ant-Dig and post-Dig reflexes were evoked by using low-intensity electrical stimulation applied to either the right or left inferior alveolar nerve. Peak-to-peak amplitudes and onset latencies were measured. RESULTS: No difference was observed between threshold and onset latency for evoking ant-Dig and post-Dig reflexes, suggesting that the latter was also evoked disynaptically. The peak-to-peak amplitude of both reflexes was significantly reduced during chewing, licking and swallowing as compared to resting period and was lowest during the jaw-closing phase of chewing and licking. Onset latency was significantly largest during the jaw-closing phase. Inhibitory level was similar between the ant-Dig and post-Dig reflex responses and between the ipsilateral and contralateral sides. CONCLUSION: These results suggest that both the ant-Dig and post-Dig reflex responses were significantly inhibited, probably due to CPG activation during feeding behaviours to maintain coordination of jaw and hyoid movements and hence ensure smooth feeding mechanics.

    DOI: 10.1111/joor.13537

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  • Atropine facilitates water-evoked swallows via central muscarinic receptors in anesthetized rats. 査読 国際誌

    Yuta Nakajima, Takanori Tsujimura, Yuhei Tsutsui, Titi Chotirungsan, Satomi Kawada, Nozomi Dewa, Jin Magara, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   325 ( 2 )   G109-G121   2023年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Anticholinergic medication causes impaired swallowing with hyposalivation. However, the underlying mechanisms by which these drugs modulate the swallowing reflex remain unclear. This study investigated the effects of the muscarinic acetylcholine receptor (mAChR) non-specific antagonist atropine on the initiation of swallowing. Experiments were performed on 124 urethane-anesthetized rats. A swallow was evoked by either topical laryngeal application of a small amount of distilled water (DW), saline, citric acid, or capsaicin; upper airway distention with a continuous airflow; electrical stimulation of the superior laryngeal nerve (SLN); or focal microinjection of NMDAinto the lateral region of the nucleus of the solitary tract (L-nTS). Swallows were identified by electromyographic bursts of the suprahyoid and thyrohyoid muscles. Either atropine, the peripheral mAChR antagonist methylatropine, or antagonists of mAChR subtypes M1-M5 were intravenously delivered. Atropine at a dose of 1 mg/kg increased the number of DW-evoked swallows compared with baseline and did not affect the number of swallows evoked by saline, citric acid, capsaicin, or upper airway distention. Methylatropine and M1-M5 antagonists did not significantly change the number of DW-evoked swallows. Bilateral SLN transection completely abolished DW-evoked swallows, and atropine decreased the swallowing threshold of SLN electrical stimulation. Finally, microinjection of NMDA receptor antagonist AP-5 into the L-nTS inhibited DW-evoked swallows, and atropine facilitated the initiation of swallowing evoked by NMDA microinjection into this region. These results suggest that atropine facilitates DW-evoked swallows via central mAChR actions.

    DOI: 10.1152/ajpgi.00039.2023

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  • Effects of Head and Neck Alignment and Pharyngeal Anatomy on Epiglottic Inversion During Swallowing in Dysphagic Patients. 査読 国際誌

    Taku Suzuki, Haruka Hino, Jin Magara, Takanori Tsujimura, Kayoko Ito, Makoto Inoue

    Dysphagia   38 ( 6 )   1519 - 1527   2023年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The effects of head and neck alignment and pharyngeal anatomy on epiglottic inversion remain unclear. This study investigated the factors involved in epiglottic inversion, including head and neck alignment and pharyngeal anatomy, in patients with dysphagia. Patients with a chief complaint of dysphagia and who underwent videofluoroscopic swallowing study at our hospital from January to July 2022 were enrolled. They were divided into three groups based on the degree of epiglottic inversion as the complete-inversion (CI), partial-inversion (PI), and non-inversion group (NI) groups. Data were compared among the three groups; a total of 113 patients were analyzed. The median age was 72.0 (IQR: 62.0-76.0) years; 41 (36.3%) and 72 (63.7%) were women and men, respectively. There were in 45 (39.8%) patients in the CI, 39 (34.5%) in the PI, and 29 (25.7%) in the NI groups, respectively. Single-variable analysis revealed significant relation to epiglottic inversion of Food Intake LEVEL Scale score, penetration-aspiration score with 3-mL thin liquid bolus, epiglottic vallecula and pyriform sinus residue, hyoid position and displacement during swallowing, pharyngeal inlet angle (PIA), epiglottis to posterior pharyngeal wall distance, and body mass index. Logistic regression analysis with complete epiglottic inversion as the dependent variable revealed the X coordinate at maximum hyoid elevation position during swallowing and PIA as significant explanatory variables. These results suggest that epiglottic inversion is constrained in patients with dysphagia who have poor head and neck alignment or posture and a narrow pharyngeal cavity just before swallowing.

    DOI: 10.1007/s00455-023-10579-w

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  • 口腔機能低下症患者における口腔機能管理の実施効果に関する縦断研究

    真柄仁, 小貫和佳奈, 井上誠

    8020   ( 22 )   139 - 142   2023年3月

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    担当区分:責任著者   記述言語:日本語   出版者・発行元:(公財)8020推進財団  

    J-GLOBAL

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  • 舌亜全摘出術後に舌接触補助床を用いて嚥下訓練を行った一例

    中嶋 優太, 真柄 仁, 坂井 遥, 渡邊 賢礼, 井上 誠

    日本口腔リハビリテーション学会雑誌   35 ( 1 )   48 - 55   2022年12月

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    記述言語:日本語   出版者・発行元:日本口腔リハビリテーション学会  

    症例は70歳男性で、舌の違和感を自覚してかかりつけ歯科受診後、翌日に当院口腔再建外科を紹介受診し、右側舌癌と診断された。化学療法後に舌亜全摘出術、左大腿遊離皮弁再建術、右側頸部郭清術、気管切開術が施行された。睡液嚥下の確認および食物を用いた直接訓練開始の可否について咽頭期精査が必要と判断し、術後13日目に嚥下内視鏡検査(VE検査)を実施した。機能評価およびVE検査の結果より、舌亜全摘出術後再建舌運動機能低下を伴う準備期、口腔期、咽頭期障害と診断し、姿勢調整下での直接訓練、間接訓練として再建舌の運動機能低下の改善を目的とした舌可動訓練・等尺性舌抵抗訓練を開始した。間接訓練の継続および構音改善と舌接触補助床(PAP)使用感への慣れを目的としてPAPを用いた訓練を継続し、術後97日目に舌癌術後・腸瘻造設後の経過良好につき退院となった。術後159日目、PAP装着時に食物の食道流入および咽頭残留においても改善が認められた。

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  • Functional evaluation of jaw and suprahyoid muscle activities during chewing 査読 国際誌

    Anna Sasa, Sirima Kulvanich, Naohito Hao, Reiko Ita, Masahiro Watanabe, Taku Suzuki, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Journal of Oral Rehabilitation   49 ( 12 )   1127 - 1134   2022年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    BACKGROUND: It has not yet been clarified how the type of the chewing task affects related muscle activity and how the suprahyoid muscles contribute to masticatory function in humans. OBJECTIVES: This study aimed to investigate the difference in the suprahyoid muscle activity between the freely and unilaterally chewing tasks and between the working and non-working sides during chewing. MATERIALS AND METHODS: Twenty healthy volunteers were instructed to chew peanuts and two different types of rice crackers in two ways; freely and unilaterally while surface electromyograms of the masseter and suprahyoid muscles were recorded. The chewing duration, number of chewing cycles and chewing rate were compared between the tasks. Further, the masseter and suprahyoid muscle activities per chewing cycle were compared between the sides. RESULTS: The chewing duration was significantly longer and the chewing rate was significantly higher during unilaterally chewing than freely chewing. The chewing duration differed significantly among the different foods; the harder the food, the longer the duration. Chewing rate was significantly higher during soft rice cracker chewing as well as suprahyoid activity per chewing cycle. Masseter activity was higher on the chewing side than on the non-chewing side while there was no difference in suprahyoid activity between the sides. CONCLUSION: The current results demonstrate a difference in the masticatory efficacy between the chewing tasks and a functional role of the suprahyoid muscles during chewing, which does not differ between the chewing and non-chewing sides.

    DOI: 10.1111/joor.13373

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  • Inhibition of Water-Evoked Swallowing During Noxious Mechanical Stimulation of Tongue in Anesthetized Rats. 査読 国際誌

    Takanori Tsujimura, Yuta Nakajima, Titi Chotirungsan, Satomi Kawada, Yuhei Tsutsui, Midori Yoshihara, Taku Suzuki, Kouta Nagoya, Jin Magara, Makoto Inoue

    Dysphagia   38 ( 3 )   965 - 972   2022年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Dysphagia is sometimes accompanied by pain. Because orofacial structures subserve mastication and swallowing, orofacial pain might impair both functions. Tongue biting can occur not only accidentally while eating but also in some pathological conditions. However, it remains unclear whether noxious mechanical stimulation of the tongue affects swallowing. To explore this question, we evaluated the effects of lingual pinch stimulation on the initiation of swallowing evoked by distilled water (DW) infusion with a flow rate of 5.0 µL/s for 20 s into the pharyngolaryngeal region in anesthetized rats. The swallowing reflex was identified by electromyographic (EMG) bursts in the suprahyoid muscles which include the anterior belly of the digastric muscle, mylohyoid and geniohyoid muscles, and laryngeal elevation by visual inspection. The number of DW-evoked swallows during pinch stimulation was significantly smaller than that in a control condition or during pressure stimulation. The onset latency of the first swallow during pinch stimulation was significantly longer than that in the control condition. DW-evoked swallowing was almost abolished following bilateral transection of the superior laryngeal nerve (SLN) compared with the control condition, suggesting that the SLN plays a crucial role in the initiation of DW-evoked swallowing. Finally, electrophysiological data indicated that some SLN-responsive neurons in the nucleus tractus solitarii (nTS) exhibited delayed latency from a single SLN stimulation during lingual pinch stimulation. These results suggest that noxious mechanical stimulation of the tongue inhibits the initiation of swallowing and modulates neuronal activity in the nTS.

    DOI: 10.1007/s00455-022-10522-5

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  • Impact of oral function on regaining oral intake and adjusting diet forms for acute stroke patients. 査読 国際誌

    Sirima Kulvanich, Haruka Sakai, Riho Takanami, Mako Yamada, Anna Sasa, Kayoko Ito, Takanori Tsujimura, Jin Magara, Makoto Inoue

    Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association   31 ( 5 )   106401 - 106401   2022年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Outcome prediction for dysphagia recovery is essential for rehabilitation treatment planning. Several studies have reported various predictors for resuming oral feeding after post-stroke dysphagia. However, evidence on oral health and function, a crucial part of feeding, has rarely been reported. Therefore, the goal of this study was to identify the oral status-related factors that could predict oral intake resumption in acute stroke patients. METHODS: 80 acute stroke patients with dysphagia were included. Clinical data, including the changes of general condition, oral and swallowing functions, were collected once a week until discharge. Patients were divided into two groups based on the outcome of the food intake level scale at discharge, and data were compared between the groups. RESULTS: 60 patients had regained complete oral intake before discharge. Multiple logistic regression showed that posterior tongue pressure could significantly predict complete oral intake recovery. Tongue pressure and modified water swallowing test score also significantly influenced diet forms. In addition, Spearman correlation analysis showed that improvement of other oral status-related factors, such as oral moisture and dentition status, also indicated the improvement of diet forms and swallowing function during the hospital stay. CONCLUSION: Tongue pressure measurement could be a useful oral status-related indicator for predicting complete oral intake and adjusting diet forms for acute stroke patients during hospitalization. Acute stroke patients should receive proper oral status evaluation and implementation to enhance functional recovery.

    DOI: 10.1016/j.jstrokecerebrovasdis.2022.106401

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  • Cause of Impairments of Bolus Transport and Epiglottis Inversion. 査読 国際誌

    Taku Suzuki, Sirima Kulvanich, Takanori Tsujimura, Jin Magara, Yasushi Ohnishi, Makoto Inoue

    Dysphagia   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.1007/s00455-022-10421-9

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  • Functional Role of Suprahyoid Muscles in Bolus Formation During Mastication. 査読 国際誌

    Anna Sasa, Sirima Kulvanich, Naohito Hao, Reiko Ita, Masahiro Watanabe, Taku Suzuki, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Frontiers in physiology   13   881891 - 881891   2022年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    It still remains unclear how the suprahyoid muscles function in bolus formation during mastication. This study aimed to investigate the contributory role of the suprahyoid muscles during mastication. A total of 20 healthy young volunteers were asked to perform tongue pressure generation tasks and unilateral mastication tasks using peanuts and two different types of rice crackers. Surface electromyographic (EMG) activity of the masseter and suprahyoid muscles and mandibular kinematics were recorded. Suprahyoid activity increased with increasing tongue pressure. Masticatory duration until the first deglutition differed significantly among the different foods; the harder the food, the longer the duration. This was also the case in masseter activity per masticatory cycle. Masticatory rate and suprahyoid activity per masticatory cycle were significantly higher during soft rice cracker mastication. Masseter activity was higher on the masticatory side than on the non-masticatory side, however, there was no difference in suprahyoid activity between the sides. Suprahyoid activity and jaw gape showed significant positive correlation in the early stage on both the masticatory and non-masticatory sides. The suprahyoid muscles functioned dominantly for jaw-opening during peanut mastication, and for bolus formation, especially in the late stage during soft rice cracker mastication. Bolus formation was performed dominantly on the masticatory side during rice cracker mastication. These findings clearly demonstrate a functional role of the suprahyoid muscles during mastication of solid foods from assessments using both EMG activity and mandibular kinematic recordings.

