Functional Imaging of the cereberal representation of swallowing; MR-kinematic and functional MR-tomographic investigations during swallowing movements in young and elderly healthy individuals and in patients after restitution of swallowing.

吞咽的神经控制由协调自主运动、感觉刺激和反射运动模式的复杂网络组成。吞咽控制的复杂性通常导致脑损伤后吞咽功能受损。从临床方面来看，识别和治疗吞咽困难至关重要，因为未被发现的误吸可能会导致复发性肺炎导致死亡。准确了解吞咽表征及其差异有形子过程有助于提高诊断。目前，这种诊断被简化为临床症状。虽然吞咽的大脑表征可以通过功能成像来检测，但仍然缺乏重要的细节来理解它，尤其是脑干，没有关于中枢模式发生器的功能磁共振成像（fMRI）数据。在第一个资助期间，我们确定了脑干中的主要控制中心。其次，关于吞咽的特异性相比，下颌运动，我们证明了重叠和差异的代表性。第三，目前还不清楚吞咽表征的时间相互作用如何与口腔和咽相的区别相关，这是治疗和诊断目的的一个重要方面。这是特别真实的其他代表性领域，而不是初级感觉运动皮层的脑磁图数据。我们研究了吞咽过程解剖学与电影序列。这些过程然后被放在上下文中与功能磁共振成像激活地图使用压力传感器的喉部。因此，有可能区分口咽期和口咽期的控制过程。在剩余的资助期内，目前正在优化现有方法，并将其与一组老年和年轻的健康受试者进行比较。在新的资助期间，我们将使用在健康受试者身上优化的方法和发现来表征吞咽困难后吞咽恢复后患者的吞咽控制。这将在空间和时间上表征。扩大了急性神经科和耳鼻喉科门诊的合作，以帮助我们找到更多的病人。

Neural control of swallowing consists of complex networks which coordinate voluntary movement, sensory stimuli and reflective movement patterns. The complexity of swallowing control often results in an impairment of swallowing after cerebral damage. From a clinical aspect it is crucial to identify and treat dysphagia, since undetected aspiration can lead to mortality due to recurrent pneumonia. Accurate knowledge of swallowing representation and their differentially tangible subprocesses could help to enhance the diagnosis. Currently this diagnosis is reduced to clinical symptoms. Although the cerebral representation of swallowing can be detected using functional imaging, there is still a lack of important details to understand it. This is especially true for the brainstem, where no functional magnetic resonance imaging (fMRI) data on central pattern generators has been produced. During the first funding period we identified the main control centers in the brainstem. Secondly, concerning the specificity of swallowing compared to jaw movements, we demonstrated an overlapping and differential representation. Thirdly, it is unclear how the temporal interaction of swallowing representation correlates with the distinction of the oral and pharyngeal phase, an important aspect for therapy and diagnosis purposes. This is especially true for other representation areas than the primary sensorimotor cortex for which magnetoencephalography data are available. We investigated the swallowing processes anatomically with a cinematographic sequence. These processes were then put in context with the fMRI activation maps using a pressure transducer on the larynx. It was thus possible to differentiate the control processes of the oral and esopharyngeal phase. In the remaining funding period the current approach is now being optimized and compared to a group of old and young healthy subjects. During the new funding period we will use the methods and findings optimized on the healthy subjects to characterize the swallowing control of patients after restitution of swallowing following dysphagia. This will be characterized both spatially and temporally. The cooperation of the acute neurology and ENT clinic was expanded to aid us in finding a larger amount of patients.