Miller Arthur J
Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, California 94143-0438, USA.
Dev Disabil Res Rev. 2008;14(2):77-86. doi: 10.1002/ddrr.12.
The neurobiological study of swallowing and its dysfunction, defined as dysphagia, has evolved over two centuries beginning with electrical stimulation applied directly to the central nervous system, and then followed by systematic investigations that have used lesioning, transmagnetic stimulation, magnetoencephalography, and functional magnetic resonance imaging. The field has evolved from mapping the central neural pathway and peripheral nerves, to defining the importance of specific regions of the lower brain stem in terms of interneurons that provide sequential control for multiple muscles in the most complex reflex elicited by the nervous system, the pharyngeal phase of swallowing. The field is now emerging into defining how the higher cortical regions interact with this brain stem control and is providing a broader perspective of how the intact nervous system functions to control the three phases of swallowing (i.e., oral, pharyngeal, and esophageal). Much of the present interest focuses on how to retrain a damaged nervous system using a variety of stimulus techniques, which follow fundamentals in rehabilitation of the nervous system.
吞咽及其功能障碍（定义为吞咽困难）的神经生物学研究已经历经了两个多世纪的发展。最初是直接对中枢神经系统进行电刺激，随后是一系列系统研究，这些研究采用了损伤法、经磁刺激、脑磁图以及功能磁共振成像等技术。该领域已经从绘制中枢神经通路和外周神经，发展到确定脑干下部特定区域的重要性，这些区域通过中间神经元对神经系统引发的最复杂反射（吞咽的咽部阶段）中的多块肌肉提供顺序控制。目前，该领域正朝着明确高级皮质区域如何与这种脑干控制相互作用的方向发展，并为完整的神经系统如何控制吞咽的三个阶段（即口腔、咽部和食管阶段）提供更广阔的视角。当前，许多研究兴趣集中在如何运用各种刺激技术对受损神经系统进行再训练，这些技术遵循神经系统康复的基本原理。