    DOI: 10.3389/fphys.2022.881891

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  • 急性期の延髄外側症候群の嚥下障害に対し、頸部回旋を併用したバルーン単純引き抜き法を行った一例

    筒井 雄平, 真柄 仁, 小貫 和佳奈, 坂 暢晃, 坂井 遥, 井上 誠

    新潟歯学会雑誌   51 ( 2 )   89 - 94   2021年12月

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    記述言語:日本語   出版者・発行元:新潟歯学会  

    症例は75歳女性。初診より2日前に階段の昇降や嚥下の困難感を自覚、翌日に症状悪化しN病院脳神経内科へ緊急搬送、頭部MRIで右延髄背外側および右小脳半球に梗塞巣が認められた。摂食嚥下機能評価およびリハビリテーション目的に当科初診となった。2病日目に実施した摂食嚥下機能評価では、右側口唇の感覚運動不良、同側軟口蓋挙上不良および反射の消失、気息性嗄声を認め、改訂水飲みテストは3b点だった。3病日目に嚥下内視鏡検査を実施し、左側臥位・頸部右回旋にてゼリー(学会分類2013、0j)摂取が可能なことを確認して、直接訓練を開始した。4病日目より頸部回旋を併用したバルーン単純引き抜き法を開始、姿勢調整下での直接訓練を継続した。17病日目には咽頭残留量の改善を認め、また、嚥下造影検査では姿勢調整下での食塊通過、およびバルーン引き抜き時に頸部回旋側の対側への通過が確認できた。21病日目にリハビリテーション目的に転院となり、上記訓練の継続を紹介状に記載、介入終了となった。急性期の延髄外側症候群に伴う球麻痺症例において、誤嚥性肺炎の予防や早期機能回復を目標に、姿勢制御下で咽頭残留を軽減しながら安全に訓練を実施できた。またバルーン単純引き抜き法に頸部回旋を併用することで、有効な訓練効果が得られる可能性が考えられた。(著者抄録)

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  • Effects of Carbonation and Temperature on Voluntary Swallowing in Healthy Humans. 査読 国際誌

    Chikako Takeuchi, Eri Takei, Kayoko Ito, Sirima Kulvanich, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Dysphagia   36 ( 3 )   384 - 392   2021年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We investigated how swallowing behaviors are affected by the temperature and carbonation of water in healthy humans. Twenty-nine healthy volunteers were instructed to drink as much natural water, carbonated water, or cider as they wanted, and we recorded the volume of solution swallowed and electromyographic (EMG) activity of the masseter and suprahyoid muscles. Sensory tests regarding the ease of holding the solution in the mouth and ease of swallowing were also performed. The volume of carbonated water swallowed was significantly lower than that of natural water and cider. The ease of holding and swallowing the solution significantly differed between solution types such that natural water was the easiest solution to hold and swallow, followed by cider and then carbonated water in both tests. EMG activity was also affected by the solution type. Masseter EMG activity was significantly lower when swallowing natural water compared with carbonated water. Suprahyoid EMG activity was significantly lower when swallowing natural water compared with carbonated water and cider. The volume of solution swallowed was significantly correlated with the ease of holding and swallowing the solution, but not with masseter or suprahyoid EMG activities. The ease of holding and swallowing the solution significantly affected masseter and suprahyoid EMG activities. The results suggested that when participants experienced difficulty holding and swallowing the solution, masseter and suprahyoid EMG activity increased. Considering our findings that mechanical stimulation with bubbles decreased the volume of solution swallowed and increased EMG activities, carbonated water swallowing may be useful in treating deglutition disorders.

    DOI: 10.1007/s00455-020-10147-6

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  • Changes of bolus properties and the triggering of swallowing in healthy humans. 査読 国際誌

    Izumi Kochi, Eri Takei, Rumiko Maeda, Kayoko Ito, Jin Magara, Takanori Tsujimura, Sirima Kulvanich, Makoto Inoue

    Journal of oral rehabilitation   48 ( 5 )   592 - 600   2021年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    There is wide variation in chewing behaviours, even among healthy humans. Further, the way in which humans determine swallowing initiation when chewing solid foods remains unclear. The current study sought to investigate how the bolus properties change over time during chewing, and to clarify which factors affect chewing and swallowing behaviours, including swallowing initiation, in healthy humans. Twenty-four healthy volunteers were instructed to chew 8 g of steamed rice and spit it out at 50%, 100% and 150% of their own chewing duration, defined as the time of chewing from onset of the first chewing cycle to onset of the first swallow. Chewing and swallowing behaviours were monitored and determined by visual inspection of video recordings. The physical properties such as hardness, cohesiveness and adhesiveness as well as water content of the bolus were measured. In each subject, maximum bite force, tongue pressure and stimulated salivary flow rate were also measured. Hardness gradually decreased, and the cohesiveness and water content of the bolus did not change up to 50% of chewing duration, followed by a slight but significant increase. The adhesiveness of the bolus rapidly decreased at the beginning of chewing. Chewing duration was significantly related to stimulated salivary flow rate; greater salivary flow rate was associated with shorter chewing duration. Variation of chewing duration and swallowing initiation was not dependent on bolus properties during the chewing of steamed rice, but mainly depended on the surface lubrication of the bolus.

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  • Relationships Between Survival and Oral Status, Swallowing Function, and Oral Intake Level in Older Patients with Aspiration Pneumonia. 査読 国際誌

    Taku Suzuki, Takanori Tsujimura, Jin Magara, Naohito Hao, Naru Shiraishi, Kazuya Maekawa, Kazuo Matsushima, Makoto Inoue

    Dysphagia   37 ( 3 )   558 - 566   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The factors affecting the survival of patients with aspiration pneumonia (AP) remain unclear. This study aimed to determine whether factors, including oral status, swallowing function, and oral intake level, were related to survival outcomes in older patients hospitalized for AP. The study enrolled patients with AP who were admitted to our hospital between February 2017 and November 2019. Patients were divided into two groups based on the 90-day mortality after the first swallowing function evaluation: survivors and deceased. The data were compared between the two groups. A total of 29 patients were diagnosed with AP. Of these patients, 13 died within 90 days. The numbers of patients who could not use removable dentures and required sputum suctioning and had cough reflex at rest were significantly higher in the deceased than in the survivors. The salivary pooling and pharyngeal clearance scores evaluated by videoendoscopy, International Dysphagia Diet Standardisation Initiative Functional Diet Scale score determined after swallowing function evaluation, and consciousness level were significantly worse in the deceased than in the survivors. There were significant differences in patients' oral status, swallowing function, oral intake level, and consciousness level between the survivors and deceased.

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  • 健常者における呼吸と咀嚼/嚥下の協調

    羽尾 直仁, 笹 杏奈, 辻村 恭憲, 那小屋 公太, 真柄 仁, 井上 誠

    日本顎口腔機能学会雑誌   27 ( 1-2 )   32 - 33   2021年3月

  • Impact of Oral and Swallowing Function on the Feeding Status of Older Adults in Nursing Homes. 査読 国際誌

    Sirima Kulvanich, Kayoko Ito, Eri Takei, Haruka Sakai, Risa Suzumi, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Gerontology   67 ( 2 )   168 - 176   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: To date, there have been few guidelines proposed for adjustment of the food consistency, particularly to match the oral function of older adults, which will guide clinicians and caregivers in appropriately modifying food. OBJECTIVE: We investigated how oral, swallowing, and cognitive conditions of older adults who required daily nursing care in a nursing home were associated with different dietary food consistencies. METHODS: Clinical examinations to record dentition status, swallowing, and cognitive functions were performed, and the feeding status, including the food consistencies and need for assistance at lunchtime, was evaluated in 37 older residents in nursing homes. The swallowing function was assessed by performing a modified water-swallowing test, and food swallowing was tested using pudding and rice crackers. The χ2 test was used to determine the relationships among the parameters. RESULTS: No participants were able to take cooked rice, nor regular and soft side dishes. There was no significant relationship between dentition status and feeding status. Of the participants, 95% ate pudding without any problems and 49% ate rice crackers without any signs of swallowing difficulty such as coughing or stopping chewing. There was a significant relationship between the food test score using a rice cracker and the level of food consistencies, and between the same test score and the level of mealtime assistance, whereby the better the score of the food test using a rice cracker, the better was the level of food consistencies including use of a thickening agent and the better was the level of mealtime assistance. CONCLUSION: The results strongly suggest that the food test using a rice cracker was associated with the level of food consistency and mealtime assistance for older adults in nursing homes.

    DOI: 10.1159/000511912

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  • Coordination of Respiration, Swallowing, and Chewing in Healthy Young Adults. 査読 国際誌

    Naohito Hao, Anna Sasa, Sirima Kulvanich, Yuta Nakajima, Kouta Nagoya, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Frontiers in physiology   12   696071 - 696071   2021年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Examining the coordination of respiration and swallowing is important for elucidating the mechanisms underlying these functions and assessing how respiration is linked to swallowing impairment in dysphagic patients. In this study, we assessed the coordination of respiration and swallowing to clarify how voluntary swallowing is coordinated with respiration and how mastication modulates the coordination of respiration and swallowing in healthy humans. Twenty-one healthy volunteers participated in three experiments. The participants were asked to swallow 3 ml of water with or without a cue, to drink 100 ml of water using a cup without breathing between swallows, and to eat a 4-g portion of corned beef. The major coordination pattern of respiration and swallowing was expiration-swallow-expiration (EE type) while swallowing 3 ml of water either with or without a cue, swallowing 100 ml of water, and chewing. Although cueing did not affect swallowing movements, the expiratory time was lengthened with the cue. During 100-ml water swallowing, the respiratory cycle time and expiratory time immediately before swallowing were significantly shorter compared with during and after swallowing, whereas the inspiratory time did not differ throughout the recording period. During chewing, the respiratory cycle time was decreased in a time-dependent manner, probably because of metabolic demand. The coordination of the two functions is maintained not only in voluntary swallowing but also in involuntary swallowing during chewing. Understanding the mechanisms underlying respiration and swallowing is important for evaluating how coordination affects physiological swallowing in dysphagic patients.

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  • Involvement of capsaicin-sensitive nerves in the initiation of swallowing evoked by carbonated water in anesthetized rats. 査読 国際誌

    Kojun Tsuji, Takanori Tsujimura, Shogo Sakai, Taku Suzuki, Midori Yoshihara, Kouta Nagoya, Jin Magara, Yoshihide Satoh, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   319 ( 5 )   G564-G572   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Capsaicin powerfully evokes the swallowing reflex and is a known therapeutic agent for improving dysphagia and preventing aspiration pneumonia. However, the role of capsaicin-sensitive nerves in the initiation of swallowing evoked by various natural stimuli remains unclear. To explore this question, we blocked laryngeal capsaicin-sensitive nerves following the coapplication of QX-314 and capsaicin (QX/Cap), and investigated the effects on swallowing evoked by mechanical and chemical stimulation in anesthetized rats. Swallows were evoked by capsaicin, carbonated water (CW), distilled water (DW), and punctate mechanical stimulation using von Frey filaments applied topically to the larynx. Swallows were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles. The initiation of swallowing by capsaicin was strongly suppressed at 5 min following QX/Cap treatment and returned in a time-dependent manner. CW-evoked swallows at 5 min following QX/Cap treatment were significantly diminished compared with before and 30 min after treatment. In contrast, DW-evoked and mechanically evoked swallows were unchanged by QX/Cap treatment. Furthermore, CW-evoked swallows were virtually abolished by transection of the superior laryngeal nerves and significantly decreased by the topical application of acid-sensing ion channel-3 (ASIC3) inhibitor APETx2, but they were not affected by the nonselective transient receptor potential channel inhibitor ruthenium red or the ASIC1 inhibitor mambalgin-1. Taken together, we speculate that capsaicin-sensitive nerves play an important role in the initiation of CW-evoked swallows.NEW & NOTEWORTHY The initiation of swallowing evoked by laryngeal capsaicin and carbonated water application was diminished by the coapplication of QX-314 and capsaicin. Carbonated water-evoked swallows were also abolished by transection of the superior laryngeal nerves and were inhibited by the acid-sensing ion channel-3 inhibitor. Capsaicin-sensitive nerves are involved in the initiation of carbonated water-evoked swallows.

    DOI: 10.1152/ajpgi.00233.2020

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  • Age-related changes in functional adaptation to bolus characteristics during chewing. 査読 国際誌

    Eri Takei, Sirima Kulvanich, Takanori Tsujimura, Jin Magara, Kayoko Ito, Ryo Takei, Hideaki Washio, Hitoshi Arao, Makoto Inoue

    Physiology & behavior   225   113102 - 113102   2020年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We investigated how the physical properties of food affect chewing kinematics, and examined the effects of aging on behavior. Twenty young and 21 older volunteers were asked to freely chew rice crackers and spit the food out at their average chewing duration. We compared chewing characteristics among the conditions (age × rice cracker), and examined the area of rectified masseter and suprahyoid electromyographic bursts per chewing cycle. We also evaluated temporal changes in those values. In addition, the bolus properties at the end of chewing were compared. The harder/larger the rice cracker, the longer the chewing duration and the greater the number of chewing cycles. These values also increased with age. Chewing cycle time was not affected by age and rice cracker properties, except in one condition: for the rice cracker with the lowest hardness and density, the chewing cycle time was longer than for the other rice crackers. Chewing cycle time decreased at the middle stage of chewing, followed by an increase, with increasing suprahyoid electromyographic activity at the late stage. The physical properties of the bolus at the end of chewing did not differ between age groups, and depended on the initial properties. The water absorption rate of the bolus was significantly greater for the rice cracker with the lowest hardness and density compared with other rice crackers. The results demonstrated that not only hardness, but also other factors, such as density, significantly affected chewing behaviors.

