Swallow remodeling of respiratory neural networks.

Swallow is defined as the coordinated neuromuscular activity of the mouth, pharynx, larynx, and esophagus. Movement of a bolus and air must be coordinated by swallow remodeling of the respiratory pattern. The brainstem contains respiratory and swallow neural control networks that generate the pattern for breathing and swallow. Swallow control of respiration is proposed to be through recruitment of swallow neural elements that retask existing respiratory neural network elements. Swallow reconfiguration of the respiratory neural network is fundamental to airway protection and integrated with other airway protective reflexes. Thus, swallow, breathing, cough, and other airway defensive behaviors are produced by a central neural motor system that shares elements. It is hypothesized that swallow and airway defensive behaviors are controlled by a recruited behavioral control assembly system that is organized in a fashion that allows for precise coordination of the expression of these behaviors to maintain airway protection.