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Cortical control swallowing

Young Hyun Ahn, Hyun-Joo Sohn, Jin-Sung Park, Tae Gyu Ahn, Yong Beom Shin, Minsu Park, Sung-Hwa Ko, Yong-Il Shin
OBJECTIVE: To investigate whether bihemispheric anodal transcranial direct current stimulation (tDCS) with conventional dysphagia therapy could improve swallowing function in chronic stroke patients with dysphagia. DESIGN: Randomized controlled trial. SUBJECTS: Twenty-six patients with dysphagia for at least 6 months post-stroke were randomly assigned into: (i) bihemispheric anodal tDCS group; or (ii) sham group. METHODS: All patients underwent 10 tDCS sessions with simultaneous conventional swallowing therapy for 2 weeks...
January 19, 2017: Journal of Rehabilitation Medicine
Eunhee Park, Min Su Kim, Won Hyuk Chang, Su Mi Oh, Yun Kwan Kim, Ahee Lee, Yun-Hee Kim
BACKGROUND: Optimal protocol of repetitive transcranial magnetic stimulation (rTMS) on post-stroke dysphagia remains uncertain with regard to its clinical efficacy. OBJECTIVE: The aim of the present study is to investigate the effects of high-frequency rTMS at the bilateral motor cortices over the cortical representation of the mylohyoid muscles in the patients with post-stroke dysphagia. METHODS: This study was a single-blind, randomized controlled study with a blinded observer...
August 11, 2016: Brain Stimulation
N Vilardell, L Rofes, W V Nascimento, D Muriana, E Palomeras, P Clavé
BACKGROUND: Cough and swallowing impairments in post-stroke patients (PSP) have been associated with increased risk for respiratory complications. AIMS: To assess the prevalence of alterations in protective cough responses in subacute PSP and its association with oropharyngeal dysphagia (OD), clinical, and neurotopographic stroke factors and clinical outcomes. METHODS: Three months after stroke, the cough reflex test (CRT) was performed by nebulizing incremental citric acid concentrations (7...
January 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Christopher Cabib, Omar Ortega, Hatice Kumru, Ernest Palomeras, Natalia Vilardell, Daniel Alvarez-Berdugo, Desirée Muriana, Laia Rofes, Rosa Terré, Fermín Mearin, Pere Clavé
Oropharyngeal dysphagia (OD) is very prevalent among poststroke patients, causing severe complications but lacking specific neurorehabilitation treatment. This review covers advances in the pathophysiology, diagnosis, and physiologically based neurorehabilitation strategies for poststroke OD. The pathophysiology of oropharyngeal biomechanics can be assessed by videofluoroscopy, as delayed laryngeal vestibule closure is closely associated with aspiration. Stroke may affect afferent or efferent neuronal circuits participating in deglutition...
July 11, 2016: Annals of the New York Academy of Sciences
Aamir Al-Toubi, Stephanie K Daniels, Maggie-Lee Huckabee, David M Corey, Sebastian H Doeltgen
Primary motor networks are known to be involved in the control of voluntary oral movements as well as the modulation of pharyngeal movements during experimentally controlled single swallows performed on command. The role of these networks in the more typical task of sequential swallowing remains unexplored. This study evaluated the hypothesis that experimental disruption of motor cortical activation would reduce the rate and regularity of repeatedly performed volitional or volitionally initiated motor tasks controlled by corticospinal (finger tapping) and corticobulbar (eyebrow movement, jaw opening, volitional sequential swallowing) motor systems, but would not influence a more reflexive corticobulbar task (reflexive sequential swallowing to pharyngeal water infusion)...
October 15, 2016: Physiology & Behavior
Teresa Pitts, Karen Wheeler Hegland, Christine M Sapienza, Donald C Bolser, Paul W Davenport
Movement of a food bolus from the oral cavity into the oropharynx activates pharyngeal sensory mechanoreceptors. Using electroencephalography, somatosensory cortical-evoked potentials resulting from oropharyngeal mechanical stimulation (PSEP) have been studied in young healthy individuals. However, limited information is known about changes in processing of oropharyngeal afferent signals with Parkinson's disease (PD). To determine if sensory changes occurred with a mechanical stimulus (air-puff) to the oropharynx, two stimuli (S1-first; S2-s) were delivered 500ms apart...
