{"id":17,"date":"2025-12-10T10:57:20","date_gmt":"2025-12-10T15:57:20","guid":{"rendered":"https:\/\/sites.bu.edu\/borderslab\/?page_id=17"},"modified":"2025-12-19T09:11:14","modified_gmt":"2025-12-19T14:11:14","slug":"our-research","status":"publish","type":"page","link":"https:\/\/sites.bu.edu\/borderslab\/our-research\/","title":{"rendered":""},"content":{"rendered":"<h1 data-start=\"310\" data-end=\"364\" style=\"text-align: center;\"><strong>Understanding Airway Protection<\/strong><\/h1>\n<h3 data-start=\"310\" data-end=\"364\" style=\"text-align: left;\"><strong data-start=\"310\" data-end=\"364\">Why swallowing and coughing matter for your health<\/strong><\/h3>\n<p><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/3546_0fb2b5d3170a755-2-636x424.jpg\" alt=\"\" width=\"382\" height=\"255\" class=\"alignleft wp-image-326\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3546_0fb2b5d3170a755-2-636x424.jpg 636w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3546_0fb2b5d3170a755-2-1024x683.jpg 1024w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3546_0fb2b5d3170a755-2-768x512.jpg 768w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3546_0fb2b5d3170a755-2-1536x1024.jpg 1536w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3546_0fb2b5d3170a755-2-2048x1365.jpg 2048w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/><\/p>\n<p data-start=\"366\" data-end=\"804\">People swallow hundreds of times each day during meals, while drinking, or even when they aren\u2019t aware of it. Coughing is just as important, acting as the body\u2019s natural defense to keep the airway clear. Together, swallowing and coughing form what we call <strong data-start=\"629\" data-end=\"650\">airway protection<\/strong>, a set of coordinated behaviors that help move food and liquid safely into the stomach and keep the lungs healthy.<\/p>\n<p data-start=\"806\" data-end=\"1145\">When either of these aren&#8217;t working as well as they should, people may experience swallowing problems (<strong data-start=\"919\" data-end=\"932\">dysphagia<\/strong>) and\/or difficulties coughing (<strong>dystussia<\/strong>). These conditions are common and affect people at any age. They often occur in people with neurologic conditions, after injury, or as part of changes that happen with aging.<\/p>\n<h3 data-start=\"1152\" data-end=\"1185\" style=\"text-align: left;\">What are swallowing disorders?<\/h3>\n<p data-start=\"1187\" data-end=\"1445\">Swallowing may seem simple, but it is a complex process involving more than 25 pairs of muscles and six cranial nerves. Even small changes can affect how safely and efficiently a person swallows.<\/p>\n<h3 data-start=\"1152\" data-end=\"1185\"><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/3826_1d612e4453964dc-636x424.jpg\" alt=\"\" width=\"382\" height=\"255\" class=\"alignright wp-image-341\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3826_1d612e4453964dc-636x424.jpg 636w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3826_1d612e4453964dc-1024x683.jpg 1024w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3826_1d612e4453964dc-768x512.jpg 768w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3826_1d612e4453964dc-1536x1024.jpg 1536w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/3826_1d612e4453964dc-2048x1365.jpg 2048w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/><\/h3>\n<h3 data-start=\"1152\" data-end=\"1185\"><\/h3>\n<p data-start=\"1447\" data-end=\"1901\"><strong data-start=\"1447\" data-end=\"1460\">Dysphagia<\/strong> (pronounced <em data-start=\"1473\" data-end=\"1486\">dis-FAY-juh<\/em>) refers to any difficulty moving food, liquid, or medication from the mouth to the stomach. Swallowing problems can arise for many reasons, including stroke, Parkinson\u2019s disease, head and neck cancer, brain injury, or structural changes in the throat. Older adults are particularly affected because aging can reduce muscle strength, sensation, and coordination. These issues often go undetected, as many people do not realize that they have a swallowing problem until they receive an evaluation.<\/p>\n<p data-start=\"1903\" data-end=\"2127\">Dysphagia affects <strong data-start=\"1936\" data-end=\"1972\">more than 1 in 10 people worldwide<\/strong>. If it is not treated, it can lead to serious health problems, including poor nutrition, dehydration, unintended weight loss, aspiration (when food or liquid enters the lungs), and pneumonia.<\/p>\n<h3 style=\"text-align: left;\">What are cough disorders?