Toogood Jillian A, Smith Rebecca C, Stevens Todd K, Gati Joe S, Menon Ravi S, Theurer Julie, Weisz Sarah, Affoo Rebecca H, Martin Ruth E
Western University, London, ON, N6A 5B9, Canada.
Dalhousie University, Halifax, Canada.
Dysphagia. 2017 Aug;32(4):526-541. doi: 10.1007/s00455-017-9794-2. Epub 2017 Mar 30.
The present study sought to elucidate the functional contributions of sub-regions of the swallowing neural network in swallowing preparation and swallowing motor execution. Seven healthy volunteers participated in a delayed-response, go, no-go functional magnetic resonance imaging study involving four semi-randomly ordered activation tasks: (i) "prepare to swallow," (ii) "voluntary saliva swallow," (iii) "do not prepare to swallow," and (iv) "do not swallow." Results indicated that brain activation was significantly greater during swallowing preparation, than during swallowing execution, within the rostral and intermediate anterior cingulate cortex bilaterally, premotor cortex (left > right hemisphere), pericentral cortex (left > right hemisphere), and within several subcortical nuclei including the bilateral thalamus, caudate, and putamen. In contrast, activation within the bilateral insula and the left dorsolateral pericentral cortex was significantly greater in relation to swallowing execution, compared with swallowing preparation. Still other regions, including a more inferior ventrolateral pericentral area, and adjoining Brodmann area 43 bilaterally, and the supplementary motor area, were activated in relation to both swallowing preparation and execution. These findings support the view that the preparation, and subsequent execution, of swallowing are mediated by a cascading pattern of activity within the sub-regions of the bilateral swallowing neural network.
本研究旨在阐明吞咽神经网络各子区域在吞咽准备和吞咽运动执行中的功能作用。七名健康志愿者参与了一项延迟反应、执行-不执行的功能磁共振成像研究，该研究涉及四项半随机排序的激活任务：（i）“准备吞咽”，（ii）“自主吞咽唾液”，（iii）“不准备吞咽”，以及（iv）“不吞咽”。结果表明，在双侧吻侧和中间前扣带回皮质、运动前皮质（左侧>右侧半球）、中央周皮质（左侧>右侧半球）以及包括双侧丘脑、尾状核和壳核在内的几个皮质下核团中，吞咽准备期间的脑激活明显大于吞咽执行期间。相比之下，与吞咽准备相比，双侧岛叶和左侧背外侧中央周皮质内与吞咽执行相关的激活明显更大。其他区域，包括双侧更靠下的腹外侧中央周区域、相邻的布罗德曼43区以及辅助运动区，在吞咽准备和执行过程中均被激活。这些发现支持了这样一种观点，即吞咽的准备和随后的执行是由双侧吞咽神经网络各子区域内的级联活动模式介导的。
