Defining pharyngeal contractile integral during high-resolution manometry in neonates: a neuromotor marker of pharyngeal vigor
Related Experiment Video
Updated: Feb 8, 2026
Visualization and Analysis of Pharyngeal Arch Arteries using Whole-mount Immunohistochemistry and 3D Reconstruction
Published on: March 31, 2020
Sudarshan R Jadcherla1,2, Varsha Prabhakar3, Kathryn A Hasenstab3
1Innovative Infant Feeding Disorders Research Program, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. sudarshan.jadcherla@nationwidechildrens.org.
Insights
Pharyngeal Contractile Integral (PhCI) reliably measures pharyngeal function in neonates. PhCI differs based on stimulation type and location, offering insights into swallowing development and disorders.
Area of Science:
- Pediatric Gastroenterology
- Swallowing Physiology
- Neonatal Development
Background:
- Pharyngeal contractility is essential for safe swallowing in neonates.
- Pharyngeal Contractile Integral (PhCI) quantifies pharyngeal contractile vigor.
- Understanding PhCI variations in neonates is crucial for assessing swallowing function.
Purpose of the Study:
- To characterize Pharyngeal Contractile Integral (PhCI) in neonates.
- To investigate if PhCI differs based on the mode of stimulation.
- To evaluate the reliability of PhCI measurement methods.
Main Methods:
- High-resolution manometry (HRM) was used in 19 neonates.
- Pharyngeal Contractile Integral (PhCI) was calculated using conventional and Automated Swallow Detection algorithm (ASDA) methods.
- Pharyngeal contractility was analyzed across different pharyngeal regions and stimulation types (spontaneous, pharyngeal, oral).
Main Results:
- PhCI varied significantly between oral and pharyngeal stimuli, as well as spontaneous swallows.
- High correlation was observed between conventional and ASDA methods for PhCI calculation.
- PhCI demonstrated differences between proximal and distal pharyngeal regions and responded distinctively to pharyngeal versus oral stimulation.
Conclusions:
- Pharyngeal Contractile Integral (PhCI) is a reliable metric for differentiating pharyngeal activity.
- PhCI can distinguish the effects of oral and pharyngeal stimulation, as well as prolonged stimulation.
- PhCI offers a valuable tool for examining changes in pharyngeal contractility related to maturation, disease, and therapeutic interventions.
Background:
Pharyngeal contractility is critical for safe bolus propulsion. Pharyngeal contractile vigor can be measured by Pharyngeal Contractile Integral (PhCI): product of mean pharyngeal contractile amplitude, length, and duration. We characterized PhCI in neonates and examined the hypothesis that PhCI differs with mode of stimulation.
Methods:
Nineteen neonates born at 38.6 (34-41) weeks gestation were evaluated at 42.9 (40.4-44.0) weeks postmenstrual age using high-resolution manometry (HRM). PhCI was calculated using: (a) Conventional and (b) Automated Swallow Detection algorithm (ASDA) methods. Contractility metrics of all pharyngeal regions were examined using mixed statistical models during spontaneous and adaptive state (pharyngeal and oral stimulus) swallowing.
Results:
PhCI of oral stimuli swallows were distinct from pharyngeal stimuli and spontaneous swallows (P < 0.05). Correlation between conventional and ASDA methods was high (P < 0.001). PhCI increased with swallows for pharyngeal stimulation (P < 0.05) but remained stable for swallows with oral stimulation. PhCI differed between proximal and distal pharynx (P < 0.001).
Conclusions:
PhCI is a novel reliable metric capable of distinguishing (1) proximal and distal pharyngeal activity, (2) effects of oral and pharyngeal stimulation, and (3) effects of prolonged stimulation. Changes in pharyngeal contractility with maturation, disease, and therapies can be examined with PhCI.
Related Concept Videos
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:23Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
02:15The Contractile Ring
A small GTPase, RhoA, controls the function and assembly of the contractile ring. RhoA belongs to the Ras superfamily of proteins. The activation of formins by RhoA promotes...
01:24Defining Psychology
01:28Piecewise-Defined Functions
01:09Defining Social Psychology