Suzuki Mikio, Asada Yuko, Ito Jin, Hayashi Kouji, Inoue Hiroshi, Kitano Hiroya
Department of Otolaryngology, Shiga University of Medical Science, Seta, Otsu, Japan.
Dysphagia. 2003 Spring;18(2):71-7. doi: 10.1007/s00455-002-0088-x.
Although regions of the sensorimotor cortex, insula, and anterior cingulate gyrus are reported to be activated during swallowing, findings concerning contributions of the cerebellum and basal ganglia have been contradictory. We investigated cerebellar and basal ganglionic activation using functional magnetic resonance imaging (fMRI). In 11 subjects, single-shot gradient-echo echoplanar image volumes sensitive to BOLD contrast were acquired in block design fashion using an oblique orientation covering both cerebrum and cerebellum. Using statistical parametric mapping, regional activation upon swallowing was observed in the sensorimotor cortex, insula, cerebellum, putamen, globus pallidus, thalamus, anterior cingulate gyrus, supplementary motor area, superior temporal gyrus, and substancia nigra. The cerebellum was activated bilaterally, especially on the left; activation of the putamen and globus pallidus was also found bilaterally. Thus, volitional swallowing involves the cerebellum and basal ganglia as well as cortical structures. The method used was well tolerated by normal subjects and should also be applicable to patients with dysphagia.
尽管据报道，感觉运动皮层、脑岛和前扣带回在吞咽过程中会被激活，但关于小脑和基底神经节的作用的研究结果却相互矛盾。我们使用功能磁共振成像（fMRI）研究了小脑和基底神经节的激活情况。在11名受试者中，采用覆盖大脑和小脑的倾斜方向，以块设计方式采集对BOLD对比敏感的单次激发梯度回波平面图像体积。使用统计参数映射，在感觉运动皮层、脑岛、小脑、壳核、苍白球、丘脑、前扣带回、辅助运动区、颞上回和黑质中观察到吞咽时的区域激活。小脑双侧被激活，尤其是左侧；壳核和苍白球也被发现双侧激活。因此，自主吞咽涉及小脑、基底神经节以及皮质结构。所使用的方法正常受试者耐受性良好，也应该适用于吞咽困难的患者。