<\/h3>\n<p data-start=\"2503\" data-end=\"2878\" style=\"text-align: left;\"><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/pexels-vlada-karpovich-5790716-636x424.jpg\" alt=\"\" width=\"382\" height=\"255\" class=\"wp-image-340 alignleft\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/pexels-vlada-karpovich-5790716-636x424.jpg 636w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/pexels-vlada-karpovich-5790716-1024x683.jpg 1024w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/pexels-vlada-karpovich-5790716-768x512.jpg 768w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/pexels-vlada-karpovich-5790716-1536x1024.jpg 1536w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/pexels-vlada-karpovich-5790716-2048x1365.jpg 2048w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/>Coughing is another key part of airway protection. A strong, well-timed cough helps clear the airway when food or liquid goes the wrong way. Some people have trouble sensing material in the airway, coughing with enough force, or coordinating breathing with coughing. These problems often co-occur with swallowing disorders in the presence of neurologic disease, illness, or aging. When coughing is weak or absent, the risk of pneumonia increases because the body isn&#8217;t able to clear unwanted material from the lungs.<\/p>\n<p>&nbsp;<\/p>\n<h1 data-start=\"310\" data-end=\"364\" style=\"text-align: center;\"><strong>Our Research<\/strong><\/h1>\n<p><strong>The Airway Protection Research Lab<\/strong> is dedicated to advancing our understanding of cough and swallowing disorders so that we can translate these findings into novel, evidence-based treatments. Our overarching goal is to improve health outcomes and quality of life for patients and care partners. To accomplish these goals, we use a range of clinical and research tools, including:<\/p>\n<h4 data-start=\"310\" data-end=\"364\" style=\"text-align: left;\">Videofluoroscopic Swallowing Imaging<\/h4>\n<p><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM-633x636.png\" alt=\"Still image from x-ray video of swallowing\" width=\"382\" height=\"384\" class=\"alignleft wp-image-294\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM-633x636.png 633w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM-1019x1024.png 1019w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM-150x150.png 150w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM-768x772.png 768w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM-1528x1536.png 1528w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.27.57\u202fPM.png 1592w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/>Videofluoroscopy is one of the <strong>most common tools used to evaluate swallowing<\/strong>. During this test, a person eats and drinks small amounts of food and liquid mixed with a contrast material. An x-ray video is taken while the person swallows, allowing us to watch how food and liquid move through the throat in real time. This test allows us to visualize anatomy, physiology, and bolus movement to evaluate swallowing function and determine the effectiveness of strategies and interventions that improve safety and efficiency. Although videofluoroscopy involves a small amount of radiation, the risk is very low. The radiation exposure from this test is much lower than other types of imaging exams. In fact, it would take more than 40 videofluoroscopy studies to exceed the radiation exposure from a routine chest CT scan.<\/p>\n<h4 data-start=\"310\" data-end=\"364\"><\/h4>\n<p>&nbsp;<\/p>\n<h4 data-start=\"310\" data-end=\"364\"><\/h4>\n<p>&nbsp;<\/p>\n<h4 data-start=\"310\" data-end=\"364\" style=\"text-align: left;\">Cough and Respiratory Measures<\/h4>\n<p><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.44.54\u202fPM-1-636x375.png\" alt=\"Chart showing coughing and breathing measurements collected using spirometry, respiratory plethysmography, and handheld peak flow meters\" width=\"382\" height=\"225\" class=\"alignright wp-image-303\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.44.54\u202fPM-1-636x375.png 636w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.44.54\u202fPM-1-1024x604.png 1024w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.44.54\u202fPM-1-768x453.png 768w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-at-12.44.54\u202fPM-1.png 1208w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/><\/p>\n<p>We measure coughing and breathing using gold-standard tools such as spirometry, respiratory plethysmography, and handheld peak flow meters. These methods allow us to <strong>measure different aspects of coughing and breathing function<\/strong>, such as lung volume or the strength and timing of a cough. We also assess cough sensitivity using small amounts of safe sensory stimuli to understand how the body responds to airway stimulation.