Differential changes in human pharyngoesophageal motor excitability induced by swallowing, pharyngeal stimulation, and anesthesia
Differential changes in human pharyngoesophageal motor excitability induced by swallowing, pharyngeal stimulation, and anesthesia
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DOI：
10.1152/ajpgi.00399.2002
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发表时间：
2003-07-01
影响因子：
4.5
通讯作者：
Hamdy, S
中科院分区：
文献类型：
--
作者：
Fraser, C;Rothwell, J;Hamdy, S
我们研究了吞咽水、咽部刺激和口咽麻醉对皮质延髓和颅延髓向人类吞咽肌肉系统投射的影响。通过肌电图测量通路兴奋性的变化，从吞咽的腔内咽和食管电极到运动脑和三叉神经磁刺激。吞咽水和刺激咽部后，咽食管皮质延髓兴奋性增加（吞咽：咽= 59 +/-12%，P < 0.001;食管= 45 +/-20%，P < 0.05;咽刺激：咽= 76 +/-19%，P < 0.001;食管= 45 +/-23%，P = 0.05），吞咽早，但刺激晚。相比之下，颅延髓兴奋性增加吞咽后早期，但仍然不受咽刺激。麻醉后，皮质延髓（咽部=-24 +/-10%，P < 0.05;食管=-28 +/-7%，P < 0.01）和颅延髓兴奋性均表现出迟发性降低。因此，吞咽诱导短暂的早期促进皮质延髓和颅延髓的预测，而电刺激促进延迟促进主要在皮层。随着输入的移除，皮质延髓和颅延髓投射均显示延迟抑制，这意味着运动神经元和/或皮质活动减少。
We investigated the effects of water swallowing, pharyngeal stimulation, and oropharyngeal anesthesia on corticobulbar and craniobulbar projections to human swallowing musculature. Changes in pathway excitability were measured via electromyography from swallowed intraluminal pharyngeal and esophageal electrodes to motor cerebral and trigeminal nerve magnetic stimulation. After both water swallowing and pharyngeal stimulation, pharyngoesophageal corticobulbar excitability increased ( swallowing: pharynx = 59 +/- 12%, P < 0.001; esophagus = 45 +/- 20%, P < 0.05; pharyngeal stimulation: pharynx = 76 +/- 19%, P < 0.001; esophagus = 45 +/- 23%, P = 0.05), being early with swallowing but late with stimulation. By comparison, craniobulbar excitability increased early after swallowing but remained unaffected by pharyngeal stimulation. After anesthesia, both corticobulbar ( pharynx = - 24 +/- 10%, P < 0.05; esophagus = - 28 +/- 7%, P < 0.01) and craniobulbar excitability showed a late decrease. Thus swallowing induces transient early facilitation of corticobulbar and craniobulbar projections, whereas electrical stimulation promotes delayed facilitation mainly in cortex. With removal of input, both corticobulbar and craniobulbar projections show delayed inhibition, implying a reduction in motoneuron and/or cortical activity.