Skip to main content
SpringerLink
Log in

Feasibility of Oral Feeding in Patients with Disorders of Consciousness

  • Chapter
  • First Online:
Coma and Disorders of Consciousness

Abstract

Eating and drinking are basic pleasures of life. However, the ease with which we perform these actions masks the complexity of the underlying neuronal control. According to several studies, dysphagia among subjects with severe brain injury is frequent. Faced with the difficult management of patients with an altered state of consciousness, the use of gustatory stimuli, as well as the rehabilitation of swallowing, could constitute an additional therapy, currently rarely considered. This review aims to summarize our current knowledge regarding the neural control of swallowing, to assess the role of awareness and willingness on swallowing control, and, finally, to establish the feasibility of oral feeding in patients with disorders of consciousness.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Mackay LE, Morgan AS, Bernstein BA. Factors affecting oral feeding with severe traumatic brain injury. J Head Trauma Rehabil. 1999;14:435–47.

    Article  CAS  PubMed  Google Scholar 

  2. Winstein CJ. Neurogenic dysphagia. Frequency, progression, and outcome in adults following head injury. Phys Ther. 1983;63(12):1992–7.

    Article  CAS  PubMed  Google Scholar 

  3. Mackay LE, Morgan AS, Bernstein BA. Swallowing disorders in severe brain injury: risk factors affecting return to oral intake. Arch Phys Med Rehabil. 1999;80:365–71.

    Article  CAS  PubMed  Google Scholar 

  4. Brady SL, Darragh M, Escobar NG, et al. Persons with disorders of consciousness: are oral feedings safe/effective? Brain Inj. 2006;20:1329–34.

    Article  PubMed  Google Scholar 

  5. Bleeckx D. Dysphagie: évaluation et rééducation des troubles de la déglutition. 1st ed. Brussels: De Boeck; 2002.

    Google Scholar 

  6. Jean A. Brain stem control of swallowing: neuronal network and cellular mechanisms. Physiol Rev. 2001;81:929–69.

    CAS  PubMed  Google Scholar 

  7. Ertekin C, Aydogdu I. Neurophysiology of swallowing. Clin Neurophysiol. 2003;114:2226–44.

    Article  PubMed  Google Scholar 

  8. Sinclair WJ. Initiation of reflex swallowing from the naso- and oropharynx. Am J Physiol. 1970;218:956–60.

    CAS  PubMed  Google Scholar 

  9. Doty R. Neural organisation of deglutition. In: Code CF, editor. Handbook of physiology. Washington: American Physiological Society; 1968. p. 1861–902.

    Google Scholar 

  10. McFarland. L’anatomie en orthophonie : Parole, voix et déglutition. Elsevier Masson; 2006.

    Google Scholar 

  11. Mistry S, Hamdy S. Neural control of feeding and swallowing. Phys Med Rehabil Clin N Am. 2008;19:709–28, vii–viii.

    Google Scholar 

  12. Miller FR, Sherrington CS. Some observations on the buccopharyngeal stage of reflex deglutition in the cat. Q J Exp Physiol. 1916;9:147–86.

    Article  Google Scholar 

  13. Ciampini G, Jean A. Role of glossopharyngeal and trigeminal afferents in the initiation and propagation of swallowing. I–Glossopharyngeal afferents. J Physiol Paris. 1980;76:49–60.

    CAS  PubMed  Google Scholar 

  14. Delaney AL, Arvedson JC. Development of swallowing and feeding: prenatal through first year of life. Dev Disabil Res Rev. 2008;14:105–17.

    Article  PubMed  Google Scholar 

  15. Peleg D, Goldman JA. Fetal deglutition: a study of the anencephalic fetus. Eur J Obstet Gynecol Reprod Biol. 1978;8:133–6.

    Article  CAS  PubMed  Google Scholar 

  16. Martin RE, Sessle BJ. The role of the cerebral cortex in swallowing. Dysphagia. 1993;8:195–202.

    Article  CAS  PubMed  Google Scholar 

  17. Miller AJ. The neuroscientific principles of swallowing and dysphagia. San Diego: Singular Publication Group; 1999.

    Google Scholar 

  18. Michou E, Hamdy S. Cortical input in control of swallowing. Curr Opin Otolaryngol Head Neck Surg. 2009;17:166–71.

    Article  PubMed  Google Scholar 

  19. Martin RE, Goodyear BG, Gati JS, Menon RS. Cerebral cortical representation of automatic and volitional swallowing in humans. J Neurophysiol. 2001;85:938–50.

    CAS  PubMed  Google Scholar 

  20. Kern MK, Jaradeh S, Arndorfer RC, Shaker R. Cerebral cortical representation of reflexive and volitional swallowing in humans. Am J Physiol Gastrointest Liver Physiol. 2001;280:G354–60.

    CAS  PubMed  Google Scholar 

  21. Young EC, Durant-Jones L. Developing a dysphagia program in an acute care hospital: a needs assessment. Dysphagia. 1990;5:159–65.

