口吃样吞咽：右侧脑岛电刺激会干扰水吞咽。病例报告。
Stuttered swallowing: electric stimulation of the right insula interferes with water swallowing. A case report.
机构信息
School of Communication Sciences and Disorders, University of Western Ontario, London, Ontario, Canada.
出版信息
BMC Neurol. 2011 Feb 5;11:20. doi: 10.1186/1471-2377-11-20.
BACKGROUND
Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear.
CASE PRESENTATION
Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA) was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity.
CONCLUSIONS
These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.
背景
各种功能磁共振成像、脑磁图和病变研究表明，脑岛皮层参与了吞咽的控制。然而，吞咽过程中脑岛激活的确切位置及其功能意义仍不清楚。
病例介绍
对一名 24 岁男子进行了侵入性脑电图监测，该男子因神经节细胞瘤而患有药物难治性刻板夜间多动性癫痫发作。在使用深部电极刺激右侧下后脑岛皮层时，患者自发报告有一种“吞咽卡顿感”。以最高强度（4 mA）刺激下后脑岛皮层也与不规则和延迟的吞咽有关。刺激上后脑岛皮层时，无论刺激强度如何，吞咽均未受损。
结论
这些结果表明，右侧下后脑岛皮层参与了吞咽控制的神经回路。
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