    DOI: 10.1016/j.physbeh.2020.113102

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  • Sustained laryngeal transient receptor potential vanilloid 1 activation inhibits mechanically induced swallowing in anesthetized rats. 査読 国際誌

    Midori Yoshihara, Takanori Tsujimura, Taku Suzuki, Kouta Nagoya, Naru Shiraishi, Jin Magara, Miho Terunuma, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   319 ( 3 )   G412-G419   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A major component of gastric acid is hydrochloric acid (HCl), which can activate transient receptor potential vanilloid 1 (TRPV1). In the present study, we investigated how sustained laryngeal TRPV1 activation affects the frequency of the swallowing reflex. Experiments were carried out on 85 male Sprague-Dawley rats. The effects of short and sustained application of chemicals (3 µl of 0.1 N HCl or capsaicin) on the frequency of swallowing and on time-dependent changes in the occurrence of swallowing evoked by supralaryngeal nerve stimulation were determined. To evaluate vascular permeability of the larynx, Evans blue dye was intravenously injected after 5 or 60 min of sustained TRPV1 activation. SB366791 (a TRPV1 inhibitor) and Cap/QX-314 (a TRPV1-expressed neuronal inhibitor) significantly inhibited HCl/capsaicin-induced swallowing, but air flow-induced swallowing was not affected. Although the number of air flow-induced swallows followed by capsaicin stimulation was not affected within 5 min, it was significantly reduced by 60-min capsaicin or HCl application. The swallowing threshold associated with supralaryngeal nerve stimulation did not significantly change throughout the recording period. Evans blue dye concentrations in the larynx were significantly higher at 60 min in the 10-5 M capsaicin group than in the control group. Our results suggest that sustained TPRV1 activation not only desensitizes TRPV1 but also inactivates mechanoreceptors, which may be attributed to increases in vascular permeability and edema, as part of an inflammatory process.NEW & NOTEWORTHY Although a transient receptor potential vanilloid 1 (TRPV1) inhibitor or TRPV1-expressed neuronal inhibitor significantly inhibited HCl/capsaicin-evoked swallowing, air flow-induced swallowing was not affected. The number of air flow-induced swallows was significantly reduced within 60 min of TRPV1 activation. Evans blue dye concentration in the larynx increased 60 min after capsaicin application. TPRV1 activation not only desensitizes TRPV1 but also inactivates mechanoreceptors caused by increases in vascular permeability and edema.

    DOI: 10.1152/ajpgi.00082.2020

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  • Inter-individual variation of bolus properties in triggering swallowing during chewing in healthy humans. 査読 国際誌

    Rumiko Maeda, Eri Takei, Kayoko Ito, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Journal of oral rehabilitation   47 ( 9 )   1161 - 1170   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: There is a wide variation of chewing behaviours even in healthy humans. The present study was aimed to clarify how the rheological properties of the bolus during chewing are different among individuals. We also investigated whether the swallowing threshold was consistent among the individuals and whether the difference in the bolus properties at the swallowing affected swallowing movement. METHODS: Twenty-nine healthy volunteers were asked to ingest 8 g of steamed rice. Based on the chewing duration defined by the time until first swallow, participants were asked to chew the food and then either spit it out or swallow it at 50%, 100% and 150% of chewing duration. In seven volunteers, the maximum bite force was measured. RESULTS: The hardness of the bolus gradually decreased throughout recording. Although the chewing duration varied widely, there was a significant negative correlation between time and hardness, regardless of the difference in individual chewing duration. The cohesiveness of the bolus was unchanged at the 100% time point, followed by a slight but significant increase. There was no significant correlation between the chewing duration and adhesiveness of the bolus. Swallowing-related bursts of Supra and Infra EMGs were not related to the chewing duration or bolus properties, and chewing duration did not affect swallowing function. CONCLUSION: The current results suggest that the bolus properties such as the hardness and cohesiveness during chewing are just dependent on the chewing duration and the difference in the bolus properties does not affect the swallowing initiation and movement.

    DOI: 10.1111/joor.13044

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  • Properties of hyoid muscle contraction during tongue lift measurement. 査読 国際誌

    Naomi Koshi, Jin Magara, Shogo Sakai, Takanori Tsujimura, Kazuhiro Ono, Makoto Inoue

    Journal of oral rehabilitation   47 ( 3 )   332 - 338   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Tongue lift movement (TLM) task is considered a treatment strategy in dysphagic patients. However, there is no evidence of effect of sustained tongue movements on the related muscle contraction. OBJECTIVES: The present study aimed to characterise the properties and time-dependent changes of the electromyographic (EMG) features of suprahyoid muscles during TLM. METHODS: Twenty young healthy volunteers were instructed to perform TLM at maximum effort in either the anterior or the posterior position, during measurement of tongue pressure for 7 s. Supra- (S-hyo) and infra-hyoid (I-hyo) EMGs were recorded. The area and power frequency of EMG burst and the area under the curve of tongue pressure were compared among the conditions: trials (1st, 2nd vs 3rd trials); anterior vs posterior TLM; and early vs late 3 s of each trial. RESULTS: There was no difference in the tongue pressure among trials or between the early and late 3 s. Anterior tongue pressure was significantly higher than posterior tongue pressure (P < .001). The area of I-hyo EMG burst was significantly larger (P = .044), and the power frequency of I-hyo EMG burst was significantly smaller (P = .042) during posterior TLM than anterior TLM. A significant difference in the power frequency of both EMG bursts was observed between early and late stages during both anterior (P < .05) and posterior (P < .01) TLM. CONCLUSION: Hyoid muscles may compensate for rapid fatigue of the tongue muscle to maintain tongue pressure by changing their activity pattern during tongue pressure generation.

    DOI: 10.1111/joor.12894

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  • Comparison of physical properties of voluntary coughing, huffing and swallowing in healthy subjects. 査読 国際誌

    Akiko Yawata, Takanori Tsujimura, Ryosuke Takeishi, Jin Magara, Li Yu, Makoto Inoue

    PloS one   15 ( 12 )   e0242810   2020年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Coughing, huffing and swallowing protect the airway from aspiration. This study was conducted to compare the physical properties of voluntary coughing, huffing and swallowing in healthy subjects. Ten healthy men were asked to huff, cough and swallow repeatedly. Electromyograms (EMGs) were recorded from the left side of the external oblique (EO), sternocleidomastoid, suprahyoid (SH) and thyrohyoid muscles. Airflow was recorded using a face mask with two-way non-rebreathing valves. The expiratory velocity of huffing and coughing and the SH EMG of all actions presented high intraclass correlation coefficients (> 0.8). The inspiratory and expiratory velocities did not differ significantly between coughing and huffing. The expiratory acceleration of coughing was significantly higher than that of huffing, whereas the expiratory volume of coughing was significantly smaller than that of huffing. The EO EMG of coughing and huffing were significantly larger than that of swallowing. The EO EMG activity during the expiratory phase was significantly higher than that of the other phases of both coughing and huffing. The SH EMG of coughing and huffing were significantly smaller than that of swallowing. Correlation analysis revealed that the expiratory velocity of coughing was strongly positively correlated with that of huffing. The expiratory volume of huffing was significantly positively correlated with hand grip strength. These results suggest that EO and SH muscle activities during huffing or coughing differ those during swallowing, and huffing and coughing may work similarly in expiratory function.

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  • 嚥下誘発と咀嚼・嚥下の協調に関する神経機構(Neural mechanisms underlying swallowing initiation and coordination between chew and swallow)

    Inoue Makoto, Tsujimura Takanori, Magara Jin, Nagoya Kouta

    日本摂食・嚥下リハビリテーション学会雑誌   23 ( 3 )   S65 - S65   2019年12月

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    記述言語:英語   出版者・発行元:(一社)日本摂食嚥下リハビリテーション学会  

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  • Involvement of the epithelial sodium channel in initiation of mechanically evoked swallows in anaesthetized rats. 査読 国際誌

    Takanori Tsujimura, Rumi Ueha, Midori Yoshihara, Eri Takei, Kouta Nagoya, Naru Shiraishi, Jin Magara, Makoto Inoue

    The Journal of physiology   597 ( 11 )   2949 - 2963   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    KEY POINTS: Afferents carried by the superior laryngeal nerve play a primary role in the initiation of laryngeal mechanically evoked swallows in anaesthetized rats. Amiloride and its analogues inhibit swallowing evoked by mechanical stimulation, but not swallowing evoked by chemical and electrical stimulation. The epithelial sodium channel is probably involved in the initiation of laryngeal mechanically evoked swallows. ABSTRACT: The swallowing reflex plays a critical role in airway protection. Because impaired laryngeal mechanosensation is associated with food bolus aspiration, it is important to know how the laryngeal sensory system regulates swallowing initiation. This study was performed to clarify the neuronal mechanism of mechanically evoked swallows. Urethane-anaesthetized Sprague-Dawley male rats were used. A swallow was identified by activation of the suprahyoid and thyrohyoid muscles on electromyography. The swallowing threshold was measured by von Frey filament and electrical stimulation of the larynx. The number of swallows induced by upper airway distension and capsaicin application (0.03 nmol, 3 μl) to the vocal folds was counted. The effects of topical application (0.3-30 nmol, 3 μl) of the epithelial sodium channel (ENaC) blocker amiloride and its analogues (benzamil and dimethylamiloride), acid-sensing ion channel (ASIC) inhibitors (mambalgine-1 and diminazene) and gadolinium to the laryngeal mucosa on swallowing initiation were evaluated. A nerve transection study indicated that afferents carried by the superior laryngeal nerve play a primary role in the initiation of laryngeal mechanically evoked swallows. The mechanical threshold of swallowing was increased in a dose-dependent manner by amiloride and its analogues and gadolinium, but not by ASIC inhibitors. The number of swallows by upper airway distension was significantly decreased by benzamil application. However, the initiation of swallows evoked by capsaicin and electrical stimulation was not affected by benzamil application. We speculate that the ENaC is involved in the initiation of laryngeal mechanically evoked swallows.

    DOI: 10.1113/JP277895

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  • Cerebellar repetitive transcranial magnetic stimulation restores pharyngeal brain activity and swallowing behaviour after disruption by a cortical virtual lesion. 査読 国際誌

    Ayodele Sasegbon, Masahiro Watanabe, Andre Simons, Emilia Michou, Dipesh H Vasant, Jin Magara, Philip M Bath, John Rothwell, Makoto Inoue, Shaheen Hamdy

    The Journal of physiology   597 ( 9 )   2533 - 2546   2019年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    KEY POINTS: Despite evidence that the human cerebellum has an important role in swallowing neurophysiology, the effects of cerebellar stimulation on swallowing in the disrupted brain have not been explored. In this study, for the first time, the application of cerebellar neurostimulation is characterized in a human model of disrupted swallowing (using a cortical virtual lesion). It is demonstrated that cerebellar stimulation can reverse the suppressed activity in the cortical swallowing system and restore swallowing function in a challenging behavioural task, suggesting the findings may have important therapeutic implications. ABSTRACT: Repetitive transcranial magnetic stimulation (rTMS) can alter neuronal activity within the brain with therapeutic potential. Low frequency stimulation to the 'dominant' cortical swallowing projection induces a 'virtual-lesion' transiently suppressing cortical excitability and disrupting swallowing behaviour. Here, we compared the ability of ipsi-lesional, contra-lesional and sham cerebellar rTMS to reverse the effects of a 'virtual-lesion' in health. Two groups of healthy participants (n = 15/group) were intubated with pharyngeal catheters. Baseline pharyngeal motor evoked potentials (PMEPs) and swallowing performance (reaction task) were measured. Participants received 10 min of 1 Hz rTMS to the pharyngeal motor cortex which elicited the largest PMEPs to suppress cortical activity and disrupt swallowing behaviour. Over six visits, participants were randomized to receive 250 pulses of 10 Hz cerebellar rTMS to the ipsi-lesional side, contra-lesional side or sham while assessing PMEP amplitude or swallowing performance for an hour afterwards. Compared to sham, active cerebellar rTMS, whether administered ipsi-lesionally (P = 0.011) or contra-lesionally (P = 0.005), reversed the inhibitory effects of the cortical 'virtual-lesion' on PMEPs and swallowing accuracy (ipsi-lesional, P < 0.001, contra-lesional, P < 0.001). Cerebellar rTMS was able to reverse the disruptive effects of a 'virtual lesion'. These findings provide evidence for developing cerebellar rTMS into a treatment for post-stroke dysphagia.

    DOI: 10.1113/JP277545

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  • Effect of attention on chewing and swallowing behaviors in healthy humans. 査読 国際誌

    Hirokazu Ashiga, Eri Takei, Jin Magara, Ryosuke Takeishi, Takanori Tsujimura, Kouta Nagoya, Makoto Inoue

    Scientific reports   9 ( 1 )   6013 - 6013   2019年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We examined how attention alters chewing and swallowing behaviors. Twenty-one healthy volunteers were asked to freely eat 8 g of steamed rice in three separate trials, and we obtained the average number of chewing cycles (N) and chewing duration (T) prior to the first swallow in each trial. We also conducted an N-limited test, in which participants chewed the food while independently counting the number of chewing cycles and swallowed the food when they reached N, and a T-limited test, in which they chewed the food for T sec and then swallowed. We recorded electromyograms (EMGs) from masseter and suprahyoid muscles and collected videoendoscopic images. In the N-limited test, chewing speed decreased, masseter muscle activity (area under the curve of the rectified EMG burst) per cycle increased, and suprahyoid muscle activity per cycle decreased. In the T-limited test, the chewing speed increased, muscle activities per cycle decreased, and the number of cycles increased. The occurrence frequency of bolus propulsion into the pharynx before swallowing was smaller in the N- and T-limited tests than in the free chewing test. Further, the whiteout time was longer in the T-limited test than in the free chewing test. Attentional chewing changes not only chewing but also swallowing behavior.

