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2017 Fiscal Year Research-status Report

高解像度マノメトリーと嚥下CTを用いた嚥下運動メカニズムの解明と嚥下治療への応用

Research Project

Project/Area Number 16K01477
Research InstitutionFujita Health University

Principal Investigator

青柳 陽一郎  藤田保健衛生大学, 医学部, 准教授 (30286661)

Co-Investigator(Kenkyū-buntansha) 加賀谷 斉  藤田保健衛生大学, 医学部, 教授 (40282181)
Project Period (FY) 2016-04-01 – 2019-03-31
Keywords高解像度マノメトリー / 嚥下造影検査 / 摂食嚥下障害
Outline of Annual Research Achievements

High-resolution impedance manometry(HRIM)を用いることで,従来のHigh-resolution manometry(HRM)による咽頭・食道内圧測定に加え、食塊通過・残留が推定できることが最近の研究で示唆されている. Omariら(2011)は,誤嚥リスクの指標としてBolus presence time(BPT),Hypopharyngeal peak pressure(PeakP),Intra-bolus distension pressure(IBP), Distension to peak contraction(DCL)の要素から計算されるSwallow risk index(SRI)を提唱した.液体で施行しSRI 0-15をNormal,15以上をAspiration riskとした.今回、重度嚥下障害患者に嚥下造影検査(VF)とHRIMを同時施行した.液体もしくはとろみ付き液体5ccを命令嚥下してもらいBPT,PeakP,IBP,DCLを計測し,SRIを算出した.VF結果よりpenetration-aspiration scale(PAS)4以上を誤嚥あり群,3以下を誤嚥なし群とし,SRIを比較検討した.これまでに解析可能であった11名(23施行, 69±11歳)を対象に予備的解析を行った.統計解析には,対応のないt検定を用いた.SRIは誤嚥あり群20.0±23.4,誤嚥なし群3.4±5.2で誤嚥あり群の方が有意に高かった.しかしBPT, IBP, PeakP, DCLの4つの個別値では有意差を認めなかった.BPT, IBP, PeakP, DCL単独では誤嚥の予測に有用とはいえないが、個別値を組み合わせてSRIを導くことで誤嚥リスクを推定できることが示唆された.HRIMを用いることで、画像検査を行わずに誤嚥リスクを予測する手段になりうると考えられた.

Current Status of Research Progress
Current Status of Research Progress

3: Progress in research has been slightly delayed.

Reason

研究実施、データ解析までは順調に進んでいる。データの解釈、論文化がやや遅れている。

Strategy for Future Research Activity

今年度もHigh-resolution impedance manometry(HRIM)から誤嚥リスクを予測することが可能かどうかの検討をすすめる。
さらに嚥下障害患者において、左右の上部食道括約筋圧と嚥下障害、優位通過側の違いについての検討をすすめる。

Causes of Carryover

研究実施に若干の遅れが出ているため

  • Research Products

    (22 results)

All 2018 2017

All Journal Article (12 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 7 results,  Open Access: 9 results) Presentation (8 results) (of which Int'l Joint Research: 6 results,  Invited: 1 results) Book (2 results)

  • [Journal Article] Effect of bolus volume and flow time on temporospatial coordination in oropharyngeal pressure production in healthy subjects2018

    • Author(s)
      Yano Jitsuro、Aoyagi Yoichiro、Ono Takahiro、Hori Kazuhiro、Yamaguchi Wakami、Fujiwara Shigehiro、Kumakura Isami
    • Journal Title

      Physiology & Behavior

      Volume: 189 Pages: 92~98

    • DOI

      10.1016/j.physbeh.2018.03.006

    • Peer Reviewed / Open Access
  • [Journal Article] Development of an oesophageal stimulation method to elicit swallowing reflex in humans2018

    • Author(s)
      Taniguchi H.、Aoyagi Y.、Matsuo K.、Nakagawa K.、Saitoh E.
    • Journal Title

      Journal of Oral Rehabilitation

      Volume: 45 Pages: 211~215

    • DOI

      10.1111/joor.12599

    • Peer Reviewed / Open Access
  • [Journal Article] Hyoid Bone Movement at Rest by Peripheral Magnetic Stimulation of Suprahyoid Muscles in Normal Individuals2018

    • Author(s)
      Kagaya Hitoshi、Ogawa Mao、Mori Shino、Aoyagi Yoichiro、Shibata Seiko、Inamoto Yoko、Mori Hitoshi、Saitoh Eiichi
    • Journal Title

      Neuromodulation: Technology at the Neural Interface

      Volume: Epub ahead of print Pages: -

    • DOI

      10.1111/ner.12777

    • Peer Reviewed / Open Access
  • [Journal Article] さまざまな高次脳機能障害の症状を理解しよう 失行(2) 口腔顔面失行とその関連症状2018

    • Author(s)
      青柳陽一郎
    • Journal Title

      リハビリナース

      Volume: 別冊 Pages: 129-133

  • [Journal Article] 摂食嚥下障害の評価2018

    • Author(s)
      青柳陽一郎
    • Journal Title

      医学のあゆみ

      Volume: 264 Pages: 1315-1319

  • [Journal Article] Efforts and effects of additional medical coverage to maintain or improve activities of daily living in an acute cardiovascular internal medicine ward2017

    • Author(s)
      Kono Y, Aoyagi Y, Kayukawa T, Mori E, Ishika A, Yatsuya K, Mizokoshi E, Izawa H, Saitoh E
    • Journal Title

      Jpn J Compr Rehabil Sci

      Volume: 8 Pages: 104-108

    • Peer Reviewed / Open Access
  • [Journal Article] The effect of bolus volume on laryngeal closure and UES opening in swallowing: Kinematic analysis using 320-row area detector CT study2017

