South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630, China.
Nat Commun. 2023 Feb 13;14(1):810. doi: 10.1038/s41467-023-36448-6.
As a traditional medical therapy, stimulation at the Lianquan (CV23) acupoint, located at the depression superior to the hyoid bone, has been shown to be beneficial in dysphagia. However, little is known about the neurological mechanism by which this peripheral stimulation approach treats for dysphagia. Here, we first identified a cluster of excitatory neurons in layer 5 (L5) of the primary motor cortex (M1) that can regulate swallowing function in male mice by modulating mylohyoid activity. Moreover, we found that focal ischemia in the M1 mimicked the post-stroke dysphagia (PSD) pathology, as indicated by impaired water consumption and electromyographic responses in the mylohyoid. This dysfunction could be rescued by electroacupuncture (EA) stimulation at the CV23 acupoint (EA-CV23) in a manner dependent on the excitatory neurons in the contralateral M1 L5. Furthermore, neuronal activation in both the parabrachial nuclei (PBN) and nucleus tractus solitarii (NTS), which was modulated by the M1, was required for the ability of EA-CV23 treatment to improve swallowing function in male PSD model mice. Together, these results uncover the importance of the M1-PBN-NTS neural circuit in driving the protective effect of EA-CV23 against swallowing dysfunction and thus reveal a potential strategy for dysphagia intervention.
作为一种传统的医学疗法,刺激位于舌骨上方凹陷处的廉泉(CV23)穴位已被证明对吞咽困难有益。然而,对于这种外周刺激方法治疗吞咽困难的神经机制知之甚少。在这里,我们首先确定了一组位于初级运动皮层(M1)第 5 层(L5)的兴奋性神经元,通过调节颏舌肌的活动来调节雄性小鼠的吞咽功能。此外,我们发现 M1 中的局灶性缺血模拟了中风后吞咽困难(PSD)的病理,表现为颏舌肌的水摄入量和肌电图反应受损。这种功能障碍可以通过 CV23 穴位的电针(EA)刺激(EA-CV23)来挽救,这种挽救方式依赖于对侧 M1 L5 中的兴奋性神经元。此外,M1 调节的臂旁核(PBN)和孤束核(NTS)中的神经元激活对于 EA-CV23 治疗改善雄性 PSD 模型小鼠吞咽功能的能力是必需的。总之,这些结果揭示了 M1-PBN-NTS 神经回路在驱动 EA-CV23 对吞咽功能障碍的保护作用中的重要性,从而为吞咽困难的干预提供了一种潜在策略。
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