    DOI: 10.1038/s41598-019-42422-4

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  • Effect of peripherally and cortically evoked swallows on jaw reflex responses in anesthetized rabbits. 査読 国際誌

    Taku Suzuki, Midori Yoshihara, Shogo Sakai, Kojun Tsuji, Kouta Nagoya, Jin Magara, Takanori Tsujimura, Makoto Inoue

    Brain research   1694   19 - 28   2018年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    This study aimed to investigate whether the jaw-opening (JOR) and jaw-closing reflexes (JCR) are modulated during not only peripherally, but also centrally, evoked swallowing. Experiments were carried out on 24 adult male Japanese white rabbits. JORs were evoked by trigeminal stimulation at 1 Hz for 30 s. In the middle 10 s, either the superior laryngeal nerve (SLN) or cortical swallowing area (Cx) was simultaneously stimulated to evoke swallowing. The peak-to-peak JOR amplitude was reduced during the middle and late 10-s periods (i.e., during and after SLN or Cx stimulation), and the reduction was dependent on the current intensity of SLN/Cx stimulation: greater SLN/Cx stimulus current resulted in greater JOR inhibition. The reduction rate was significantly greater during Cx stimulation than during SLN stimulation. The amplitude returned to baseline 2 min after 10-s SLN/Cx stimulation. The effect of co-stimulation of SLN and Cx was significantly greater than that of SLN stimulation alone. There were no significant differences in any parameters of the JCR between conditions. These results clearly showed that JOR responses were significantly suppressed, not only during peripherally evoked swallowing but also during centrally evoked swallowing, and that the inhibitory effect is likely to be larger during centrally compared with peripherally evoked swallowing. The functional implications of these results are discussed.

    DOI: 10.1016/j.brainres.2018.05.002

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  • 聴神経腫瘍術後に脳幹・小脳出血を合併し摂食嚥下障害を認めた1症例 査読

    笹 杏奈, 辻 光順, 渡邊 賢礼, 那小屋 公太, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   37 - 41   2018年6月

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    記述言語:日本語   出版者・発行元:新潟歯学会  

    聴神経腫瘍術後に嚥下障害を認めた一例を報告する。症例は56歳女性。2017年2月に小脳・脳幹を圧迫する聴神経鞘腫に対する摘出術施行、術後左小脳出血及び延髄から橋にかけて低吸収域を認めたため、脳内血腫除去および減圧開頭術が施行された。術後11日目に嚥下機能評価目的に当科初診となった。小脳前庭症状としての姿勢保持困難と失調性構音障害、球麻痺症状としての顔面神経麻痺、舌運動減弱、開鼻声を伴う右カーテン徴候を認めた。反復唾液嚥下テストは2回、改訂水飲みテストおよびとろみ付液体3ccでのテストでは3a点(嚥下後湿性音あり)であった。嚥下内視鏡検査時、安静時より咽頭内分泌物貯留、左側披裂・声帯は傍正中位固定で声門閉鎖不良、ホワイトアウトは減弱しており、とろみ付液体摂取時の食道流入不良、鼻咽腔逆流を認めた。さらに、残留物は不顕性誤嚥をしていた。重度摂食嚥下障害の診断にて、口腔ケア・間接訓練から介入を開始した。耐久性が改善した術後19日目以降は間接訓練の負荷を増やし、少量のとろみ付液体を用いた直接訓練も開始した。術後35日目に実施した嚥下造影検査では、依然として嚥下後の咽頭残留量が多く食事開始にはいたらなかった。転院を前に術後55日目に実施した最終評価では、幻暈などの前庭症状は改善していたものの球麻痺症状に大きな変化は認められなかった。最終的に食事開始までは至らなかったものの、訓練の効果による咽頭残留の軽減と姿勢調整を行うことで安全な経口摂取方法の提案ができた。(著者抄録)

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  • Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure. 査読 国際誌

    Takanori Tsujimura, Taku Suzuki, Midori Yoshihara, Shogo Sakai, Naomi Koshi, Hirokazu Ashiga, Naru Shiraishi, Kojun Tsuji, Jin Magara, Makoto Inoue

    Journal of applied physiology (Bethesda, Md. : 1985)   124 ( 5 )   1148 - 1154   2018年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow, evoked by punctate mechanical stimulation to the larynx, was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG). Areas under the curve of the swallowing pressure at the OP, UES, and CE from two trials indicated high intrasubject reproducibility. Effects of transecting the hypoglossal nerve (12N) and recurrent laryngeal nerve (RLN) on swallowing were investigated. Following bilateral hypoglossal nerve transection (Bi-12Nx), OP pressure was significantly decreased, and time intervals between peaks of thyrohyoid EMG bursts and OP pressure were significantly shorter. Decreased OP pressure and shortened times between peaks of thyrohyoid EMG bursts and OP pressure following Bi-12Nx were significantly increased and longer, respectively, after covering the hard and soft palates with acrylic material. UES pressure was significantly decreased after bilateral RLN transection compared with that before transection. These results suggest that the 12N and RLN play crucial roles in OP and UES pressure during swallowing, respectively. We speculate that covering the palates with a palatal augmentation prosthesis may reverse the reduced swallowing pressure in patients with 12N or tongue damage by the changes of the sensory information and of the contact between the tongue and a palates. NEW & NOTEWORTHY Hypoglossal nerve transection reduced swallowing pressure at the oropharynx. Covering the hard and soft palates with acrylic material may reverse the reduced swallowing function caused by hypoglossal nerve damage. Recurrent laryngeal nerve transection reduced upper esophageal sphincter negative pressure during swallowing.

    DOI: 10.1152/japplphysiol.00944.2017

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  • Immediate effect of laryngeal surface electrical stimulation on swallowing performance. 査読 国際誌

    Keizo Takahashi, Kazuhiro Hori, Hirokazu Hayashi, Masako Fujiu-Kurachi, Takahiro Ono, Takanori Tsujimura, Jin Magara, Makoto Inoue

    Journal of applied physiology (Bethesda, Md. : 1985)   124 ( 1 )   10 - 15   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Surface electrical stimulation of the laryngeal region is used to improve swallowing in dysphagic patients. However, little is known about how electrical stimulation affects tongue movements and related functions. We investigated the effect of electrical stimulation on tongue pressure and hyoid movement, as well as suprahyoid and infrahyoid muscle activity, in 18 healthy young participants. Electrical stimulation (0.2-ms duration, 80 Hz, 80% of each participant's maximal tolerance) of the laryngeal region was applied. Each subject swallowed 5 ml of barium sulfate liquid 36 times at 10-s intervals. During the middle 2 min, electrical stimulation was delivered. Tongue pressure, electromyographic activity of the suprahyoid and infrahyoid muscles, and videofluorographic images were simultaneously recorded. Tongue pressure during stimulation was significantly lower than before or after stimulation and was significantly greater after stimulation than at baseline. Suprahyoid activity after stimulation was larger than at baseline, while infrahyoid muscle activity did not change. During stimulation, the position of the hyoid at rest was descended, the highest hyoid position was significantly inferior, and the vertical movement was greater than before or after stimulation. After stimulation, the positions of the hyoid at rest and at the maximum elevation were more superior than before stimulation. The deviation of the highest positions of the hyoid before and after stimulation corresponded to the differences in tongue pressures at those times. These results suggest that surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. NEW & NOTEWORTHY Surface electrical stimulation applied to the laryngeal region during swallowing may facilitate subsequent hyoid movement and tongue pressure generation after stimulation. Tongue muscles may contribute to overshot recovery more than hyoid muscles.

    DOI: 10.1152/japplphysiol.00512.2017

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  • Effects of pharyngeal electrical stimulation on swallowing performance. 査読 国際誌

    Ryosuke Takeishi, Jin Magara, Masahiro Watanabe, Takanori Tsujimura, Hirokazu Hayashi, Kazuhiro Hori, Makoto Inoue

    PloS one   13 ( 1 )   e0190608   2018年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Pharyngeal electrical stimulation (PEStim) has been found to facilitate voluntary swallowing. This study investigated how PEStim contributed to modulation of swallowing function in 15 healthy humans. In the involuntary swallowing test, water was injected onto the pharynx at 0.05 ml/s and the onset latency of the first swallow was measured. In the voluntary swallowing test, subjects swallowed their own saliva as quickly as possible for 30 s and the number of swallows was counted. Voluntary and involuntary swallowing was evaluated before (baseline), immediately after, and every 10 min after 10-min PEStim for 60 min. A voluntary swallowing test with simultaneous 30-s PEStim was also conducted before and 60 min after 10-min PEStim. The number of voluntary swallows with simultaneous PEStim significantly increased over 60 min after 10-min PEStim compared with the baseline. The onset latency of the first swallow in the involuntary swallowing test was not affected by 10-min PEStim. The results suggest that PEStim may have a long-term facilitatory effect on the initiation of voluntary swallowing in healthy humans, but not on peripherally-evoked swallowing. The physiological implications of this modulation are discussed.

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  • Effect of body posture on chewing behaviours in healthy volunteers 査読

    T. Iizumi, J. Magara, T. Tsujimura, M. Inoue

    JOURNAL OF ORAL REHABILITATION   44 ( 11 )   835 - 842   2017年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY  

    Mastication is essential to the eating process and forms an important part of feeding behaviour. Many factors related to the food bolus, such as bolus texture and size, are known to influence mastication. The aim of this study was to determine the effects of body posture on (i) chewing duration prior to the first swallow and (ii) patterns of mastication-related EMG activity. We asked 10 healthy adults to chew 8g of steamed rice with barium sulphate while we recorded masseter, suprahyoid and infrahyoid muscle activity and simultaneously collected videofluorographic images. Participants chewed in either an upright or reclining position. Chewing duration, which was defined as the time from the start of mastication to the first swallow, was not different between the positions. However, the variability of chewing duration was larger in the upright versus reclining position, and the chewing duration in the reclining position was distributed around 15s. Masseter activity gradually decreased in a time-dependent manner and was significantly larger at the early versus late stage of mastication. Suprahyoid activity was significantly larger at the early versus middle stage of mastication in the upright position only. Finally, masseter activity per second was negatively correlated with changes in chewing duration, that is, the larger the increase in chewing duration in the reclining position, the more the decrease in masseter activity per second. These results suggest that position-dependent changes in chewing behaviours, as described by chewing duration and EMG activity, may vary among participants.

    DOI: 10.1111/joor.12555

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  • Central inhibition of initiation of swallowing by systemic administration of diazepam and baclofen in anaesthetized rats. 査読 国際誌

    Takanori Tsujimura, Shogo Sakai, Taku Suzuki, Izumi Ujihara, Kojun Tsuji, Jin Magara, Brendan J Canning, Makoto Inoue

    American journal of physiology. Gastrointestinal and liver physiology   312 ( 5 )   G498-G507 - G507   2017年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER PHYSIOLOGICAL SOC  

    Dysphagia is caused not only by neurological and/or structural damage but also by medication. We hypothesized memantine, dextromethorphan, diazepam, and baclofen, all commonly used drugs with central sites of action, may regulate swallowing function. Swallows were evoked by upper airway (UA)/pharyngeal distension, punctate mechanical stimulation using a von Frey filament, capsaicin or distilled water (DW) applied topically to the vocal folds, and electrical stimulation of a superior laryngeal nerve (SLN) in anesthetized rats and were documented by recording electromyographic activation of the suprahyoid and thyrohyoid muscles and by visualizing laryngeal elevation. The effects of intraperitoneal or topical administration of each drug on swallowing function were studied. Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABAA receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABAB receptor antagonist diminished the effects of baclofen. Topically applied diazepam or baclofen had no effect on swallowing. These data indicate that diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats.NEW & NOTEWORTHY Systemic administration of diazepam and baclofen, but not memantine or dextromethorphan, inhibited swallowing evoked by mechanical, chemical, and electrical stimulation. Both benzodiazepines and GABAA receptor antagonists diminished the inhibitory effects of diazepam, whereas a GABAB receptor antagonist diminished the effects of baclofen. Topical applied diazepam or baclofen was without effect on swallowing. Diazepam and baclofen act centrally to inhibit swallowing in anesthetized rats.

    DOI: 10.1152/ajpgi.00299.2016

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  • Impact of oral ingestion on oral health condition in dysphagic inpatients 査読

    Tejima Y, Ito K, Magara J, Tsujimura T, Inoue M

    Oral Health and Dental Management   16 ( 1 )   1 - 9   2017年

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  • 歩行機能と摂食機能の比較 身体的フレイル患者における検討

    保田 麻里, 真柄 仁, 井上 誠

    日本口腔リハビリテーション学会雑誌   29 ( 1 )   60 - 61   2016年12月

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    記述言語:日本語   出版者・発行元:日本口腔リハビリテーション学会  

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  • Differential response properties of peripherally and cortically evoked swallows by electrical stimulation in anesthetized rats. 査読 国際誌

    Takanori Tsujimura, Kojun Tsuji, Jin Magara, Shogo Sakai, Taku Suzuki, Yuki Nakamura, Kayoko Nozawa-Inoue, Makoto Inoue

    Brain research bulletin   122   12 - 8   2016年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    We compared onset latency, motor-response patterns, and the effect of electrical stimulation of the cortical masticatory area between peripherally and cortically evoked swallows by electrical stimulation in anesthetized rats. The number of swallows and the motor patterns were determined using electromyographic recordings from the thyrohyoid, digastric, and masseter muscles. The onset latency of the first swallow evoked by electrical stimulation of the cortical swallowing area (Cx) was significantly longer than that evoked by stimulation of the superior laryngeal nerve (SLN). The duration of thyrohyoid burst activity associated with SLN-evoked swallows was significantly longer than that associated with either Cx-evoked or spontaneous swallows. Combining Cx with SLN stimulation increased the number of swallows at low levels of SLN stimulation. Finally, A-area (the orofacial motor cortex) stimulation inhibited Cx-evoked swallows significantly more than it inhibited SLN-evoked swallows. These findings suggest that peripherally and cortically evoked swallows have different response properties and are affected differently by the mastication network.