    • Author(s)
      Shibata S.、Inamoto Y.、Saitoh E.、Kagaya H.、Aoyagi Y.、Ota K.、Akahori R.、Fujii N.、Palmer J. B.、Gonz?lez-Fern?ndez M.
    • Journal Title

      Journal of Oral Rehabilitation

      Volume: 44 Pages: 974~981

    • DOI

      10.1111/joor.12573

    • Peer Reviewed / Open Access
  • [Journal Article] The Mendelsohn Maneuver and its Effects on Swallowing: Kinematic Analysis in Three Dimensions Using Dynamic Area Detector CT2017

    • Author(s)
      Inamoto Yoko、Saitoh Eiichi、Ito Yuriko、Kagaya Hitoshi、Aoyagi Yoichiro、Shibata Seiko、Ota Kikuo、Fujii Naoko、Palmer Jeffrey B.
    • Journal Title

      Dysphagia

      Volume: Epub ahead of print Pages: -

    • DOI

      10.1007/s00455-017-9870-7

    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] マノメトリーでわかること2017

    • Author(s)
      青柳陽一郎, 粟飯原けい子
    • Journal Title

      MEDICAL REHABILITATION

      Volume: 212 Pages: 107-112

  • [Journal Article] 摂食嚥下障害のCT評価2017

    • Author(s)
      青柳陽一郎, 稲本陽子, 才藤栄一
    • Journal Title

      The Japanese Journal of Rehabilitation Medicine

      Volume: 54 Pages: 661-665

    • Open Access
  • [Journal Article] 呼吸器疾患に対するリハビリテーションとエビデンス2017

    • Author(s)
      青柳陽一郎, 河野裕治
    • Journal Title

      JOURNAL OF CLINICAL REHABILITATION

      Volume: 26 Pages: 390-395

    • Peer Reviewed / Open Access
  • [Journal Article] 咀嚼を意識した摂食嚥下障害の評価と治療2017

    • Author(s)
      柴田斉子, 加賀谷斉, 小野木啓子, 松尾浩一郎, 稲本陽子, 青柳陽一郎, 戸田芙美, 赤堀遼子, 小川真央, 才藤栄一
    • Journal Title

      The Japanese Journal of Rehabilitation Medicine

      Volume: 54 Pages: 986-992

    • Open Access
  • [Presentation] Effect of temperature in eliciting swallowing reflex by esophageal stimulation in humans2018

    • Author(s)
      Aoyagi Y, Taniguchi H, Imaeda S, Hirumuta M, Saitoh E
    • Organizer
      2018 Annual Dysphagia Research Society Annual Meeting
    • Int'l Joint Research
  • [Presentation] Improvement of posture and thermal sensitivity for an esophageal stimulation method to elicit swallowing reflex in humans2018

    • Author(s)
      Taniguchi H, Aoyagi Y, Imaeda S, Hirumuta M, Matsuo K, Saitoh E
    • Organizer
      2018 Annual Dysphagia Research Society Annual Meeting
    • Int'l Joint Research
  • [Presentation] .高齢呼吸器疾患患者における身体機能と栄養指標 -誤嚥性肺炎と非誤嚥性肺炎の比較-2018

    • Author(s)
      青柳陽一郎, 田矢理子,大橋美穂,河野裕治, 辻有佳子, 渥美雅子, 溝越恵里子, 蛭牟田誠 山本聖美, 加賀谷斉, 才藤栄一
    • Organizer
      第41回日本嚥下医学会総会
  • [Presentation] Effects of head rotation on pharyngeal and upper esophageal sphincter pressures –a study using high resolution manometry2017

    • Author(s)
      Aoyagi Y, Ando S, Aihara K, Imaeda S, Inamoto Y, Shibata S, Kagaya H, Saitoh E
    • Organizer
      7th ESSD Congress
    • Int'l Joint Research
  • [Presentation] Development of an esophageal mechanical stimulation method for eliciting the swallowing reflex in healthy young humans2017

    • Author(s)
      Taniguchi H, Aoyagi Y, Imaeda S, Hirumuta M, Matsuo K, Saitoh E
    • Organizer
      7th ESSD Congress
    • Int'l Joint Research
  • [Presentation] Effects of Mendelsohn maneuver and effortful swallow on esophageal motility2017

    • Author(s)
      Imaeda S, Aoyagi Y, H. Taniguchi H. Inamoto Y, Hirumuta M, Saitoh E
    • Organizer
      7th ESSD Congress
    • Int'l Joint Research
  • [Presentation] Rehabilitation strategies for dysphagia2017

    • Author(s)
      Maggie-Lee Huckabee, Shaheen Hamdy, Yoko Inamoto, Yoichiro Aoyagi
    • Organizer
      7th ESSD Congress
    • Int'l Joint Research / Invited
  • [Presentation] 嚥下反射中の圧パラメータ変化に関する解剖学的基盤 -高解像度マノメトリーと嚥下CTを用いた検討-2017

    • Author(s)
      青柳陽一郎, 稲本陽子,粟飯原けい子,金森大輔, 石黒百合子, 柴田斉子, 加賀谷斉, 才藤栄一
    • Organizer
      第23回日本摂食嚥下 リハビリテーション学会学術大会
  • [Book] Dysphagia and treatment from the perspective of rehabilitation medicine2017

    • Author(s)
      Pongpipatpaiboon K, Inamoto Y, Matsuo K, Aoyagi Y, Shibata S, Kagaya H, Saitoh E
    • Total Pages
      194
    • Publisher
      Springer
  • [Book] Dysphagia and treatment from the perspective of rehabilitation medicine2017

    • Author(s)
      青柳陽一郎
    • Total Pages
      10
    • Publisher
      リハビリテーション総論

URL: 

Published: 2018-12-17  

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