Clinical Neurophysiology and Neurology, Medical School Hospital, Ege University, Bornova, 35100, Izmir, Turkey.
Dysphagia. 2011 Jun;26(2):183-92. doi: 10.1007/s00455-010-9319-8. Epub 2010 Dec 15.
This review examines the evidence regarding the clinical and neurophysiological differences between voluntary and spontaneous swallows. From the clinical point of view, voluntary swallow (VS) occurs when a human has a desire to eat or drink during the awake and aware state. Spontaneous swallow (SS) is the result of accumulated saliva and/or food remnants in the mouth. It occurs without awareness while awake and also during sleep. VS is a part of eating behavior, while SS is a type of protective reflex action. In VS, there is harmonized and orderly activation of perioral, lingual, and submental striated muscles in the oral phase. In SS, the oral phase is bypassed in most cases, although there may be partial excitation. Following the oral phase, both VS and SS have a pharyngeal phase, which is a reflex phenomenon that protects the upper airway from any escape of food and direct the swallowed material into the esophagus. This reflexive phase of swallowing should not be confused with SS. VS and SS are similar regarding their dependence on the swallowing Central Pattern Generator (CPG) at the brainstem, which receives sensory feedback from the oropharynx. There are differences in the role of the corticobulbar input between VS and SS.
这篇综述检查了自愿性和自发性吞咽之间在临床和神经生理学方面的差异的证据。从临床角度来看，自愿性吞咽（VS）发生在人在清醒和有意识的状态下有进食或饮水的欲望时。自发性吞咽（SS）是由于口腔中积聚的唾液和/或食物残渣引起的。它在清醒时无意识地发生，也在睡眠中发生。VS 是进食行为的一部分，而 SS 是一种保护反射动作。在 VS 中，口腔阶段协调有序地激活口周、舌和颏下横纹肌。在 SS 中，口腔阶段在大多数情况下被绕过，尽管可能有部分兴奋。口腔阶段之后，VS 和 SS 都有咽阶段，这是一种反射现象，可保护上呼吸道免受食物逸出，并将吞咽的物质引导入食管。不应将这种反射性吞咽阶段与 SS 混淆。VS 和 SS 在对脑桥吞咽中枢模式发生器（CPG）的依赖性方面相似，CPG 从口咽部接收感觉反馈。VS 和 SS 之间在皮质延髓输入的作用上存在差异。