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  • Effect of body posture on involuntary swallow in healthy volunteers. 査読 国際誌

    Yoshitaka Shiino, Shogo Sakai, Ryosuke Takeishi, Hirokazu Hayashi, Masahiro Watanabe, Takanori Tsujimura, Jin Magara, Kayoko Ito, Tetsu Tsukada, Makoto Inoue

    Physiology & behavior   155   250 - 9   2016年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    Clinically, reclining posture has been reported to reduce risk of aspiration. However, during involuntary swallow in reclining posture, changes in orofacial and pharyngeal movement before and during pharyngeal swallow should be considered. Further, the mechanisms underlying the effect of body posture on involuntary swallow remain unclear. The aim of the present study was to determine the effect of body posture on activity patterns of the suprahyoid muscles and on patterns of bolus transport during a natural involuntary swallow. Thirteen healthy male adults participated in a water infusion test and a chewing test. In the water infusion test, thickened water was delivered into the pharynx at a very slow rate until the first involuntary swallow was evoked. In the chewing test, subjects were asked to eat 10 g of gruel rice. In both tests, the recording was performed at four body postures between upright and supine positions. Results showed that reclining changed the location of the bolus head at the start of swallow and prolonged onset latency of the swallowing initiation. Muscle burst duration and whiteout time measured by videoendoscopy significantly increased with body reclining and prolongation of the falling time. In the chewing test, reclining changed the location of the bolus head at the start of swallow, and the frequency of bolus residue after the first swallow increased. Duration and area of EMG burst and whiteout time significantly increased with body reclining. These data suggest that body reclining may result in prolongation of pharyngeal swallow during involuntary swallow.

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  • Contribution of synovial lining cells to synovial vascularization of the rat temporomandibular joint. 査読 国際誌

    Kayoko Nozawa-Inoue, Fumiko Harada, Jin Magara, Atsushi Ohazama, Takeyasu Maeda

    Journal of anatomy   228 ( 3 )   520 - 9   2016年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    The lining layer of the synovial membrane in the temporomandibular joint (TMJ) contains two types of lining cells: macrophage-like type A and fibroblast-like type B cells. The type B cells are particularly heterogeneous in their morphology and immunoreactivity, so that details of their functions remain unclear. Some of the type B cells exhibit certain resemblances in their ultrastructure to those of an activated capillary pericyte at the initial stage of the angiogenesis. The articular surface, composed of cartilage and the disc in the TMJ, has few vasculatures, whereas the synovial lining layer is richly equipped with blood capillaries to produce the constituent of synovial fluid. The present study investigated at both the light and electron microscopic levels the immunocytochemical characteristics of the synovial lining cells in the adult rat TMJ, focusing on their contribution to the synovial vascularization. It also employed an intravascular perfusion with Lycopersicon esculentum (tomato) lectin to identify functional vessels in vivo. Results showed that several type B cells expressed desmin, a muscle-specific intermediate filament which is known as the earliest protein to appear during myogenesis as well as being a marker for the immature capillary pericyte. These desmin-positive type B cells showed immunoreactions for vimentin and pericyte markers (neuron-glial 2; NG2 and PDGFRβ) but not for the other markers of myogenic cells (MyoD and myogenin) or a contractile apparatus (αSMA and caldesmon). Immunoreactivity for RECA-1, an endothelial marker, was observed in the macrophage-like type A cells. The arterioles and venules inside the synovial folds extended numerous capillaries with RECA-1-positive endothelial cells and desmin-positive pericytes to distribute densely in the lining layer. The distal portion of these capillaries showing RECA-1-immunoreactivity lacked lectin-staining, indicating a loss of blood-circulation due to sprouting or termination in the lining layer. The desmin-positive type B and RECA-1-positive type A cells attached to this portion of the capillaries. Some capillaries in the lining layer also expressed ninein, a marker for sprouting endothelial cells, called tip cells. Since an activated pericyte, macrophage and tip cell are known to act together at the forefront of the vessel sprout during angiogenesis, the desmin-positive type B cell and RECA-1-positive type A cell might serve as these angiogenic cells in the synovial lining layer. Tomato lectin perfusion following decalcification would be a highly useful tool for research on the vasculature of the mineralized tissue. Use of this technique combined with immunohistochemistry should permit future extensive investigations on the presence of the physiological angiogenesis and on the function of the lining cells in the synovial membrane.

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  • Changes in jaw muscle activity and the physical properties of foods with different textures during chewing behaviors. 査読 国際誌

    Hiroko Iguchi, Jin Magara, Yuki Nakamura, Takanori Tsujimura, Kayoko Ito, Makoto Inoue

    Physiology & behavior   152 ( Pt A )   217 - 24   2015年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    This study aimed to investigate how the activity of the masseter (Mas) and suprahyoid (Hyoid) muscles is influenced by the physical properties of food, how changes in the rheological properties of food differ between different foods during the process of food reduction, and how different salivary flow rates affect bolus-making capability during masticatory behavior in healthy humans. Ten healthy adults participated in this study. Electromyographic (EMG) recordings were obtained from the Mas and Hyoid muscles, and 15 g of steamed rice and rice cake was prepared as test foods. In the ingestion test, the subjects were asked to eat each food in their usual manner. The chewing duration, number of chewing cycles before the first swallow, Mas and Hyoid EMG activity, and chewing cycle time were compared between the foods. Total chewing duration was divided into three substages: early, middle, and late; chewing cycle time and EMG activity per chewing cycle of each substage were compared between the foods and among the substages. In the spitting test, the rheological properties of the bolus at the end of each substage were compared between the foods and among the substages. Finally, stimulated salivary flow rates were measured and the relationships between salivary flow rate and chewing duration, EMG activity, and changes in physical food characteristics were investigated. There were significant differences in total chewing duration and the number of chewing cycles, but not in chewing cycle time, between the foods, which had similar hardness values. The EMG activity levels of the Mas and Hyoid per chewing cycle for the rice cake were significantly greater than for the steamed rice throughout the recording periods. While Mas activity did not change among the substages during chewing, Hyoid EMG activity decreased as chewing progressed. Chewing cycle time also gradually decreased as chewing progressed. The hardness of both foods initially increased, then gradually decreased back to baseline. The adhesiveness of the rice cake initially increased, and did not fall throughout the recording period; the adhesiveness of the steamed rice did not significantly change. Cohesiveness barely changed in either of the two foods during chewing, but was significantly greater for the rice cake than for the steamed rice. Finally, a correlation between the stimulated salivary flow rate and chewing performance was evident only in a change in Mas EMG activity. The current results demonstrate that the activities of the Mas and Hyoid muscles changed as chewing progressed, and were affected by hardness, adhesiveness, and cohesiveness. Salivary flow rate may affect the changes in Mas activity during the process of bolus formation.

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  • Peripheral and central control of swallowing initiation in healthy humans. 査読 国際誌

    Seiya Aida, Ryosuke Takeishi, Jin Magara, Masahiro Watanabe, Kayoko Ito, Yuki Nakamura, Takanori Tsujimura, Hirokazu Hayashi, Makoto Inoue

    Physiology & behavior   151   404 - 11   2015年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    We investigated (1) how peripheral inputs might assist central inputs in the control of voluntary evoked swallowing, (2) inter-individual variation in involuntary and voluntary swallowing initiation, and (3) whether natural chewing behavior affects the initiation of involuntary swallowing in healthy humans. Eleven participants completed a repetitive saliva swallowing test (RSST), chewing test (CHEW), and rest period (REST). In RSST, participants repetitively swallowed as quickly as possible. In CHEW, subjects chewed gum freely. We delivered pharyngeal electrical stimulation (PEStim) to the laryngopharynx and compared the number of swallows that occurred with and without PEStim. PEStim significantly increased the number of voluntary evoked swallows in RSST, as well as the number of swallows in CHEW and REST trials, although this facilitatory effect was larger in REST trials. We found a positive correlation between the number of swallows at RSST without PEStim and that at REST with PEStim within individuals. Additionally, we found a significant positive correlation between the number of swallows at RSST with PEStim and the sum of that at RSST without PEStim and at REST with PES. Based on the current results, we suggest that (1) peripheral inputs within a certain range appear to facilitate the central inputs that control voluntary swallowing, (2) inter-individual variations in swallowing initiation may arise from differences in the excitability of the common neural network in the lower brainstem, and (3) during chewing, food reduction in the oral cavity is prioritized, such that the neural network associated with chewing may regulate swallowing initiation.

    DOI: 10.1016/j.physbeh.2015.08.003

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  • Comparison of mechanical analyses and tongue pressure analyses during squeezing and swallowing of gels 査読

    Kazuhiro Hori, Hirokazu Hayashi, Sumiko Yokoyama, Takahiro Ono, Sayaka Ishihara, Jin Magara, Hiroshige Taniguchi, Takahiro Funami, Yoshinobu Maeda, Makoto Inoue

    Food Hydrocolloids   44   145 - 155   2015年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier  

    Dysphagic patients are fed soft meals made of gels and process them by squeezing the food with the tongue, which reduces food size. Although the gels are designed based on rheological analyses, the impact of the initial gel texture on tongue kinetics is not known. This study investigated the effect of gel consistency on tongue pressure during squeezing and swallowing and compared results of the mechanical analyses. Fifteen healthy young subjects participated in this study. Tongue pressure during squeezing and swallowing was measured by a sensor sheet with five measuring points. Five ml of water and six gel samples prepared using two gelling agents at three concentrations each were used as test materials. Subjects were instructed not to chew the food but to squeeze it using their tongue. The shape of the tongue pressure waveform during the initial squeeze was similar to the stress-time curve using a texture analyzer. However, the sequential order of tongue pressure during squeezing and swallowing was different. Tongue pressure during the initial squeeze was affected by gel consistency. The amplitude of tongue pressure during swallowing increased as gel consistency increased, but the duration of pressure was not affected. The slopes of tongue pressure generation were not affected by gel consistency, although the mechanical measurements showed increases in these slopes with increasing gel consistency. These results suggest that findings regarding characteristics of tongue movement during squeezing and textural properties of gels might be useful for food design and clarification of oral physiology.

    DOI: 10.1016/j.foodhyd.2014.09.029

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  • Changes in the frequency of swallowing during electrical stimulation of superior laryngeal nerve in rats. 査読 国際誌

    Kojun Tsuji, Takanori Tsujimura, Jin Magara, Shogo Sakai, Yuki Nakamura, Makoto Inoue

    Brain research bulletin   111   53 - 61   2015年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:PERGAMON-ELSEVIER SCIENCE LTD  

    The aim of the present study was to investigate the adaptation of the swallowing reflex in terms of reduced swallowing reflex initiation following continuous superior laryngeal nerve stimulation. Forty-four male Sprague Dawley rats were anesthetized with urethane. To identify swallowing, electromyographic activity of the left mylohyoid and thyrohyoid muscles was recorded. To evoke the swallowing response, the superior laryngeal nerve (SLN), recurrent laryngeal nerve, or cortical swallowing area was electrically stimulated. Repetitive swallowing evoked by continuous SLN stimulation was gradually reduced, and this reduction was dependent on the resting time duration between stimulations. Prior SLN stimulation also suppressed subsequent swallowing initiation. The reduction in evoked swallows induced by recurrent laryngeal nerve or cortical swallowing area stimulation was less than that following superior laryngeal nerve stimulation. Decerebration had no effect on the reduction in evoked swallows. Prior subthreshold stimulation reduced subsequent initiation of swallowing, suggesting that there was no relationship between swallowing movement evoked by prior stimulation and the subsequent reduction in swallowing initiation. Overall, these data suggest that reduced sensory afferent nerve firing and/or trans-synaptic responses, as well as part of the brainstem central pattern generator, are involved in adaptation of the swallowing reflex following continuous stimulation of swallow-inducing peripheral nerves and cortical areas.

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  • Role of tongue pressure production in oropharyngeal swallow biomechanics. 査読 国際誌

    Kazuhiro Hori, Hiroshige Taniguchi, Hirokazu Hayashi, Jin Magara, Yoshitomo Minagi, Qiang Li, Takahiro Ono, Makoto Inoue

    Physiological reports   1 ( 6 )   e00167   2013年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The tongue is important for orofacial movements, including swallowing. Although numerous studies have focused on tongue pressure against the palate, its physiological role has not been fully evaluated. The tongue pressure generation may have the temporal coordination with the swallowing relational organs. The aim of this study was to clarify the physiological mechanisms of tongue pressure and to investigate the temporal relationship among tongue pressure, supra-hyoid muscle activity, and videofluorographic (VF) images during swallowing. Fifteen healthy young subjects participated. Tongue pressure measured using a sensor sheet with five channels, electromyographic EMG, and VF was recorded synchronously during 4-ml barium swallowing. Swallowing behavior in VF images with and without the sensor sheet was compared. Furthermore, the temporal relationship between events measured from tongue pressure, EMG, and VF was evaluated. Swallowing behavior on VF images was not affected by placement of the sensor sheet. Tongue pressure at the posterio-lateral point of the hard palate tended to have biphasic peaks. Tongue pressure production with a monophasic pattern appeared during the same period as the second peak in the biphasic pattern. The onset of tongue pressure was later than the start of hyoid movement and onset of EMG, and offset was observed between the hyoid at the up-forward position and reposition. Onset of tongue pressure at the anterior area was correlated with the start of slight hyoid elevation. Offset of tongue pressure at the posterio-lateral points was strongly time locked with the hyoid at the up-forward position. The present results suggested the temporal coordination of tongue pressure generation with the swallowing-related organs. That is, the tongue pressure was produced for bolus propulsion, and was closely related to hyoid movement temporally during swallowing. These results may contribute to clarify the clinical state with the disorder of tongue kinetics.

    DOI: 10.1002/phy2.167

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  • Effects of chewing and swallowing behavior on jaw opening reflex responses in freely feeding rabbits. 査読 国際誌

    Aki Yamada, Yuka Kajii, Shogo Sakai, Takanori Tsujimura, Yuki Nakamura, Sajjiv Ariyasinghe, Jin Magara, Makoto Inoue

    Neuroscience letters   535   73 - 7   2013年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ELSEVIER IRELAND LTD  

    It has been reported that the jaw opening reflex (JOR) evoked by intra-oral innocuous stimulation was suppressed during a reflex swallow in anesthetized animals only. However, the mechanism of JOR inhibition during swallowing has not yet been elucidated. The aim of the present study was to investigate the effects of peripheral nerve stimulation on masticatory behaviors, as well as the modulation of low threshold afferent evoked JOR responses during chewing and swallowing in freely feeding animals. The JOR in the digastric muscle was evoked by low threshold electrical stimulation of the inferior alveolar nerve (IAN). Changes in the peak-to-peak amplitude of digastric electromyographic responses were compared among the phases of chewing and swallowing. IAN stimulation did not produce any differences in cycle duration, gape of the jaw in one cycle, or swallowing interval, suggesting a minimal effect on feeding behaviors. The JOR amplitude during the fast-closing, slow-closing, and slow-opening phases of chewing was significantly smaller than that of the control (recorded when the animal was at rest) and fast-opening phase. During swallowing, the JOR amplitude was significantly less than the control. Inhibition of the JOR during swallowing is assumed to prevent unnecessary opposing jaw opening motion.

