Abstract
Oropharyngeal dysphagia is prevalent in age-related neurological disorders presenting with impaired efficacy and safety of swallowing due to a loss of muscle force and sensory deficits. Stimulating the oropharynx with capsaicin that mediates Substance P release is an emerging pharmacological treatment option which needs further scientific evidence. Our aim was to comprehensively evaluate the effect of capsaicin on biochemical, neurophysiological, and biomechanical parameters of swallowing function. In a randomized study on healthy individuals, the impact of orally administered capsaicinoids at different dosages and application durations in comparison to non-carbonated water was evaluated. Time course and magnitude of salivary Substance P increase were monitored. Magnetoencephalography was used to detect cortical swallowing network alterations. Modifications in swallowing biomechanics were measured applying high-resolution pharyngeal manometry. Capsaicinoids at 10 μmol/L improved swallowing efficacy as seen by a significant increase of pharyngeal contractile integral and upper esophageal sphincter activation and relaxation times in manometry. Significant improvement of precision in a challenging swallow task accompanied by a reduction in swallowing-related submental electromyographic power was observed with capsaicinoids preconditioning at 10 μmol/L over 5 min, but not with continuous stimulation. The cortical activation pattern remained unchanged after any intervention. A significant increase of salivary Substance P was not detected with 10 μmol/L but with 50 μmol/L and lasted for 15 min after application. Capsaicinoids mediate dose-dependent Substance P release and positively alter swallowing biomechanics in healthy subjects. The results provide supportive evidence for the value of natural capsaicinoids to improve swallowing function.
Highlights
Swallowing is an essential neuromuscular function of the respiratory, oropharyngeal, and gastrointestinal structures to transport material from the mouth to the stomach while protecting the airway
Data are given as mean ± standard deviation *Indicates statistical significance † Upper esophageal sphincter
Swallowing performance in the challenged task was significantly improved by capsaicinoids preconditioning (Table 2)
Summary
Swallowing is an essential neuromuscular function of the respiratory, oropharyngeal, and gastrointestinal structures to transport material from the mouth to the stomach while protecting the airway. Has recently been recognized as a geriatric syndrome [1] It presents with impaired efficacy and safety of swallowing [2, 3] due to disturbed biomechanics caused by a loss of muscle force and function, reduction of tissue elasticity, saliva production, and gustatory function, impaired dental status, and reduced swallowing processing efficiency of the aging brain [4]. This is complemented by decreased oropharyngeal sensory perception due to a reduction of myelinated nerve fibers of the superior laryngeal nerve leading to delayed initiation of the swallow response [5]. Evidence for the effectiveness of these interventions is low [8, 10, 11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