July 15, 2016: Respiratory Physiology & Neurobiology
Yaprak Seçil, Şehnaz Arıcı, Tülay Kurt İncesu, Nevin Gürgör, Yeşim Beckmann, Cumhur Ertekin
OBJECTIVE: To investigate electrophysiological parameters of swallowing in all stages of Alzheimer's disease. METHODS: Forty Alzheimer's disease patients, 20 age-matched normal controls and 20 young normal controls were included. Dysphagia limit (DL) and sequential water swallowing (SWS) tests were performed. Cardiac rhythm, respiration and sympathetic skin responses were concomitantly recorded. RESULTS: Dysphagia was found in 30/40 (75%) of Alzheimer's disease patients...
June 2016: Neurophysiologie Clinique, Clinical Neurophysiology
Juan Du, Fang Yang, Ling Liu, Jingze Hu, Biyang Cai, Wenhua Liu, Gelin Xu, Xinfeng Liu
OBJECTIVE: This randomized, sham-controlled, double-blind study was conducted to investigate the effects of high-frequency versus low-frequency repetitive transcranial magnetic stimulation (rTMS) on patients with poststroke dysphagia during early rehabilitation. METHODS: Forty patients with poststroke dysphagia were randomized to receive five daily sessions of sham, 3-Hz ipsilesional, or 1-Hz contralesional rTMS. Swallowing function, the severity of stroke and functional disability, and cortical excitability were examined before, immediately after five daily sessions, as well as the first, second, and third month after the last session...
March 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Camila Dalbosco Gadenz, Tais de Campos Moreira, Dirce Maria Capobianco, Mauriceia Cassol
OBJECTIVE: To systematically review randomized controlled trials that evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on rehabilitation aspects related to communication and swallowing functions. METHODS: A search was conducted on PubMed, Clinical Trials, Cochrane Library, and ASHA electronic databases. Studies were judged according to the eligibility criteria and analyzed by 2 independent and blinded researchers. RESULTS: We analyzed 9 studies: 4 about aphasia, 3 about dysphagia, 1 about dysarthria in Parkinson's disease and 1 about linguistic deficits in Alzheimer's disease...
2015: Folia Phoniatrica et Logopaedica
Silvia Erika Kober, Bettina Gressenberger, Jürgen Kurzmann, Christa Neuper, Guilherme Wood
In the present study, we show for the first time that motor imagery of swallowing, which is defined as the mental imagination of a specific motor act without overt movements by muscular activity, can be successfully used as mental strategy in a neurofeedback training paradigm. Furthermore, we demonstrate its effects on cortical correlates of swallowing function. Therefore, N = 20 healthy young adults were trained to voluntarily increase their hemodynamic response in swallowing related brain areas as assessed with near-infrared spectroscopy (NIRS)...
2015: PloS One
Miranda J Cullins, Jeffrey P Gill, Jeffrey M McManus, Hui Lu, Kendrick M Shaw, Hillel J Chiel
Behavioral variability is ubiquitous [1-6], yet variability is more than just noise. Indeed, humans exploit their individual motor variability to improve tracing and reaching tasks [7]. What controls motor variability? Increasing the variability of sensory input, or applying force perturbations during a task, increases task variability [8, 9]. Sensory feedback may also increase task-irrelevant variability [9, 10]. In contrast, sensory feedback during locust flight or to multiple cortical areas just prior to task performance decreases variability during task-relevant motor behavior [11, 12]...
October 19, 2015: Current Biology: CB
Christy L Ludlow
This review of the central nervous control systems for voice and swallowing has suggested that the traditional concepts of a separation between cortical and limbic and brain stem control should be refined and be more integrative. For voice production, a separation of the nonhuman vocalization system from the human learned voice production system has been posited based primarily on studies of nonhuman primates. However, recent humans studies of emotionally based vocalizations and human volitional voice production have shown more integration between these two systems than previously proposed...
August 2015: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Jonathan D Breshears, Annette M Molinaro, Edward F Chang
OBJECT: The human ventral sensorimotor cortex (vSMC) is involved in facial expression, mastication, and swallowing, as well as the dynamic and highly coordinated movements of human speech production. However, vSMC organization remains poorly understood, and previously published population-driven maps of its somatotopy do not accurately reflect the variability across individuals in a quantitative, probabilistic fashion. The goal of this study was to describe the responses to electrical stimulation of the vSMC, generate probabilistic maps of function in the vSMC, and quantify the variability across individuals...