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  • Alterations in intermediate filaments expression in disc cells from the rat temporomandibular joint following exposure to continuous compressive force. 査読 国際誌

    Jin Magara, Kayoko Nozawa-Inoue, Akiko Suzuki, Yoshiro Kawano, Kazuhiro Ono, Shuichi Nomura, Takeyasu Maeda

    Journal of anatomy   220 ( 6 )   612 - 21   2012年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    The articular disc in the temporomandibular joint (TMJ) that serves in load relief and stabilizing in jaw movements is a dense collagenous tissue consisting of extracellular matrices and disc cells. The various morphological configurations of the disc cells have given us diverse names, such as fibroblasts, chondrocyte-like cells and fibrochondrocytes; however, the characteristics of these cells have remained to be elucidated in detail. The disc cells have been reported to exhibit heterogeneous immunoreaction patterns for intermediate filaments including glial fibrillary acidic protein (GFAP), nestin and vimentin in the adult rat TMJ. Because these intermediate filaments accumulate in the disc cells as tooth eruption proceeds during postnatal development, it might be surmised that the expression of these intermediate filaments in the disc cells closely relates to mechanical stress. The present study was therefore undertaken to examine the effect of a continuous compressive force on the immunoexpression of these intermediate filaments and an additional intermediate filament - muscle-specific desmin - in the disc cells of the TMJ disc using a rat experimental model. The rats wore an appliance that exerts a continuous compressive load on the TMJ. The experimental period with the appliance was 5 days as determined by previous studies, after which some experimental animals were allowed to survive another 5 days after removal of the appliance. Histological observations demonstrated that the compressive force provoked a remarkable acellular region and a decrease in the thickness of the condylar cartilage of the mandible, and a sparse collagen fiber distribution in the articular disc. The articular disc showed a significant increase in the number of desmin-positive cells as compared with the controls. In contrast, immunopositive cells for GFAP, nestin and vimentin remained unchanged in number as well as intensity. At 5 days after removal of the appliance, both the disc and cartilage exhibited immunohistological and histological features in a recovery process. These findings indicate that the mature articular cells are capable of producing desmin instead of the other intermediate filaments against mechanical stress. The desmin-positive disc cells lacked α-smooth muscle actin (α-SMA) in this study, even though desmin usually co-exists with α-SMA in the vascular smooth muscle cells or pericytes. Because the precursor of a pericyte has such an immunoexpression pattern during angiogenesis, there is a further possibility that the formation of new vessels commenced in response to the extraordinary compressive force.

    DOI: 10.1111/j.1469-7580.2012.01501.x

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  • Phenotypes of articular disc cells in the rat temporomandibular joint as demonstrated by immunohistochemistry for nestin and GFAP. 査読 国際誌

    Hitoshi Miyako, Akiko Suzuki, Kayoko Nozawa-Inoue, Jin Magara, Yoshiro Kawano, Kazuhiro Ono, Takeyasu Maeda

    Journal of anatomy   219 ( 4 )   472 - 80   2011年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:WILEY-BLACKWELL  

    The articular disc is a dense collagenous tissue containing disc cells that are phenotypically described as chondrocyte-like cells or fibrochondrocytes. Despite the possible existence of these phenotypes in systemic joints, little is known about the detailed classification of the articular disc cells in the temporomandibular joint. In this immunocytochemical study we examined the localization and distribution patterns of nestin and glial fibrillary acidic protein (GFAP) in the articular disc of the rat temporomandibular joint at postnatal day 1, and weeks 1, 2, 4 and 8, based on the status of tooth eruption and occlusion. Nestin and GFAP are intermediate filament proteins whose expression patterns are closely related to cell differentiation and cell migration. Both types of immunopositive cell greatly increased postnatally to a stable level after postnatal week 4, but they showed different distribution patterns and cell morphologies. Nestin-reactive disc cells, which were characterized by a meagre cytoplasm and thin cytoplasmic processes, were scattered in the articular disc, whereas GFAP-positive cells, characterized by broader processes, existed exclusively in the deeper area. In mature discs, the major proportion of articular disc cells exhibited GFAP immunoreactivity. Furthermore, a double-immunostaining demonstrated that the nestin-negative cells, consisting of GFAP-positive and -negative cells, exhibited immunoreactions for heat shock protein 25. These findings indicate that the articular disc cells comprise at least three types in the rat temporomandibular joint and suggest that their expressions closely relate to mechanical loading forces within the joint, including occlusal force, as observed through postnatal development.

    DOI: 10.1111/j.1469-7580.2011.01404.x

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  • 高齢義歯装着者の義歯への満足度に影響する要因について

    昆 はるか, 佐藤 直子, 野村 修一, 櫻井 直樹, 田中 みか子, 細貝 暁子, 山田 一穂, 金城 篤史, 甲斐 朝子, 山下 絵美, 金子 敦郎, 真柄 仁, 小林 博, 宮崎 秀夫, 葭原 明弘, 河野 正司

    日本補綴歯科学会誌 = Annals of Japan Prosthodontic Society   1 ( 4 )   361 - 369   2009年10月

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    記述言語:日本語   出版者・発行元:公益社団法人 日本補綴歯科学会  

    <B>目的:</B>自立して社会生活を送る一般的な高齢者の義歯に対する主観的評価と「咬めること」,「食事中に外れないこと」,「痛くないこと」の3要因ならびに歯の欠損形態,咀嚼可能な食品との関連を明らかにすることを目的とした.<br><B>方法:</B>対象は,平成19年度厚生科学研究「口腔保健と全身的な健康状態の関係について」の調査に参加した,新潟市在住で義歯を装着している79~80歳の256名とした.義歯の満足度と「咬めること」,「外れにくいこと」,「痛みがないこと」についてVAS値でアンケートを行った.さらに,欠損形態を宮地分類でグループ化し,義歯満足度との関連を調べた.また,15品目の食品が咀嚼可能かを調べた.<br><B>結果:</B>義歯の満足度は,「咬めること」,「外れにくいこと」,「痛みがないこと」との間に相関があったが,一つの項目のみが突出して高い関連を示すことはなかった.宮地分類と義歯に対する満足度との間に,関連は認められなかった.義歯の満足度(VAS値)により分けた4群間では,不良群で咬める食品数が有意に低かった.<br><B>結論:</B>義歯の満足度を高めるには,咬めて,外れにくく,使用時に痛みのないことが必要であることが確認された.一方,今回の調査からは義歯の満足度と宮地分類との間には関連が認められなかった.これは,難しい欠損形態でも義歯の製作や調整次第で,満足が得られる可能性を示唆すると考えられた.

    DOI: 10.2186/ajps.1.361

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    その他リンク: http://search.jamas.or.jp/link/ui/2010031506

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  • 誤嚥性肺炎入院患者に対する摂食嚥下機能評価フローの立案と有効性の検討 査読

    建部 一毅, 石田 雅樹, 真柄 仁, 小幡 裕明, 樋浦 徹, 前川 和也, 伊藤 加代子, 辻村 恭憲, 井上 誠

    日本摂食嚥下リハビリテーション学会雑誌   25 ( 2 )   90 - 101   2021年8月

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    担当区分:責任著者   記述言語:日本語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:(一社)日本摂食嚥下リハビリテーション学会  

    本研究は誤嚥性肺炎入院患者の治療体系において、主たる原因である嚥下機能低下に注目し、摂食嚥下機能評価フロー立案と、その実施効果の検証を目的とした。誤嚥性肺炎入院患者に対し、患者の基本情報の他、全身状態、食事摂取状況、嚥下機能、口腔状態の4つの側面と細項目から構成された摂食嚥下機能評価項目を設定し評価を実施した。言語聴覚士による(1)介入開始時、(2)肺炎治療終了時、嚥下機能が安定した(3)介入終了時の3点による機能評価を102名(男性50名、年齢中央値90歳)について経口退院群と死亡・非経口退院群で2群比較検討した。さらに、肺炎治療とあわせた摂食嚥下機能評価フローを立案し、51名(男性24名、年齢中央値91歳)を対象に実施効果を検討した。肺炎治療終了時には、年齢、BMI、Barthel Index、意識レベル、従命可否、排痰の可否、咽頭吸引の要不要、経口摂取量、含嗽力、口腔ケア自立度において2群間で有意な差が認められた。これらを独立変数、経口摂取退院を目的変数とした多重ロジスティック回帰分析の結果、食事の経口摂取量と従命可否が有意な項目となった。摂食嚥下機能評価フローの導入前後における、入院から退院までの全体の在院日数の比較では、有意な差は認められなかった。肺炎治療終了後から介入終了時までの在院日数の比較では、経口退院群においてフロー導入後に有意な短縮が認められ、摂食嚥下機能評価とそれに対応する患者支援が有効に進んでいたと考えられた。誤嚥性肺炎入院患者に対して、摂食嚥下機能評価フローを導入することで、経口摂取可能な患者では、入院期間短縮の点で有効である可能性が考えられた。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/default/link?pub_year=2021&ichushi_jid=J03152&link_issn=&doc_id=20211020030002&doc_link_id=%2Fcb5dvsph%2F2021%2F002502%2F002%2F0090-0101%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2021%2F002502%2F002%2F0090-0101%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 固定性補綴装置によりアンテリアガイダンスを修復して咬合再構成を行った一症例 査読

    真柄 仁

    日本補綴歯科学会誌   10 ( 1 )   91 - 94   2018年1月

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    担当区分:筆頭著者, 責任著者   記述言語:日本語   出版者・発行元:(公社)日本補綴歯科学会  

    症例の概要:患者は60歳の女性、歯の動揺と咬合時の疼痛と義歯不適合を主訴に来院した。診査の結果、咬合性外傷を伴う重度歯周炎と、臼歯部欠損による咀嚼障害と診断した。歯周治療とプロビジョナルレストレーションを用いたアンテリアガイダンスの再構築を行った。考察:本症例のアンテリアガイダンスは、最終補綴物製作時に半調節性咬合器とカスタムインサイザルテーブルを用いて適切に再構成することができた。結論:咬合再構成において長期的な機能維持を得るためには、アンテリアガイダンスの確立が重要であり、プロビジョナルレストレーションを用いてアンテリアガイダンスを検討し、最終補綴物を製作する方法は有効と考えられる。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J05334&link_issn=&doc_id=20180123350016&doc_link_id=%2Fdv5proso%2F2018%2F001001%2F016%2F0091-0094%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdv5proso%2F2018%2F001001%2F016%2F0091-0094%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 嚥下時における舌骨の運動様相と食塊移送の検討 査読

    真柄 仁, 林 宏和, 神田 知佳, 堀 一浩, 谷口 裕重, 小野 和宏, 井上 誠

    日本顎口腔機能学会雑誌   20 ( 1 )   22 - 32   2013年9月

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    担当区分:筆頭著者, 責任著者   記述言語:日本語   出版者・発行元:日本顎口腔機能学会  

    本研究は、嚥下障害のある患者と健常者の舌骨運動時間と距離、舌骨位、および食塊移送のタイミングを比較することにより、嚥下障害における病態の一つと考えられる舌骨位の下垂が嚥下機能にどのように影響しているかを検証することを目的とした。対象は、嚥下障害を主訴として来院され嚥下造影検査を行った65名の患者(以下患者群)、対照として健常被験者10名(以下健常群)とした。得られたデータから、舌尖の運動開始を基準に舌骨運動・食塊移送の時間経過を計測し、また、第四頸椎前下縁を基準として舌骨位を計測し、患者群と健常群で比較を行った。患者群では食塊移送時間が口腔、咽頭ともに延長しており、更に食塊の咽頭流入は嚥下反射惹起を示す急速な舌骨挙上と比べ有意に先行していた。第四頸椎を基準とした場合、患者群と健常群に明らかな舌骨位の違いは認めなかった。疾患別の検索を行うと、嚥下反射以降は各疾患とも類似した舌骨の動きが認められたが、嚥下反射前は複雑な軌跡を示した。いくつかの疾患では、嚥下反射惹起前の舌骨の移動距離と移動時間に正の相関関係が認められたため、舌骨位が嚥下反射惹起遅延に影響を与えている可能性が考えられた。(著者抄録)

    DOI: 10.7144/sgf.20.22

    CiNii Article

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J02994&link_issn=&doc_id=20140217240004&doc_link_id=%2Fex2gakuk%2F2013%2F002001%2F004%2F0022-0032%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fex2gakuk%2F2013%2F002001%2F004%2F0022-0032%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 麻酔ラットへのアトロピン静脈内投与がもたらす嚥下誘発の変調効果

    中嶋優太, 辻村恭憲, 吉原翠, 那小屋公太, 真柄仁, 井上誠

    日本顎口腔機能学会学術大会プログラム・事前抄録集   68th   2022年

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  • 神経変性疾患患者における舌圧と摂食嚥下障害との関連

    鈴木拓, 真柄仁, 那小屋公太, 板離子, 辻村恭憲, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   28th   2022年

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  • 咽頭電気刺激がもたらす嚥下機能改善効果

    真柄仁, HAMDY Shaheen, 井上誠, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   28th   2022年

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  • 口腔機能の低下に対する補綴歯科の可能性~嚥下・構音・睡眠時呼吸~

    真柄仁, 服部麻里子, 奥野健太郎, 奥野健太郎

    日本補綴歯科学会誌(Web)   14   2022年

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  • 口腔機能低下症患者における口腔機能管理の実施効果