<\/p>\n<h4 data-start=\"310\" data-end=\"364\" style=\"text-align: left;\">Brain Imaging<\/h4>\n<p style=\"text-align: left;\"><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-120401-636x436.png\" alt=\"Brain imaging using infrared spectroscopy (fNIRS)\" width=\"382\" height=\"262\" class=\"alignleft wp-image-277\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-120401-636x436.png 636w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/Screenshot-2025-12-12-120401.png 756w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/>Functional near-infrared spectroscopy (fNIRS) is a safe and non-invasive way to <strong>measure brain activity<\/strong>. It uses a soft cap worn on the head and works well during tasks that involve some degree of movement, such as swallowing or coughing. We use fNIRS to study how the brain controls airway protection and how treatment improves brain function. We work closely with collaborators at the <a href=\"https:\/\/www.bu.edu\/neurophotonics\/\" target=\"_blank\" rel=\"noopener noreferrer\">BU Neurophotonics Center<\/a> to use state-of-the-art brain imaging tools to answer these and other research questions.<\/p>\n<h4 data-start=\"310\" data-end=\"364\"><\/h4>\n<h4 data-start=\"310\" data-end=\"364\"><\/h4>\n<h4 data-start=\"310\" data-end=\"364\"><\/h4>\n<p>&nbsp;<\/p>\n<h4 data-start=\"310\" data-end=\"364\"><\/h4>\n<h4 data-start=\"310\" data-end=\"364\" style=\"text-align: left;\">Meta-Science and Causal Modeling<\/h4>\n<p data-start=\"310\" data-end=\"364\"><strong><img loading=\"lazy\" src=\"\/borderslab\/files\/2025\/12\/bayes-636x265.png\" alt=\"\" width=\"382\" height=\"159\" class=\"wp-image-270 alignright\" srcset=\"https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-636x265.png 636w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-1024x427.png 1024w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-768x320.png 768w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-1536x640.png 1536w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-2048x853.png 2048w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-1200x500.png 1200w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-992x413.png 992w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-1500x624.png 1500w, https:\/\/sites.bu.edu\/borderslab\/files\/2025\/12\/bayes-1984x826.png 1984w\" sizes=\"(max-width: 382px) 100vw, 382px\" \/><\/strong>Answering complex questions about airway protection requires science that is rigorous, transparent, and reproducible. To meet these standards, our lab emphasizes areas like <strong>causal inference, statistical modeling, and clinical trial design<\/strong>. We collaborate closely with experts across these disciplines to rigorously address questions such as how swallowing and cough function change over time and which physiologic, cognitive, or treatment-related factors drive improvement.<\/p>\n<p style=\"text-align: left;\">These analytic approaches allow us to move beyond simple correlations and instead interrogate casual mechanisms that meaningfully inform clinical practice. Our lab is equally committed to <strong>meta-science<\/strong>, with the goal of improving how our research is designed, conducted, analyzed, and reported. This includes strengthening the transparency of our work through open science practices, reducing sources of bias, enhancing analytic rigor, and promoting computational reproducibility.<\/p>\n<p style=\"text-align: left;\">Through these efforts, we aim to foster a scientific environment that is open, diverse, and reproducible, ultimately maximizing the impact of our research for patients, clinicians, and care partners.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Understanding Airway Protection Why swallowing and coughing matter for your health People swallow hundreds of times each day during meals, while drinking, or even when they aren\u2019t aware of it. Coughing is just as important, acting as the body\u2019s natural defense to keep the airway clear. Together, swallowing and coughing form what we call airway [&hellip;]<\/p>\n","protected":false},"author":25565,"featured_media":0,"parent":0,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"page-templates\/no-sidebars.php","meta":[],"_links":{"self":[{"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/pages\/17"}],"collection":[{"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/users\/25565"}],"replies":[{"embeddable":true,"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/comments?post=17"}],"version-history":[{"count":51,"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/pages\/17\/revisions"}],"predecessor-version":[{"id":530,"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/pages\/17\/revisions\/530"}],"wp:attachment":[{"href":"https:\/\/sites.bu.edu\/borderslab\/wp-json\/wp\/v2\/media?parent=17"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}