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Partnering June, 2016
Glenbrook’s Micro-Fluoroscopy Aids in Dysphagia Research
By Jim McMahon
ploying, high-resolution micro-fluo- roscopy technology, developed and patented by Glenbrook Technologies, which enables researchers to view the swallowing function of mice while eat- ing and drinking. This is the first time such real-time images have been viewed with X-ray technology. The research program aims to
T
better understand the causes and de- velopment of dysphagia, the medical term for swallowing impairment. Per- sons with dysphagia generally experi- ence slow, delayed and uncoordinated swallowing that compromises airway function, often leading to pneumonia. The condition is associated with a number of diseases, such as Parkin- son’s disease, amyotrophic lateral scle- rosis (ALS) known as Lou Gehrig’s dis- ease, Muscular Dystrophy (MD), and dozens of different medical conditions. Millions of Amer icans are chronically afflicted with dysphagia, with limited treatment options available.
Say “Aaaah” The standard technique for di-
agnosing swallowing disorders is a technique known as videofluo- roscopy. A videofluoroscopic swallow study is a radiologic examination of an individual’s swallowing function
he University of Missouri School of Medicine research laboratory is now using a new system em-
that uses an X-ray device called a fluoroscope. The patient is observed swallowing various foods and liquids mixed with a contrast agent that can be seen by fluoroscopy, in order to evaluate his or her ability to swallow safely and effectively. But, a long-term study of the
swallowing ability of an individual is not feasible. Instead, the research team at the University of Missouri studies the swallowing function of healthy C57BL/6 mice — also called Black 6 mice — throughout their ap- proximate two-year lifespan. Black 6 mice, the most widely-used mouse model in research, have a long lifes- pan and low susceptibility to cancer tumors, making them a good model for understanding the aging process relative to swallowing function for translational application to humans. “We have established fifteen
metrics in Black 6 mice that could be compared to the human swallowing function,” says Dr. Teresa Lever, Ph.D., assistant professor at the De- partment of Otolaryngology at the University of Missouri. “These in- clude swallow rate, pharyngeal tran- sit time — the time it takes liquid to be swallowed through the pharynx and into the esophagus, and the number of
ineffective swallows
through the esophagus. We have found that healthy aging mice devel-
op symptoms of swallowing impair- ment that closely resemble the im- pairments seen in human older adults, such as slowed swallowing function, impaired tongue function, larger size of the amount swallowed, and an increase in the time it takes liquid to travel through the throat to the stomach.” However, until recently these
results were unknown. Researchers could only study mice from outside of their bodies, to examine how they swal low. Existing medical diagnostic fluoroscopes have not had the resolu- tion to see the internal organs of a mouse. “We could only view the mice
from the outside, we could see them licking and chewing, but we had no idea what was happening on the in- side,” says Dr. Lever. “One of the biggest challenges for us was dealing with the tiny movements in mice that happen about ten times faster than in humans.”
Micro-Fluoroscopy Dr. Lever was introduced to a
technology which allowed minute components to be viewed via micro- fluoroscopy. She speculated that this technology might be adapted for use on a live, moving animal, such as to capture dynamic structural and functional movements of a mouse
during swallowing. Through a cooperative effort be-
tween the University of Missouri and Glenbrook Technologies, the compa- ny’s LabScope™ micro-fluoroscopy system was customized to adapt to Dr. Lever’s dynamic X-ray imaging requirements, providing real-time imaging capability. It is this unusual micro-fluoroscopy technology that has enabled Dr. Lever’s swallow-test protocol to determine if a mouse has dysphagia, and produce the high-res- olution, real-time images character- izing the condition. “Using the LabScope system
with a 30-frames-per-second camera, we are able to see swallowing function in mice, while eating and drinking, which has never been viewed with x- ray equipment before,” adds Dr. Lever. “And, the quality of the imag- ing is extremely high-resolution.” The LabScope operates with an
anode voltage of 25 to 30 kV com- pared to X-ray machines in human medical and veterinary applications that operate at approximately 75 kV. The much smaller radiation dosage allows Dr. Lever to fine-tune the ex- amination of small features in the mice that have a low volume of tissue mass. It also permits her to test the mice more frequently, allowing for longer-term test protocols. Also, the lower radiation dose requires less shielding, which is conveniently built into the machine, eliminating the need for a separate X-ray room. “It has a very small footprint
compared to the X-ray systems used for humans,” says Dr. Lever. “This allows it to be located directly inside our laboratory, while being ade- quately shielded during use. It per- mits other lab workers to continue performing their activities within the lab space. And, we do not need to rely on a radiologist or technician. One researcher in our lab can operate the machine safely.” The addition of micro-fluoroscopy
to Dr. Lever’s lab is just one of the lat- est advanced techniques employed for its research into better understanding dysphagia. In addition to micro-fluo- roscopy, the lab conducts electro-phys- iology experiments, genotyping, be- havioral phenotyping, general histol- ogy, immunohistochemistry, and 3D stereology using bright field and fluo- rescence microscopy. Dr. Lever’s re- search team is now focused on identi- fying pathological changes in the mus- cles, nerves, and brain of Black 6 mice in order to find effective treatments for
dysphagia. Contact: Glenbrook Technolo-
gies, Inc., 11 Emery Avenue, Ran- dolph, NJ 07869 % 973-361-8866 E-mail:
szweig@glenbrooktech.com Web:
www.glenbrooktech.com r
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