    真柄仁, 小貫和佳奈, 辻村恭憲, 井上誠, 井上誠

    8020公募研究報告書抄録(Web)   2021   2021年

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  • 口腔機能低下症診断患者における予後の検討

    小貫和佳奈, 真柄仁, 辻村恭憲, 伊藤加代子, 坂井遥, 中嶋優太, 坂暢晃, 井上誠, 井上誠, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   26th/27th   2021年

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  • 病院から施設まで介入を継続している心原性脳塞栓症の一例

    那小屋公太, 真柄仁, 辻村恭憲, 井上誠

    日本嚥下医学会抄録(Web)   42nd   2019年

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  • 聴神経腫瘍術後に脳幹・小脳出血を合併し摂食嚥下障害を認めた1症例 査読

    笹 杏奈, 辻 光順, 渡邊 賢礼, 那小屋 公太, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   37 - 41   2018年6月

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    記述言語:日本語   出版者・発行元:新潟歯学会  

    聴神経腫瘍術後に嚥下障害を認めた一例を報告する。症例は56歳女性。2017年2月に小脳・脳幹を圧迫する聴神経鞘腫に対する摘出術施行、術後左小脳出血及び延髄から橋にかけて低吸収域を認めたため、脳内血腫除去および減圧開頭術が施行された。術後11日目に嚥下機能評価目的に当科初診となった。小脳前庭症状としての姿勢保持困難と失調性構音障害、球麻痺症状としての顔面神経麻痺、舌運動減弱、開鼻声を伴う右カーテン徴候を認めた。反復唾液嚥下テストは2回、改訂水飲みテストおよびとろみ付液体3ccでのテストでは3a点(嚥下後湿性音あり)であった。嚥下内視鏡検査時、安静時より咽頭内分泌物貯留、左側披裂・声帯は傍正中位固定で声門閉鎖不良、ホワイトアウトは減弱しており、とろみ付液体摂取時の食道流入不良、鼻咽腔逆流を認めた。さらに、残留物は不顕性誤嚥をしていた。重度摂食嚥下障害の診断にて、口腔ケア・間接訓練から介入を開始した。耐久性が改善した術後19日目以降は間接訓練の負荷を増やし、少量のとろみ付液体を用いた直接訓練も開始した。術後35日目に実施した嚥下造影検査では、依然として嚥下後の咽頭残留量が多く食事開始にはいたらなかった。転院を前に術後55日目に実施した最終評価では、幻暈などの前庭症状は改善していたものの球麻痺症状に大きな変化は認められなかった。最終的に食事開始までは至らなかったものの、訓練の効果による咽頭残留の軽減と姿勢調整を行うことで安全な経口摂取方法の提案ができた。(著者抄録)

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  • 舌癌術後の摂食嚥下障害に対し間接訓練ならびに直接訓練を実施した1症例 査読

    小貫 和佳奈, 笹 杏奈, 辻 光順, 渡邊 賢礼, 白石 成, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   43 - 48   2018年6月

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    記述言語:日本語   出版者・発行元:新潟歯学会  

    頭頸部癌術後は、高頻度に摂食嚥下障害を生じる。今回、舌癌術後に摂食嚥下障害を生じ、リハビリテーションによる食形態や姿勢の調整によって経口摂取が可能となった症例を経験したので報告する。症例は68歳の男性。舌亜全摘術、両側頸部郭清術、腹直筋皮弁再建術、気管切開術、胃瘻造設術後、放射線治療開始と同時にN大学医歯学総合病院摂食嚥下機能回復部に紹介受診となった。初診時、頸部拘縮、舌切除による創部瘢痕化を伴う口腔移送不良・鼻咽腔閉鎖不全・咽頭収縮不全を認めた。嚥下内視鏡検査と嚥下造影検査により、リクライニング60度、左側臥位・右側頸部回旋位にてとろみ付液体2ccの食道流入が可能なことを確認して、毎日の間接訓練および代償法を用いた直接訓練を開始した。術後放射線治療の影響による口腔粘膜炎は自制内であり、訓練手技を獲得して耐久性が向上した介入29日目より食事開始、介入35日目には口腔移送改善を目的として舌接触補助床を用いた訓練を開始したものの、違和感や嘔気が強く常時使用にはいたらなかった。今後は、経口摂取のみでの栄養確保、歯科補綴学的アプローチによる口腔準備期の改善も可能であると考えている。(著者抄録)

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  • 舌癌術後の摂食嚥下障害に対し間接訓練ならびに直接訓練を実施した1症例 査読

    小貫 和佳奈, 笹 杏奈, 辻 光順, 渡邊 賢礼, 白石 成, 伊藤 加代子, 真柄 仁, 辻村 恭憲, 井上 誠

    新潟歯学会雑誌   48 ( 1 )   43 - 48   2018年6月

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    記述言語:日本語   出版者・発行元:新潟歯学会  

    頭頸部癌術後は、高頻度に摂食嚥下障害を生じる。今回、舌癌術後に摂食嚥下障害を生じ、リハビリテーションによる食形態や姿勢の調整によって経口摂取が可能となった症例を経験したので報告する。症例は68歳の男性。舌亜全摘術、両側頸部郭清術、腹直筋皮弁再建術、気管切開術、胃瘻造設術後、放射線治療開始と同時にN大学医歯学総合病院摂食嚥下機能回復部に紹介受診となった。初診時、頸部拘縮、舌切除による創部瘢痕化を伴う口腔移送不良・鼻咽腔閉鎖不全・咽頭収縮不全を認めた。嚥下内視鏡検査と嚥下造影検査により、リクライニング60度、左側臥位・右側頸部回旋位にてとろみ付液体2ccの食道流入が可能なことを確認して、毎日の間接訓練および代償法を用いた直接訓練を開始した。術後放射線治療の影響による口腔粘膜炎は自制内であり、訓練手技を獲得して耐久性が向上した介入29日目より食事開始、介入35日目には口腔移送改善を目的として舌接触補助床を用いた訓練を開始したものの、違和感や嘔気が強く常時使用にはいたらなかった。今後は、経口摂取のみでの栄養確保、歯科補綴学的アプローチによる口腔準備期の改善も可能であると考えている。(著者抄録)

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  • 身体的フレイル患者における歩行機能と口腔機能との関連

    井上 誠, 保田 麻里, 真柄 仁

    8020: はち・まる・にい・まる   ( 17 )   136 - 137   2018年2月

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    記述言語:日本語   出版者・発行元:(公財)8020推進財団  

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  • 摂食嚥下障害の臨床普及に向けて 第3報 摂食嚥下治療登録医養成事業の展開

    真柄仁, 真柄仁, 笹杏奈, 辻村恭憲, 竹石龍右, 井上誠, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   24th   2018年

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  • 摂食嚥下障害の臨床普及に向けて 第2報 嚥下内視鏡セミナー

    古志奈緒美, 真柄仁, 辻村恭憲, 笹杏奈, 竹石龍右, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   23rd   2017年

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  • 摂食嚥下障害の臨床普及に向けて 第1報 摂食嚥下治療登録医養成研修

    真柄仁, 真柄仁, 古志奈緒美, 笹杏奈, 竹石龍右, 辻村恭憲, 井上誠

    日本摂食嚥下リハビリテーション学会学術大会抄録集(Web)   23rd   2017年

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  • 研修歯科医に対する介護保険施設での口腔ケアおよび摂食指導研修

    船山 さおり, 伊藤 加代子, 堀 一浩, 谷口 裕重, 辻村 恭憲, 中村 由紀, 真柄 仁, 渡邊 賢礼, 林 宏和, 辻 光順, 酒井 翔悟, 井上 誠

    日本摂食・嚥下リハビリテーション学会雑誌   20 ( 2 )   80 - 85   2016年8月

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    記述言語:日本語   出版者・発行元:(一社)日本摂食嚥下リハビリテーション学会  

    介護保険施設において、口腔ケアおよび摂食指導を必要としている要介護高齢者は少なくない。今後、研修歯科医が食事の場面に立ち会い、摂食指導をすることが重要であるが、その機会はまだ少ないと考えられる。新潟大学では、特別養護老人ホームを週に1回訪問し、口腔ケアや摂食指導を行っているが、その際に研修歯科医が2〜3名ずつ同行して、実際の口腔ケアや摂食指導を研修している。今後、よりよい研修プログラムを提供するため、研修歯科医の介護保険施設における口腔ケアおよび摂食指導の経験の有無や、本プログラムを研修した感想等に関するアンケート調査を実施した。対象は、2009〜2013年度に、口腔ケアおよび摂食指導の研修を行った本学研修歯科医144名とし、口腔ケアおよび摂食指導に対する知識・経験の有無について調査した。その結果、80.4%が口腔ケアの知識があると回答していたが、実際に口腔ケアあるいは摂食指導を経験したことがある者は少なかった(口腔ケア56.6%、摂食指導18.2%)。また、大半が、口腔ケアおよび摂食指導が勉強になったと回答していた。口腔ケアあるいは摂食指導に対する歯科専門スタッフの介入価値があると思うと回答した者は、口腔ケアでは82.5%、摂食指導では78.3%と高い割合を示した。要介護高齢者の数は増加の一途をたどっており、今後、口腔ケアおよび摂食指導において歯科医師が果たす役割は、ますます大きくなっていくと思われる。患者家族やコメディカルに摂食指導をする立場にある歯科医師の臨床研修に、介護保険施設等における口腔ケアおよび摂食指導を導入することは重要であるといえる。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J03152&link_issn=&doc_id=20170524040003&doc_link_id=%2Fcb5dvsph%2F2016%2F002002%2F003%2F0080-0085%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb5dvsph%2F2016%2F002002%2F003%2F0080-0085%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

  • 口腔機能の改善が嚥下機能回復に寄与した一例 査読

    設樂 仁子, 手嶋 謡子, 真柄 仁, 谷口 裕重, 井上 誠

    新潟歯学会雑誌   44 ( 2 )   93 - 98   2014年12月

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    担当区分:責任著者   記述言語:日本語   出版者・発行元:新潟歯学会  

    症例は79歳男性、当院呼吸器内科に左小細胞肺癌/右非小細胞肺癌切除術後で通院中であったが、2014年3月19日から発熱を伴う全身状態悪化により3月22日に当院呼吸器内科に緊急入院となった。右下葉の斑状影を伴う肺炎、肝嚢胞の腫大と内部出血を認め、さらに脳梗塞を併発した。抗生剤、解熱剤投与にて徐々に全身状態改善みられ、内服を試みたところ、むせが頻回に認められたため、4月1日に摂食嚥下機能回復部に紹介された。初診時、全身状態として低栄養、炎症傾向が継続しており、摂食機能評価では、口腔衛生状態は不良、改定水飲みテスト3b点であった。介入3日目の嚥下内視鏡検査実施では、咽頭残留はあるもの摂取方法や食形態の制限を行うことで誤嚥・喉頭侵入なく食事摂取可能と判断し、4日目よりペースト食にて食事を開始した。口腔機能の改善、食形態の改善を図るため、15日目に義歯の製作を開始、17日目には嚥下造影検査を施行し、液体のとろみ付け継続の必要性を確認した。28日目には上下全部床義歯を装着、数回の調整を行い、32日目に行った摂食機能評価では口腔衛生状態、口腔内乾燥は顕著な改善を認め、改定水飲みテスト5点に改善、食形態の食上げは可能と判断し、粥食を米飯に食上げした。42日目に実施した嚥下造影検査では、前回と比べ喉頭侵入量の改善は認めたものの、液体の多量摂取時には不顕性誤嚥を認めたため、液体に1%程度のゆるめのとろみを付けることを継続とした。当科介入中に、口腔機能の改善に伴い摂食嚥下機能が回復し、43日目に経過良好にて転院となった。(著者抄録)

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  • 咽頭電気刺激がもたらす嚥下関連機能の神経可塑性変化

    真柄仁, 谷口裕重, 林宏和, 竹石龍右, 辻村恭憲, 堀一浩, 井上誠

    日本顎口腔機能学会雑誌   21 ( 1 )   2014年

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  • 【高齢者の栄養について考える】高齢者の嚥下障害

    谷口 裕重, 真柄 仁, 井上 誠

    静脈経腸栄養   28 ( 5 )   1069 - 1074   2013年9月

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    記述言語:日本語   出版者・発行元:(株)ジェフコーポレーション  

    高齢者の摂食・嚥下障害の問題は、複数の疾患がもたらす病態の複雑化、多剤服用がもたらす副作用、生理的加齢変化や認知機能の低下といった本人の問題のみならず、キーパーソンをはじめとする周囲の環境によって予後が左右される可能性も高いことなどを十分に考慮する必要がある。臨床現場では、嚥下機能にとって重要な役割をもつ舌と舌骨筋の機能変化に注意を払うことが大切である。全身と舌の加齢に伴う機能低下を比較すると、舌筋の筋萎縮の速度が全身の筋に比べて遅いことは、加齢に伴う全身の運動機能低下に対して舌運動機能の衰退が比較的検出されにくいことと関連していると考えられる。これに対して、喉頭を上から吊ってこれを引き上げるために重要な働きを示す舌骨上筋は加齢による影響を受けやすく、喉頭下垂や咽頭収縮と喉頭閉鎖との時間的協調を崩すこととなり、結果的に誤嚥のリスクを増加させるのかも知れない。(著者抄録)

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J03242&link_issn=&doc_id=20131002030007&doc_link_id=10.11244%2Fjjspen.28.1069&url=https%3A%2F%2Fdoi.org%2F10.11244%2Fjjspen.28.1069&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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講演・口頭発表等

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受賞

  • Oral presentation award

    2021年8月   2nd World Dysphagia Summit  

    Jin Magara

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  • デンツプライシロナ賞

    2018年6月   日本補綴歯科学会  

    真柄 仁

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  • 学術大会 優秀賞

    2014年4月   日本顎口腔機能学会  

    真柄 仁

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共同研究・競争的資金等の研究

  • 舌機能改善プロセスから考える感覚運動統合 -アクティブタッチの探索-

    研究課題/領域番号:22K10053

    2022年4月 - 2025年3月

    制度名:科学研究費助成事業 基盤研究(C)