    Article  CAS  PubMed  Google Scholar 

  22. Gordon C, Hewer RL, Wade DT. Dysphagia in acute stroke. Br Med J (Clin Res Ed). 1987;295:411–4.

    Article  CAS  Google Scholar 

  23. Hamdy S, Aziz Q, Rothwell JC, et al. The cortical topography of human swallowing musculature in health and disease. Nat Med. 1996;2:1217–24.

    Article  CAS  PubMed  Google Scholar 

  24. Hamdy S, Aziz Q, Rothwell JC, et al. Explaining oropharyngeal dysphagia after unilateral hemispheric stroke. Lancet. 1997;350:686–92.

    Article  CAS  PubMed  Google Scholar 

  25. Hamdy S, Rothwell JC, Aziz Q, et al. Long-term reorganization of human motor cortex driven by short-term sensory stimulation. Nat Neurosci. 1998;1:64–8.

    Article  CAS  PubMed  Google Scholar 

  26. Hamdy S, Aziz Q, Rothwell JC, et al. Recovery of swallowing after dysphagic stroke relates to functional reorganization in the intact motor cortex. Gastroenterology. 1998;115:1104–12.

    Article  CAS  PubMed  Google Scholar 

  27. Hamdy S, Mikulis DJ, Crawley A, et al. Cortical activation during human volitional swallowing: an event-related fMRI study. Am J Physiol. 1999;277:G219–25.

    CAS  PubMed  Google Scholar 

  28. Hamdy S, Rothwell JC, Brooks DJ, et al. Identification of the cerebral loci processing human swallowing with H2(15)O PET activation. J Neurophysiol. 1999;81:1917–26.

    CAS  PubMed  Google Scholar 

  29. Mosier K, Patel R, Liu WC, et al. Cortical representation of swallowing in normal adults: functional implications. Laryngoscope. 1999;109:1417–23.

    Article  CAS  PubMed  Google Scholar 

  30. Zald DH, Pardo JV. The functional neuroanatomy of voluntary swallowing. Ann Neurol. 1999;46:281–6.

    Article  CAS  PubMed  Google Scholar 

  31. Mosier KM, Liu WC, Maldjian JA, Shah R, Modi B. Lateralization of cortical function in swallowing: a functional MR imaging study. AJNR Am J Neuroradiol. 1999;20:1520–6.

    CAS  PubMed  Google Scholar 

  32. Paus T. Primate anterior cingulate cortex: where motor control, drive and cognition interface. Nat Rev Neurosci. 2001;2:417–24.

    Article  CAS  PubMed  Google Scholar 

  33. Daniels SK, Foundas AL. The role of the insular cortex in dysphagia. Dysphagia. 1997;12:146–56.

    Article  CAS  PubMed  Google Scholar 

  34. Penfield W, Rasmussen T. The cerebral cortex of man. New York: Macmillan; 1950.

    Google Scholar 

  35. Burton H, Benjamin RM. Central projections of the gustatory system. In: Beidler LM, editor. Handbook of sensory physiology. Chemical senses Sect 2, taste, vol 4. Berlin: Springer; 1971. p. 148–63.

    Google Scholar 

  36. Small DM, Jones-Gotman M, Zatorre RJ, et al. A role for the right anterior temporal lobe in taste quality recognition. J Neurosci. 1997;17:5136–42.

    CAS  PubMed  Google Scholar 

  37. Miall RC. The cerebellum, predictive control and motor coordination. Novartis Found Symp. 1998;218:272–84; discussion 84–90

    CAS  PubMed  Google Scholar 

  38. Ivry R. Cerebellar timing systems. Int Rev Neurobiol. 1997;41:555–73.

    Article  CAS  PubMed  Google Scholar 

  39. Doya K. Complementary roles of basal ganglia and cerebellum in learning and motor control. Curr Opin Neurobiol. 2000;10:732–9.

    Article  CAS  PubMed  Google Scholar 

  40. Hikosaka O, Nakahara H, Rand MK, et al. Parallel neural networks for learning sequential procedures. Trends Neurosci. 1999;22:464–71.

    Article  CAS  PubMed  Google Scholar 

  41. Robbins J, Levin RL. Swallowing after unilateral stroke of the cerebral cortex: preliminary experience. Dysphagia. 1988;3:11–7.

    Article  CAS  PubMed  Google Scholar 

  42. Lichter I, Muir RC. The pattern of swallowing during sleep. Electroencephalogr Clin Neurophysiol. 1975;38:427–32.

    Article  CAS  PubMed  Google Scholar 

  43. Sato K, Nakashima T. Human adult deglutition during sleep. Ann Otol Rhinol Laryngol. 2006;115:334–9.

    Article  PubMed  Google Scholar 

  44. de Larminat V, Dureuil B. Changes in the deglutition reflex during the perioperative period. Ann Fr Anesth Reanim. 1994;13:49–56.

    Article  PubMed  Google Scholar 

  45. Giacino JT, Ashwal S, Childs N, et al. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002;58:349–53.

    Article  PubMed  Google Scholar 

  46. Laureys S, Owen AM, Schiff ND. Brain function in coma, vegetative state, and related disorders. Lancet Neurol. 2004;3:537–46.

