title: Human hyolaryngeal movements show adaptive motor learning during swallowing.
abstract: The hyoid bone and larynx elevate to protect the airway during swallowing. However, it is unknown whether hyolaryngeal movements during swallowing can adjust and adapt to predict the presence of a persistent perturbation in a feed-forward manner (adaptive motor learning). We investigated adaptive motor learning in nine healthy adults. Electrical stimulation was administered to the anterior neck to reduce hyolaryngeal elevation, requiring more strength to swallow during the perturbation period of this study. We assessed peak hyoid bone and laryngeal movements using videofluoroscopy across thirty-five 5-ml water swallows. Evidence of adaptive motor learning of hyolaryngeal movements was found when (1) participants showed systematic gradual increases in elevation against the force of electrical stimulation and (2) hyolaryngeal elevation overshot the baseline (preperturbation) range of motion, showing behavioral aftereffects, when the perturbation was unexpectedly removed. Hyolaryngeal kinematics demonstrates adaptive, error-reducing movements in the presence of changing and unexpected demands. This is significant because individuals with dysphagia often aspirate due to disordered hyolaryngeal movements. Thus, if rapid motor learning is accessible during swallowing in healthy adults, patients may be taught to predict the presence of perturbations and reduce errors in swallowing before they occur.
authors.affiliation: Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, 98 North Broadway, Baltimore, MD 21231, USA. ihumber1@jhmi.edu
authors.forename: Ianessa A
authors.initials: IA
authors.lastname: Humbert
authors.forename: Heather
authors.initials: H
authors.lastname: Christopherson
authors.forename: Akshay
authors.initials: A
authors.lastname: Lokhande
authors.forename: Rebecca
authors.initials: R
authors.lastname: German
authors.forename: Marlis
authors.initials: M
authors.lastname: Gonzalez-Fernandez
authors.forename: Pablo
authors.initials: P
authors.lastname: Celnik
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001696:Biomechanical Phenomena; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D006928:Hyoid Bone / Q000000981:diagnostic imaging / Q000502:physiology*; D007830:Larynx / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D010614:Pharynx / Q000000981:diagnostic imaging / Q000502:physiology*; D011859:Radiography; D012016:Reference Values; D055815:Young Adult