title: Brain and behavioral effects of swallowing carbonated water on the human pharyngeal motor system.
abstract: Chemical stimulation of the swallowing network with carbonation and citric acid has been investigated, showing potential benefits on swallowing of dysphagic patients. Despite this, the underlying mechanisms for these effects are not fully understood. Here we investigated the effects of 5 ml liquid bolus swallows of carbonated, citric acid, and still water on a swallowing reaction-time tasks paradigm in 16 healthy adults (8 male, mean age 33 ± 3.7 yr, protocol 1). We then investigated the net effects of "sensory bolus interventions" (40 repeated swallows every 15 s) of the three different liquid boluses on corticobulbar excitability, as examined with single-pulse transcranial magnetic stimulation (TMS) in 16 participants (8 female, mean age 33 ± 3.7 yr, protocol 2). The findings showed that a larger number of correctly timed swallows (within a predetermined time window) was accomplished mainly with carbonated liquids (z = -2.04, P = 0.04 vs. still water, protocol 1). Both carbonated and citric acid liquid interventions with 40 swallows increased corticobulbar excitability of the stronger pharyngeal projection, suggesting a similar modulatory pathway for the effects on swallowing. However, carbonation showed superiority (P = 0.04, F = 4.75, 2-way ANOVA), with the changes lasting up to 60 min following the intervention. These results hold significance for future further and in-depth physiological investigations of the differences between different stimuli on swallowing neural network.
authors.affiliation: Gastrointestinal Centre, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom; and.
authors.forename: Omsaad
authors.initials: O
authors.lastname: Elshukri
authors.affiliation: Gastrointestinal Centre, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom; and emilia.michou@manchester.ac.uk.
authors.forename: Emilia
authors.initials: E
authors.lastname: Michou
authors.affiliation: Gastrointestinal Centre, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom; and Department Pädagogik und Rehabilitation, Ludwig-Maximilians-Universität München, Munich, Germany.
authors.forename: Hannah
authors.initials: H
authors.lastname: Mentz
authors.affiliation: Gastrointestinal Centre, Institute of Inflammation and Repair, Manchester Academic Health Sciences Centre (MAHSC), University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom; and.
authors.forename: Shaheen
authors.initials: S
authors.lastname: Hamdy
mesh_terms: D000328:Adult; D001921:Brain / Q000187:drug effects* / Q000502:physiology*; D061545:Carbonated Water / Q000008:administration & dosage*; D019343:Citric Acid / Q000008:administration & dosage; D019054:Evoked Potentials, Motor / Q000187:drug effects / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000187:drug effects* / Q000502:physiology*; D009415:Nerve Net / Q000187:drug effects / Q000502:physiology; D010614:Pharynx / Q000187:drug effects* / Q000502:physiology*; D011930:Reaction Time / Q000187:drug effects / Q000502:physiology; D055815:Young Adult
chemical_list: D061545:Carbonated Water; D019343:Citric Acid
keywords: carbonation; motor evoked potentials; transcranial magnetic stimulation