The functional neuroanatomy of voluntary swallowing
The functional neuroanatomy of voluntary swallowing
复制标题
自主吞咽的功能神经解剖学
作者：
D. Zald;J. Pardo
吞咽是一个复杂的生理过程，涉及自愿和反射性运动活动、感觉运动整合、流涎和内脏调节。尽管正常吞咽需要许多过程，但吞咽中枢控制的传统模型只强调脑干和下中央前回（IPCG）的参与。然而，许多涉及其他大脑区域的神经系统疾病也会导致吞咽困难。为了确定参与自主吞咽的大脑区域，我们用正电子发射断层扫描（PET）测定了健康人类受试者吞咽、横向舌头运动或闭眼休息时的区域脑血流量（rCBF）。自主吞咽在双侧 IPCG、右前岛叶/屏状体和左小脑内产生了强烈的 rCBF 增加。这些区域的最大值与横向舌头运动引起的最大值不同。吞咽还会导致壳核、丘脑和其他几个皮质区域的 rCBF 增加，但这些病灶与舌头运动期间产生的活动没有明显区别。这些发现表明吞咽涉及大规模分布式神经网络的募集，其中包括前岛叶和小脑。该网络的分布式性质有助于解释为什么如此多的神经系统疾病会导致吞咽困难。
Swallowing is a complex physiological process involving voluntary and reflexive motor activity, sensorimotor integration, salivation, and visceral regulation. Despite the numerous processes required for normal deglutition, traditional models of the central control of swallowing only emphasize the involvement of the brainstem and the inferior precentral gyrus (IPCG). However a number of neurological disorders involving other brain regions also cause dysphagia. To determine the brain regions participating in voluntary swallowing, we assayed regional cerebral blood flow (rCBF) with positron emission tomography (PET) while healthy human subjects swallowed, performed lateral tongue movements, or rested with their eyes closed. Voluntary swallowing produced strong rCBF increases within the IPCG bilaterally, the right anterior insula/claustrum, and the left cerebellum. The maxima in these regions differed from those induced by lateral tongue movements. Swallowing also produced rCBF increases in the putamen, thalamus, and several additional cortical areas, but these foci were not as clearly distinguishable from activity arising during tongue movements. These findings indicate that swallowing involves the recruitment of a large‐scale distributed neural network that includes the anterior insula and cerebellum. The distributed nature of this network helps to explain why so many neurological conditions produce dysphagia.
DOI：
10.1044/jshr.3705.1041
发表时间：
1994-10-01
期刊：
JOURNAL OF SPEECH AND HEARING RESEARCH
影响因子：
--
作者：
BISCH, EM;LOGEMANN, JA;LAZARUS, CL
通讯作者：
LAZARUS, CL
DOI：
10.1016/0003-9993(93)90063-g
发表时间：
1993-10-01
影响因子：
4.3
作者：
LAZARUS, CL;LOGEMANN, JA;HALPER, A
通讯作者：
HALPER, A
解剖标准化：功能性大脑图像的线性缩放和非线性变形。
DOI：
--
发表时间：
1994
期刊：
Journal of nuclear medicine : official publication, Society of Nuclear Medicine
影响因子：
--
作者：
Minoshima,S;Koeppe,RA;Frey,KA;Kuhl,DE
通讯作者：
Kuhl,DE