Centre for Gastrointestinal Sciences, Division of Diabetes, Gastroenterology and Endocrinology, School of Medical Sciences, University of Manchester, UK.
Department of Organismal Biology and Anatomy, University of Chicago, USA.
J Neurol Sci. 2022 Nov 15;442:120434. doi: 10.1016/j.jns.2022.120434. Epub 2022 Sep 23.
This review aims to update the current knowledge on the cerebral control of swallowing. We review data from both animal and human studies spanning across the fields of neuroanatomy, neurophysiology and neuroimaging to evaluate advancements in our understanding in the brain's role in swallowing. Studies have collectively shown that swallowing is mediated by multiple distinct cortical and subcortical regions and that lesions to these regions can result in dysphagia. These regions are functionally connected in separate groups within and between the two hemispheres. While hemispheric dominance for swallowing has been reported in most human studies, the laterality is inconsistent across individuals. Moreover, there is a shift in activation location and laterality between swallowing preparation and execution, although such activation changes are less well-defined than that for limb motor control. Finally, we discussed recent neurostimulation treatments that may be beneficial for dysphagia after brain injury through promoting the reorganization of the swallowing neural network.
本篇综述旨在更新目前对于吞咽的大脑控制的相关知识。我们回顾了跨越神经解剖学、神经生理学和神经影像学领域的动物和人类研究数据,以评估我们对大脑在吞咽中作用的理解的进展。研究表明,吞咽是由多个不同的皮质和皮质下区域介导的,这些区域的损伤会导致吞咽困难。这些区域在两个半球内和半球之间的不同组中具有功能连接。虽然大多数人类研究报告了吞咽的大脑半球优势,但个体之间的偏侧性并不一致。此外,在吞咽准备和执行之间,激活位置和偏侧性发生了转移,尽管这种激活变化不如肢体运动控制那样明确。最后,我们讨论了最近的神经刺激治疗方法,这些方法可能通过促进吞咽神经网络的重组,对脑损伤后的吞咽困难有益。