Exploiting Experience-Dependent Plasticity in Dysphagia Rehabilitation: Current Evidence and Future Directions

Abstract

Experience-dependent plasticity (EDP) is a general term used to describe neural and associated behavioral adaptations resulting from experience. Because the objective of dysphagia rehabilitation is to induce long-term permanent change in swallowing physiology, understanding EDP processes is crucial for documenting the efficacy of treatments. There is little information about natural processes of EDP related to swallowing (i.e., changes associated with aging and impairment). Therefore, the “baseline” on which we apply dysphagia treatments remains unclear. Because EDP is characterized by peripheral and central adaptations of physiologic and functional measures over time, effectively documenting EDP requires multiple outcome measures at multiple time points. This review will discuss mechanisms of endogenously induced EDP, including aging and impairment. A review of current dysphagia rehabilitation literature will be provided to indicate the state of evidence for exogenously induced EDP. Future considerations for the study of EDP related to dysphagia will also be offered.