    Article  PubMed  Google Scholar 

  47. MacKay LaM AS. Early swallowing disorders with severe head injuries: relationships between the RLA and the progression of oral intake. Dysphagia. 1993;8:161.

    Google Scholar 

  48. Hansen TS, Engberg AW, Larsen K. Functional oral intake and time to reach unrestricted dieting for patients with traumatic brain injury. Arch Phys Med Rehabil. 2008;89(8):1556–62.

    Google Scholar 

  49. Cherney LR, Halper AS. Swallowing problems in adults with traumatic brain injury. Semin Neurol. 1996;16:349–53.

    Article  CAS  PubMed  Google Scholar 

  50. Morgan A, Ward E, Murdoch B, et al. Incidence, characteristics, and predictive factors for Dysphagia after pediatric traumatic brain injury. J Head Trauma Rehabil. 2003;18:239–51.

    Article  PubMed  Google Scholar 

  51. O’Neil-Pirozzi TM, Momose KJ, Mello J, et al. Feasibility of swallowing interventions for tracheostomized individuals with severely disordered consciousness following traumatic brain injury. Brain Inj. 2003;17:389–99.

    Article  PubMed  Google Scholar 

  52. Splaingard ML, Hutchins B, Sulton LD, Chaudhuri G. Aspiration in rehabilitation patients: video fluoroscopy vs bedside clinical assessment. Arch Phys Med Rehabil. 1988;69:637–40.

    CAS  PubMed  Google Scholar 

  53. Linden P, Kuhlemeier KV, Patterson C. The probability of correctly predicting subglottic penetration from clinical observations. Dysphagia. 1993;8:170–9.

    Article  CAS  PubMed  Google Scholar 

  54. Coombes K. FOTT (facial oral tract therapy). iADH Magazine. International Association for Disability and Oral Health; 2008; 11-2, http://iadh.org/wp-content/uploads/2014/01/2008spring.pdf

  55. Bicego A, Lejoly K, Maudoux A, et al. Déglutition et états de conscience altérée (Swallowing in disorders of consciousness). Rev Neurol (Paris). 2014;170(10):630–41.

    Article  CAS  Google Scholar 

  56. Formisano R, Voogt RD, Buzzi MG, et al. Time interval of oral feeding recovery as a prognostic factor in severe traumatic brain injury. Brain Inj. 2004;18:103–9.

    Article  CAS  PubMed  Google Scholar 

  57. Hagen C. The Rancho levels of cognitive functioning. The revised levels. 3rd ed. Downey: Rancho Los Amigos Medical Center; 1998.

    Google Scholar 

  58. Ward EC, Green K, Morton AL. Patterns and predictors of swallowing resolution following adult traumatic brain injury. J Head Trauma Rehabil. 2007;22(3):184–91.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oto-Rhino-Laryngology Head and Neck Surgery Department, University Hospital of Liège, Sart-Tilman-B35, 4000, Liège, Belgium

    Audrey Maudoux M.D., Ph.D.

  2. Coma Science Group, GIGA Research Center and Neurology Department, University and University Hospital of Liège, Liège, Belgium

    Audrey Maudoux M.D., Ph.D., Olivia Gosseries Ph.D., Evelyne Mélotte & Audrey Vanhaudenhuyse Ph.D.

  3. Head and Neck Carcinologic Department, Gustave Roussy, University Paris-Saclay, Villejuif, France

    Ingrid Breuskin M.D., Ph.D.

  4. Physical Medicine Department, University Hospital of Liège, Sart-Tilman-B35, 4000, Liège, Belgium

    Evelyne Mélotte

  5. Department of Neurosurgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA

    Caroline Schnakers Ph.D.

  6. Department of Research, Casa Colina Hospital and Centers for Healthcare, Pomona, CA, USA

    Caroline Schnakers Ph.D.

  7. Algology and Palliative Care Department, University Hospital of Liège, Sart Tilman B35, 4000, Liège, Belgium

    Audrey Vanhaudenhuyse Ph.D.

Authors
  1. Audrey Maudoux M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ingrid Breuskin M.D., Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olivia Gosseries Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Evelyne Mélotte
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Caroline Schnakers Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Audrey Vanhaudenhuyse Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Audrey Maudoux M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Research, Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA

    Caroline Schnakers

  2. GIGA Consciousness, Coma Science Group & Neurology Department, Liège, Belgium

    Steven Laureys

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Maudoux, A., Breuskin, I., Gosseries, O., Mélotte, E., Schnakers, C., Vanhaudenhuyse, A. (2018). Feasibility of Oral Feeding in Patients with Disorders of Consciousness. In: Schnakers, C., Laureys, S. (eds) Coma and Disorders of Consciousness. Springer, Cham. https://doi.org/10.1007/978-3-319-55964-3_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-55964-3_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55963-6

  • Online ISBN: 978-3-319-55964-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation