Characterising the central mechanisms of sensory modulation in human swallowing motor cortex
Characterising the central mechanisms of sensory modulation in human swallowing motor cortex
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DOI：
10.1016/j.clinph.2004.05.017
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发表时间：
2004-10-01
影响因子：
4.7
通讯作者：
Hamdy, S
中科院分区：
文献类型：
--
作者：
Gow, D;Hobson, AR;Hamdy, S
目的：咽部刺激可以引起吞咽运动皮层的兴奋性显著增加，这与吞咽困难卒中患者吞咽行为的短期改善有关。然而，这种输入诱导皮层变化的机制仍不清楚。我们的目的是探索刺激诱导的皮质-延髓投射对吞咽肌肉组织的促进作用，并检查来自咽部的输入如何与吞咽运动皮质相互作用。在8名健康受试者中，进行了经颅磁刺激（TMS）配对脉冲调查，包括单一条件化咽部电刺激（脉冲宽度0.2 ms，240 V），然后以10- 100 ms的刺激间间期（ISI）进行皮层TMS。咽部感觉诱发电位（PSEP）也进行了测量的顶点。结果：在ISI为50 ~ 80 ms时，咽部刺激可使TMS诱发的咽部运动诱发电位易化（Delta平均增加47 ± 6%，P < 0.05）。这与PSEP的PI分量的峰值潜伏期（平均79.6 ± 8.5 ms）相关。脑磁图证实，相当于PI峰活动定位于尾外侧感觉和运动皮质（BA 4，1，2）.结论：咽部刺激对皮质-延髓通路的易化作用与感觉运动皮质的同步传入有关。这些发现对于咽部刺激如何增加运动兴奋性具有重要的机制意义，并为将来的吞咽操作提供了时间窗指导运动皮层(C)2004年国际临床神经生理学联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: Pharyngeal stimulation can induce remarkable increases in the excitability of swallowing motor cortex, which is associated with short-term improvements in swallowing behaviour in dysphagic stroke patients. However, the mechanism by which this input induces cortical change remains unclear. Our aims were to explore the stimulus-induced facilitation of the cortico-bulbar projections to swallowing musculature and examine how input from the pharynx interacts with swallowing motor cortex.Methods: In 8 healthy subjects, a transcranial magnetic stimulation (TMS) paired-pulse investigation was performed comprising a single conditioning electrical pharyngeal stimulus (pulse width 0.2 ms, 240 V) followed by cortical TMS at inter-stimulus intervals (ISI) of 10-100ms. Pharyngeal sensory evoked potentials (PSEP) were also measured over the vertex. In 6 subjects whole-brain magnetoencephalography (MEG) was further acquired following pharyngeal stimulation.Results: TMS evoked pharyngeal motor evoked potentials were facilitated by the pharyngeal stimulus at ISI between 50 and 80 ms (Delta mean increase: 47 +/- 6%, P < 0.05). This correlated with the peak latency of the PI component of the PSEP (mean 79.6 +/- 8.5 ms). MEG confirmed that the equivalent PI peak activities were localised to caudolateral sensory and motor cortices (BA 4, 1, 2).Conclusions: Facilitation of the cortico-bulbar pathway to pharyngeal stimulation relates to coincident afferent input to sensorimotor cortex.Significance: These findings have mechanistic importance on how pharyngeal stimulation may increase motor excitability and provide guidance on temporal windows for future manipulations of swallowing motor cortex. (C) 2004 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.