August 2015: Journal of Neurosurgery
Xiao-Dong Yuan, Li-Fu Zhou, Shu-Juan Wang, Yan-Sheng Zhao, Xiao-Jie Wang, Li-Li Zhang, Shou-Hong Wang, Ya-Jie Zhang, Li Chen
We speculate that cortical reactions evoked by swallowing activity may be abnormal in patients with central infarction with dysphagia. The present study aimed to detect functional imaging features of cerebral cortex in central dysphagia patients by using blood oxygen level-dependent functional magnetic resonance imaging techniques. The results showed that when normal controls swallowed, primary motor cortex (BA4), insula (BA13), premotor cortex (BA6/8), supramarginal gyrus (BA40), and anterior cingulate cortex (BA24/32) were activated, and that the size of the activated areas were larger in the left hemisphere compared with the right...
March 2015: Neural Regeneration Research
Anne-Sophie Windel, Paul Glad Mihai, Martin Lotze
We investigated the neural representation of swallowing in two age groups for a total of 51 healthy participants (seniors: average age 64 years; young adults: average age 24 years) using high spatial resolution functional magnetic resonance imaging (fMRI). Two statistical comparisons (classical and Bayesian inference) revealed no significant differences between subject groups, apart from higher cortical activation for the seniors in the frontal pole 1 of Brodmann's Area 10 using Bayesian inference. Seniors vs...
June 1, 2015: Behavioural Brain Research
Balaji Rangarathnam, Erin Kamarunas, Gary H McCullough
The objective of this review is to gather available evidence regarding the role of the cerebellum in swallowing-related functions. We reviewed literature on cerebellar functions related to healthy swallowing, patterns of dysphagia in individuals with cerebellar lesions, and the role of the cerebellum in therapeutic intervention of neurogenic dysphagia since 1980. A collective understanding of these studies suggests that both hemispheres of the cerebellum, predominantly the left, participate in healthy swallowing...
December 2014: Cerebellum
Phoebe R Macrae, Richard D Jones, Maggie-Lee Huckabee
Transcranial magnetic stimulation (TMS) has been used extensively as a method of investigating the corticomotor physiology of many motor tasks, including healthy and disordered swallowing. Changes in excitability of cortical projections to various swallowing muscles have been documented in response to treatments with TMS induced motor evoked potentials (MEPs). These studies have provided valuable insight into CNS response to swallowing impairment, and more importantly, the adaptations associated with functional recovery...
August 15, 2014: Journal of Neuroscience Methods
Mary Hägg, Lita Tibbling
This study aims to examine any motility disturbance in any quadrant of the face other than the quadrant innervated by the lower facial nerve contralateral to the cortical lesion after stroke. Thirty-one stroke-afflicted patients with subjective dysphagia, consecutively referred to a swallowing centre, were investigated with a facial activity test (FAT) in all four facial quadrants and with a swallowing capacity test (SCT). Fifteen healthy adult participants served as FAT controls. Sixteen patients were judged to have a central facial palsy (FP) according to the referring physician, but all 31 patients had a pathological FAT in the lower quadrant contralateral to the cortical lesion...
2014: Neurology Research International
Sriramya Somasundaram, Christian Henke, Tobias Neumann-Haefelin, Stefan Isenmann, Elke Hattingen, Matthias W Lorenz, Oliver C Singer
BACKGROUND AND PURPOSE: Bedside evaluation of dysphagia may be challenging in left middle cerebral artery (MCA) stroke due to frequently existing aphasia. Here we analyse the predictive value of common bedside screening tests and of two items of cortical dysfunction, aphasia and buccofacial apraxia (BFA), for the detection of dysphagia. METHODS: We prospectively examined 67 consecutive patients with clinical and imaging evidence of acute (<72 h) left MCA stroke...
2014: Cerebrovascular Diseases
Sonja Suntrup, Inga Teismann, Andreas Wollbrink, Tobias Warnecke, Martin Winkels, Christo Pantev, Rainer Dziewas
OBJECTIVE: Current neuroimaging research on functional disturbances provides growing evidence for objective neuronal correlates of allegedly psychogenic symptoms, thereby shifting the disease concept from a psychological towards a neurobiological model. Functional dysphagia is such a rare condition, whose pathogenetic mechanism is largely unknown. In the absence of any organic reason for a patient's persistent swallowing complaints, sensorimotor processing abnormalities involving central neural pathways constitute a potential etiology...
2014: PloS One
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