The role of the cerebral cortex in swallowing.
ABSTRACT This paper reviews clinical, neuroanatomical, and neurophysiological studies that have implicated the cerebral cortex in the initiation and/or regulation of swallowing as well as related functions such as mastication. Cortical dysfunction has been reported to result in a variety of swallowing impairments. Furthermore, swallowing can be evoked and/or modulated by stimulation applied to restricted regions of the cortex. Neuroanatomical investigations and single neuron recording studies also provide some insights into the cortical structures, pathways, and mechanisms that may mediate deglutition.
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ABSTRACT: The corticobulbar projection to the hypoglossal nucleus was studied from the frontal, parietal, cingulate and insular cortices in the rhesus monkey using high-resolution anterograde tracers and stereology. The hypoglossal nucleus received bilateral input from the face/head region of the primary (M1), ventrolateral pre- (LPMCv), supplementary (M2), rostral cingulate (M3), and caudal cingulate (M4) motor cortices. Additional bilateral corticohypoglossal projections were found from the dorsolateral premotor cortex (LPMCd), ventrolateral proisocortical motor area (ProM), ventrolateral primary somatosensory cortex (S1), rostral insula and pregenual region of the anterior cingulate gyrus (areas 24/32). Dense terminal projections arose from the ventral region of M1, moderate projections from LPMCv and rostral part of M2, with considerably less hypoglossal projections arising from the other cortical regions. These findings demonstrate that extensive regions of the non-human primate cerebral cortex innervate the hypoglossal nucleus. The widespread and bilateral nature of this corticobulbar connection suggests recovery of tongue movement after cortical injury that compromises a subset of these areas, may occur from spared corticohypoglossal projection areas located on the lateral, as well as medial surfaces of both hemispheres. Since functional imaging studies have shown that homologous cortical areas are activated in humans during tongue movement tasks, these corticobulbar projections may exist in the human brain. J. Comp. Neurol., 2014. © 2014 Wiley Periodicals, Inc.The Journal of Comparative Neurology 04/2014; · 3.51 Impact Factor
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ABSTRACT: To determine predictors of early recovery of functional swallow in patients who had gastrostomy (percutaneous endoscopic gastrostomy [PEG]) placement for dysphagia and were discharged to inpatient rehabilitation (IPR) after stroke.Annals of rehabilitation medicine. 08/2014; 38(4):467-75.
Conference Paper: Occurrences of Yawn and Swallow are Temporally Related[Show abstract] [Hide abstract]
ABSTRACT: Objective: Yawning and swallowing are mediated by brainstem circuits and recruit the upper aerodigestive tract musculature. Yawning may be associated with increased salivation, which in turn may elicit swallowing. Therefore, this study tested the hypothesis that occurrences of yawning and swallowing are temporally related. Method: Contagious yawning was evoked in 14 healthy adults (mean ± SD age: 25.1 ± 3.3 years; 8 female) who were blinded to the study hypothesis. Following a pre-treatment baseline period, the subjects viewed videotaped images of human yawning or mouth-opening (i.e., gape) during 2 experimental conditions, each followed by a baseline period: (1) yawn video viewing, (2) post-yawn-video baseline, (3) gape video viewing, and (4) post-gape-video baseline. Lateral-view video images of the subject’s head, neck and torso, as well as laryngeal and respiratory movement and neck acoustic signals, were recorded throughout all baseline and treatment conditions. Two blinded, trained judges independently analyzed the video data for all motor behaviors; swallows identified from the video analysis were subsequently verified through blinded physiologic data analysis. Result: The number of yawns produced during the entire experimental protocol of ~60 min was 12.6 ± 8.3 (mean ± SD). Overall, 82% of yawns were followed by a swallow within 10 seconds, with a yawn-swallow latency of 4.4 ± 1.7 seconds (mean ± SD). Moreover, the swallowing rate during the 10-second period immediately following yawning was approximately five times greater than the swallowing rate calculated over the remaining periods during which yawning did not occur (4.1 ± 1.4 versus 0.8 ± 0.4 swallow/min, means ± SD, p<0.001). Conclusion: These findings establish that occurrences of yawning and swallowing are temporally related. Therefore, stimulation of yawning may have potential as a clinical approach to facilitating swallowing in dysphagic populations.IADR General Session 2012; 06/2012