Functional oropharyngeal sensory disruption interferes with the cortical control of swallowing
Functional oropharyngeal sensory disruption interferes with the cortical control of swallowing
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DOI：
10.1186/1471-2202-8-62
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发表时间：
2007-08-02
期刊：
影响因子：
2.4
通讯作者：
Dziewas, Rainer
中科院分区：
文献类型：
--
作者：
Teismann, Inga K.;Steinstraeter, Olaf;Dziewas, Rainer
背景：感觉输入对吞咽的启动和调节起着至关重要的作用。从临床角度来看，口咽感觉缺陷已被证明是中风患者吞咽困难和吞咽困难的重要原因。因此，在目前的研究中，我们调查了功能性口咽断裂对吞咽的皮质控制的影响。我们使用全头脑磁图研究了10名健康受试者在口咽部局部麻醉和非局部口咽麻醉条件下自主吞咽时的皮质活动。一项简单的吞咽筛选测试证实，在所有受试者中，麻醉导致吞咽困难，吞咽速度减慢，每次吞咽体积减少。用合成孔径磁测法(SAM)对数据进行分析，并对个体SAM数据进行分组分析。结果：正常吞咽分析显示双侧中外侧初级感觉运动皮质激活。口咽麻醉导致感觉和运动活动明显减少。结论：我们的结果提示口咽感觉输入的短期减少阻碍了皮层对吞咽的控制。除了感觉活动减少外，还发现初级运动皮质的激活减少。这些发现有助于我们理解吞咽困难的病理生理学。
Background: Sensory input is crucial to the initiation and modulation of swallowing. From a clinical point of view, oropharyngeal sensory deficits have been shown to be an important cause of dysphagia and aspiration in stroke patients. In the present study we therefore investigated effects of functional oropharyngeal disruption on the cortical control of swallowing. We employed wholehead MEG to study cortical activity during self-paced volitional swallowing with and without topical oropharyngeal anesthesia in ten healthy subjects. A simple swallowing screening-test confirmed that anesthesia caused swallowing difficulties with decreased swallowing speed and reduced volume per swallow in all subjects investigated. Data were analyzed by means of synthetic aperture magnetometry ( SAM) and the group analysis of the individual SAM data was performed using a permutation test.Results: The analysis of normal swallowing revealed bilateral activation of the mid-lateral primary sensorimotor cortex. Oropharyngeal anesthesia led to a pronounced decrease of both sensory and motor activation.Conclusion: Our results suggest that a short- term decrease in oropharyngeal sensory input impedes the cortical control of swallowing. Apart from diminished sensory activity, a reduced activation of the primary motor cortex was found. These findings facilitate our understanding of the pathophysiology of dysphagia.