Dysphagia Due to Unilateral Infarction in the Vascular Territory of the Anterior Insula

Riecker, Axel; Gastl, Regina; Kühnlein, Peter; Kassubek, Jan; Prosiegel, Mario

doi:10.1007/s00455-008-9164-1

Cited by 38 publications

(29 citation statements)

References 15 publications

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“…28,29 A recent intracortical microstimulation study found that stimulation of the anterior sector of the dorsal insula triggered swallowing, mouthing, and chewing in monkeys. 30 Oroalimentary behavior, including motor automatisms, has been described during epileptic seizures originating in this part of the insula.…”

Section: Neuroanatomical Predictors Of Acute Risk Of Aspirationmentioning

confidence: 99%

“…31 Stroke patients with discrete lesions of the anterior insula have been shown to suffer from dysphagia in small case studies. 28,29 Furthermore, sensory and motor signaling from and to various areas might be mediated by the insula (eg, interacting with the oropharynx and the esophagus). 32 A magnetoencephalographic study demonstrated consistent long-lasting activation of the insular cortex before swallowing.…”

Section: Neuroanatomical Predictors Of Acute Risk Of Aspirationmentioning

confidence: 99%

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Lesion Location Predicts Transient and Extended Risk of Aspiration After Supratentorial Ischemic Stroke

Galovic

Leisi

Müller

et al. 2013

Stroke

100

108

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Section: Neuroanatomical Predictors Of Acute Risk Of Aspirationmentioning

confidence: 99%

Section: Neuroanatomical Predictors Of Acute Risk Of Aspirationmentioning

confidence: 99%

Lesion Location Predicts Transient and Extended Risk of Aspiration After Supratentorial Ischemic Stroke

Galovic

Leisi

Müller

et al. 2013

Stroke

100

108

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show abstract

“…First, several clinical and functional imaging data point at a contribution of intrasylvian cortex to swallowing. For example, an investigation of patients with unilateral damage to the insular cortex was able to document dysphagia in all three cases with infarction of the anterior insula, whereas a subject who had suffered ischemia of posterior intrasylvian cortex did not exhibit any swallowing problems (Daniels and Foundas 1997; for further evidence see Riecker et al 2009). And, second, several case studies noted the presence of bucco-facial apraxia in patients suffering from, by and large, circumscribed uni-or bilateral insular lesions (Habib et al 1995;Nagao et al 1999).…”

Section: Participation Of the Anterior Insula In The Control Of Non-smentioning

confidence: 99%

The contribution(s) of the insula to speech production: a review of the clinical and functional imaging literature

2010

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Skilled spoken language production requires fast and accurate coordination of up to 100 muscles. A long-standing concept--tracing ultimately back to Paul Broca--assumes posterior parts of the inferior frontal gyrus to support the orchestration of the respective movement sequences prior to innervation of the vocal tract. At variance with this tradition, the insula has more recently been declared the relevant "region for coordinating speech articulation", based upon clinico-neuroradiological correlation studies. However, these findings have been criticized on methodological grounds. A survey of the clinical literature (cerebrovascular disorders, brain tumours, stimulation mapping) yields a still inconclusive picture. By contrast, functional imaging studies report more consistently hemodynamic insular responses in association with motor aspects of spoken language. Most noteworthy, a relatively small area at the junction of insular and opercular cortex was found sensitive to the phonetic-linguistic structure of verbal utterances, a strong argument for its engagement in articulatory control processes. Nevertheless, intrasylvian hemodynamic activation does not appear restricted to articulatory processes and might also be engaged in the adjustment of the autonomic system to ventilatory needs during speech production: Whereas the posterior insula could be involved in the cortical representation of respiration-related metabolic (interoceptive) states, the more rostral components, acting upon autonomic functions, might serve as a corollary pathway to "voluntary control of breathing" bound to corticospinal and -bulbar fiber tracts. For example, the insula could participate in the implementation of task-specific autonomic settings such as the maintenance of a state of relative hyperventilation during speech production.

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“…With respect to its cortical representation, the following representational sites have been described: bilateral inferior pre-and postcentral gyri (39,59), bilateral anterior insula (25,26,51), anterior cingulate cortex (59), bilateral temporal pole, and the supplementary motor area (SMA) (23,45). Opercular areas are lateralized to the left dominant hemisphere (40,41).…”

mentioning

confidence: 99%

Differentiation of cerebral representation of occlusion and swallowing with fMRI

Mihai

Halbach

Lotze

2013

American Journal of Physiology-Gastrointestinal and Liver Physi

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Mihai PG, von Bohlen und Halbach O, Lotze M. Differentiation of cerebral representation of occlusion and swallowing with fMRI. Am J Physiol Gastrointest Liver Physiol 304: G847-G854, 2013. First published March 14, 2013 doi:10.1152/ajpgi.00456.2012.-Early work on representational specificity and recent findings on temporomandibular joint (TMJ) movement representation raise doubts that a specific swallow representation does exist. Additionally, during cortical stimulation TMJ movements and swallowing show a high overlap of representational areas in the primary motor cortex. It has thus been hypothesized that they overall might share the same neural structures. To differentiate these two movements, we performed a functional MRI (fMRI) study that enabled a direct comparison of functional representation of both actions in the same subject group. Effort during these tasks was controlled by skin conductance response. When balancing effort, we found a comparable neural representation pattern for both tasks but increased resources necessary to perform swallowing in direct comparison between tasks. For the first time, with the usage of fMRI, we demonstrated a representation in the brainstem for swallowing and occlusion. Increased activation for swallowing was observed in bilateral sensorimotor cortex, bilateral premotor and supplementary motor cortex, motor cingulate, thalamus, cerebellar hemispheres, left pallidum, bilateral pons, and midbrain. Peaks of activation in primary motor cortex between both conditions were about 5 mm adjacent. Brainstem activation was found corresponding to the sensory nucleus of the trigeminal nerve, the solitary nucleus for swallowing, and the trigeminal nucleus for occlusion. Our data suggest that cerebral representation of occlusion and swallowing are spatially widely overlapping, differing predominantly with respect to the quantity of neural resources involved. Both brainstem and primary motor representation differ in location with respect to somatotopy and contribution of cranial nerve nuclei.

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Dysphagia Due to Unilateral Infarction in the Vascular Territory of the Anterior Insula

Cited by 38 publications

References 15 publications

Lesion Location Predicts Transient and Extended Risk of Aspiration After Supratentorial Ischemic Stroke

Lesion Location Predicts Transient and Extended Risk of Aspiration After Supratentorial Ischemic Stroke

The contribution(s) of the insula to speech production: a review of the clinical and functional imaging literature

Differentiation of cerebral representation of occlusion and swallowing with fMRI

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