Department of Neurology, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
Department of Neurology and Geriatrics, Johanniter Hospital Stendal, Wendstrasse 31, 39576, Hansestadt Stendal, Germany.
Dysphagia. 2023 Jun;38(3):923-932. doi: 10.1007/s00455-022-10517-2. Epub 2022 Sep 10.
Oral stereognosis is the ability to recognize, discriminate and localize a bolus in the oral cavity. Clinical observation indicates deficits in oral stereognosis in patients with vascular or neurodegenerative diseases particularly affecting the parietal lobes. However, the precise neural representation of oral stereognosis remains unclear whereas the neural network of manual stereognosis has already been identified. We hypothesize that oral and manual stereognosis share common neuronal substrates whilst also showing somatotopic distribution. Functional magnetic resonance images (fMRI; Siemens Prisma 3 T) from 20 healthy right-handed participants (11 female; mean age 25.7 years) using a cross-modal task of oral and manual spatial object manipulation were acquired. Data were analyzed using FSL software using a block design and standard analytical and statistical procedures. A conjunction analysis targeted the common neuronal substrate for stereognosis. Activations associated with manual and oral stereognosis were found in partially overlapping fronto-parietal networks in a somatotopic fashion, where oral stereognosis is located caudally from manual stereognosis. A significant overlap was seen in the left anterior intraparietal sulcus. Additionally, cerebellar activations were shown particularly for the oral condition. Spatial arrangement of shaped boli in the oral cavity is associated with neuronal activity in fronto-parietal networks and the cerebellum. These findings have significant implications for clinical diagnostics and management of patients with lesions or atrophy in parietal lobule (e.g. Alzheimer's disease, stroke). More studies are required to investigate the clinical effect of damage to these areas, such as loss of oral stereognosis or an impaired oral phase.
口腔实体觉是指在口腔中识别、区分和定位团块的能力。临床观察表明，血管或神经退行性疾病患者的口腔实体觉受损，特别是影响顶叶的患者。然而，口腔实体觉的确切神经表现仍不清楚，而手动实体觉的神经网络已经确定。我们假设口腔和手动实体觉共享共同的神经元基底，同时也表现出躯体定位分布。使用口腔和手动空间物体操作的跨模态任务，从 20 名健康右利手参与者（11 名女性；平均年龄 25.7 岁）中获取了功能磁共振成像（fMRI；西门子 Prisma 3T）数据。使用 FSL 软件使用块设计和标准分析和统计程序分析数据。联合分析针对实体觉的共同神经元基底。在躯体定位的方式下，在部分重叠的额顶网络中发现了与手动和口腔实体觉相关的激活，其中口腔实体觉位于手动实体觉的尾部。在左侧前内顶叶沟中观察到显著的重叠。此外，还显示出小脑的激活，特别是在口腔条件下。口腔中形状团块的空间排列与额顶网络和小脑的神经元活动有关。这些发现对临床诊断和顶叶叶（如阿尔茨海默病、中风）病变或萎缩患者的管理具有重要意义。需要更多的研究来调查这些区域损伤的临床影响，例如口腔实体觉丧失或口腔阶段受损。