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    真柄 仁, 井上 誠, 島田 明子

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    配分額:4160000円 ( 直接経費:3200000円 、 間接経費:960000円 )

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  • 咀嚼が変える、嚥下調整食のこれから

    2021年4月 - 2022年3月

    提供機関:ロッテ財団 第8回 奨励研究助成

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    担当区分:研究代表者 

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  • 口腔機能低下症患者における口腔機能管理の実施効果

    2021年4月 - 2022年3月

    制度名:令和3年度8020財団研究事業

    提供機関:8020財団

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    担当区分:研究代表者 

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  • 顎口腔運動学習による嚥下関連高次脳ネットワーク再構築を検証する

    2019年4月 - 2022年3月

    制度名:基盤研究(C)

    提供機関:科学研究費助成事業

    真柄 仁

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    担当区分:研究代表者  資金種別:競争的資金

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  • 口腔への温度刺激がもたらす嚥下機能の変化 -感覚運動の統合機構の解明-

    2017年4月 - 2019年3月

    制度名:若手研究(B)

    提供機関:科学研究費助成事業

    真柄 仁

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    担当区分:研究代表者  資金種別:競争的資金

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  • レオロジーの異なる炭酸飲料による嚥下機能への刺激効果の解明

    研究課題/領域番号:23K01992

    2023年4月 - 2027年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    岩森 大, 澁谷 顕一, 真柄 仁

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    配分額:4810000円 ( 直接経費:3700000円 、 間接経費:1110000円 )

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  • モデル動物を用いた多面的アプローチによる嚥下障害の病態解明

    研究課題/領域番号:22KK0139

    2022年10月 - 2025年3月

    制度名:科学研究費助成事業

    研究種目:国際共同研究加速基金(国際共同研究強化(B))

    提供機関:日本学術振興会

    井上 誠, 辻村 恭憲, 那小屋 公太, 吉原 翠, 真柄 仁

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    配分額:20150000円 ( 直接経費:15500000円 、 間接経費:4650000円 )

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  • 摂食嚥下機能に関わる前帯状皮質の役割

    研究課題/領域番号:22K19616

    2022年6月 - 2025年3月

    制度名:科学研究費助成事業

    研究種目:挑戦的研究(萌芽)

    提供機関:日本学術振興会

    井上 誠, 辻村 恭憲, 那小屋 公太, 吉原 翠, 真柄 仁

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    配分額:6500000円 ( 直接経費:5000000円 、 間接経費:1500000円 )

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  • 生体と食品の併行アプローチによる新たな咀嚼嚥下機能の理解

    研究課題/領域番号:22K10073

    2022年4月 - 2025年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    小野 和宏, 井上 誠, 伊藤 加代子, 真柄 仁

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    配分額:4290000円 ( 直接経費:3300000円 、 間接経費:990000円 )

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  • 脳可塑性変化に基づく口腔リハビリテーション効果の解析

    研究課題/領域番号:22H03284

    2022年4月 - 2025年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(B)

    提供機関:日本学術振興会

    島田 明子, 高橋 一也, 佐々木 啓一, 松原 貴子, 村田 比呂司, 飯田 崇, 小見山 道, 鳥巣 哲朗, 真柄 仁

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    配分額:17810000円 ( 直接経費:13700000円 、 間接経費:4110000円 )

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  • 脳梗塞における摂食嚥下障害の病態解明とその回復に顎口腔機能がもたらす効果

    研究課題/領域番号:21H03128

    2021年4月 - 2024年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(B)

    提供機関:日本学術振興会

    井上 誠, 辻村 恭憲, 那小屋 公太, 照沼 美穂, 吉原 翠, 真柄 仁

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    配分額:17290000円 ( 直接経費:13300000円 、 間接経費:3990000円 )

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  • 顎・舌運動と食塊移送から読みとく咀嚼機能評価

    研究課題/領域番号:20K10265

    2020年4月 - 2023年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    渡邊 賢礼, 井上 誠, 真柄 仁

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    配分額:4420000円 ( 直接経費:3400000円 、 間接経費:1020000円 )

    健常者20名を対象として,口蓋への舌押し付け運動時の舌骨上筋群活動を表面筋電図にて記録した(実験1).油分と硬さが異なる2種の米菓(ハッピーターン,ハイハイン),ピーナツ各3 gを対象として,自由摂取ならびに片側咀嚼による筋電図(左右咬筋,左右舌骨上筋群,左側舌骨下筋群筋電図),嚥下内視鏡画像,VICONを用いた頭部ならび下顎の三次元運動軌跡の記録を行った(実験2).
    舌圧発揮の程度に依存して舌骨上筋群活動は有意に上昇し,最大舌圧発揮時には最大開口時に近い活動量が得られたことで,舌骨上筋群は舌全体を引き上げることで舌運動を補助していることが示された.実験2では,全量摂取時間,最初の嚥下までの咀嚼時間,咀嚼回数とも食品の硬さに応じて延長した.また,いずれの食品摂取時においても,自由咀嚼に比べて片側咀嚼では,咀嚼時間,咀嚼回数は延長し,咀嚼サイクル時間はわずかに延長した.一方,咬筋活動量は硬さに依存して増加したものの,舌骨上筋群活動には咀嚼タスクによる違い,咀嚼側と非咀嚼側による違いは認められず,開口や食塊形成における左右差は明らかではなかった.
    食品粉砕が主となる咀嚼前期においては,いずれの被験者においても舌骨上筋群活動量とこれに依存すると期待される開口量との間に高い正の相関が得られた.これらの値を用いて, 1咀嚼サイクルにおいて舌骨上筋群が開口優位に働いたサイクル(JO),食塊形成優位に働いたサイクル(De)を定義し,条件間で比較したところ,JOはピーナッツで有意にその回数,頻度ともに高かったのに対して,Deはハイハインにて有意に高い頻度だった.舌骨上筋群活動量/開口量を比較したところ,ハイハイン咀嚼時には咀嚼側,非咀嚼側ともに後期に上昇しており,咀嚼側で高かった.これらの関係を調べることが,食塊形成における舌骨上筋群の働きを明らかにするために有用であることが示唆された.

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  • 摂食嚥下機能評価をベースとした誤嚥性肺炎患者に対するクリニカルパス策定と有効性の検討

    2018年4月 - 2020年3月

    制度名:(分担)

    提供機関:新潟市医師会地域医療研究助成

    建部 一毅

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    資金種別:競争的資金

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  • 消化器外科手術後の包括的嚥下機能評価に関する研究

    2017年4月 - 2020年3月

    制度名:基盤研究(C)(分担)

    提供機関:科学研究費助成事業

    小杉 伸一

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    資金種別:競争的資金

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  • 加齢に伴う摂食関連機能と形態変化ならびにその関係

    2017年4月 - 2020年3月

    制度名:基盤研究(C)(分担)

    提供機関:科学研究費助成事業

    小野 和宏

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    資金種別:競争的資金

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  • 口腔と咽頭をつなぐ三叉神経傍核が咀嚼嚥下に果たす役割

    研究課題/領域番号:17K11775

    2017年4月 - 2020年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    辻村 恭憲, 井上 誠, 真柄 仁

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    配分額:4550000円 ( 直接経費:3500000円 、 間接経費:1050000円 )

    本研究は,咀嚼嚥下における三叉神経傍核(Pa5)の役割を検証することを目的とした.麻酔ラットを用いてPa5の電気刺激を行ったところ,上喉頭神経の電気刺激による嚥下誘発は抑制された.グルタミン酸受容体作用薬およびGABAA受容体拮抗薬をPa5に微量注入した際には,嚥下関連筋活動に変化はみられず,孤束核へ微量注入した際には,いずれも嚥下が誘発された.また,喉頭に対する機械刺激によって誘発される嚥下には,上喉頭神経が主な伝導路となっており,さらに上皮型ナトリウムチャネルが関与することが確認された.

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  • 摂食運動に関わる咀嚼と嚥下の機能連関

    2016年4月 - 2019年3月

    制度名:基盤研究(B)(分担)

    提供機関:科学研究費助成事業

    井上 誠

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    資金種別:競争的資金

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  • 末梢複合刺激がもたらす嚥下機能変調効果

    研究課題/領域番号:16K11885

    2016年4月 - 2019年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    渡邊 賢礼, 井上 誠, 真柄 仁

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    配分額:4680000円 ( 直接経費:3600000円 、 間接経費:1080000円 )

    摂食嚥下機能の向上させるリハビリテーションには様々な手法があるが重度嚥下障害を有する患者に対して安全性を確保した効果的なリハビリを提供しすることは困難であり,この様な患者に対するリハビリ手法の確立は急務である.そこで我々はブラックペッパーオイル(BPO)を用いた嗅覚刺激が嚥下機能に与える影響を調査し,1分間のBPOの吸引は大脳皮質一次運動野における咽頭筋支配領域の興奮性を吸引後30分に亘り増加させた.以上からBPOを嗅ぐことで中枢性の興奮性変化を生じ嚥下機能を活性化する可能性があることが示された.

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  • 咽頭電気刺激の嚥下誘発効果と神経・筋機構の解明

    2014年4月 - 2017年3月

    制度名:若手研究(B)

    提供機関:科学研究費助成事業

    真柄 仁

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    担当区分:研究代表者  資金種別:競争的資金

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  • 舌骨喉頭位と嚥下機能との関連

    研究課題/領域番号:25462992

    2013年4月 - 2016年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(C)

    提供機関:日本学術振興会

    小野 和宏, 井上 誠, 真柄 仁, 谷口 裕重

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    配分額:5070000円 ( 直接経費:3900000円 、 間接経費:1170000円 )

    嚥下障害における主たる病態のひとつに舌骨や喉頭下垂があり,これが食塊の移送不良や嚥下後の食塊残留,ひいては喉頭侵入や誤嚥を招くといわれていることから,エックス線透視画像の解析を通して,舌骨・喉頭下垂や食塊移送と嚥下機能との関連,さらには実際の舌圧発揮能力と嚥下機能との関連を健常者と高齢者,嚥下障害患者を対象として調べることにより,顎口腔・咽喉頭形態と食塊移送・嚥下機能との関連を明らかにした.

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  • ヒト嚥下反射誘発および高次機能評価システムの構築

    研究課題/領域番号:25670814

    2013年4月 - 2016年3月

    制度名:科学研究費助成事業

    研究種目:挑戦的萌芽研究

    提供機関:日本学術振興会

    井上 誠, 辻村 恭憲, 真柄 仁, 谷口 裕重

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    配分額:3770000円 ( 直接経費:2900000円 、 間接経費:870000円 )

    申請者らが独自に考案した咽頭電気刺激による嚥下反射誘発システムは,すべての嚥下関連筋を制御下で同時に活性化できる画期的な方法である.本研究の目的は,このシステムを用い,随意性嚥下を促進することを明らかにし,さらに刺激がもたらす上位脳への影響を解明することであった.その結果,本刺激がもたらす随意性嚥下および反射性嚥下への効果が安静時,咀嚼時,随意性嚥下時で異なることを明らかにした.

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  • 摂食・嚥下機能に関わる中枢と末梢の制御機構

    研究課題/領域番号:24390431

    2012年4月 - 2015年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(B)

    提供機関:日本学術振興会

    井上 誠, 堀 一浩, 谷口 裕重, 辻村 恭憲, 中村 由紀, 真柄 仁

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    配分額:18070000円 ( 直接経費:13900000円 、 間接経費:4170000円 )

    ヒトならびに動物実験により,1)末梢性の嚥下反射誘発は口腔感覚の影響を受けないものの,咀嚼運動や咀嚼中枢の影響により抑制を受ける,2)嚥下反射誘発をもたらす末梢刺激によって咀嚼運動パターンそのものは変化しないことから,運動パターン制御に関わる相互の機能連関は乏しい,3)嚥下運動誘発に関わる上位脳からの入力と末梢からの入力の効果には相関があることから,これの個人差は共通する神経回路である脳幹に由来する,4)条件付けされた咽頭への末梢刺激によって,随意性嚥下に係わる神経回路は短期的には抑制されるが,可塑性変化によって興奮性の増加をもたらす可能性があることを明らかにした.

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  • 機械的負荷が顎関節円板内細胞に及ぼす影響―中間径フィラメントに着目して

    2012年4月 - 2014年3月

    制度名:研究活動スタート支援

    提供機関:科学研究費助成事業

    真柄 仁

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    担当区分:研究代表者  資金種別:競争的資金

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担当経験のある授業科目

  • 加齢歯科学

    2022年
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    機関名:新潟大学

  • 歯科衛生学実習III

    2021年
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    機関名:新潟大学

  • 摂食機能評価学演習IB

    2021年
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    現在
    機関名:新潟大学

  • 摂食機能評価学演習IIA

    2021年
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    機関名:新潟大学

  • 基礎・臨床連続講義II(摂食・嚥下機能評価学)

    2021年
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    現在
    機関名:新潟大学

  • 摂食機能評価学演習IIB

    2021年
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    現在
    機関名:新潟大学

  • 摂食機能評価学演習IA

    2021年
    -
    現在
    機関名:新潟大学

  • 高齢者・障害者歯科学

    2020年
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    現在
    機関名:新潟大学

  • 摂食嚥下障害学

    2020年
    -
    現在
    機関名:新潟大学

  • 訪問歯科診療

    2019年
    -
    現在
    機関名:新潟大学

  • 摂食機能評価学演習ⅠA

    2017年
    -
    2018年
    機関名:新潟大学

  • 摂食機能評価学演習ⅡA

    2017年
    -
    2018年
    機関名:新潟大学

  • 摂食機能評価学演習ⅠB

    2017年
    機関名:新潟大学

  • 摂食機能評価学演習ⅡB

    2017年
    機関名:新潟大学

  • 加齢歯科学Ⅱ

    2016年
    -
    2018年
    機関名:新潟大学

▶ 全件表示