Participation of the nucleus tractus solitarius in the therapeutic effect of electroacupuncture on post‐stroke dysphagia through the primary motor cortex

Abstract

BackgroundPost‐stroke dysphagia (PSD), a common and serious disease, affects the quality of life of many patients and their families. Electroacupuncture (EA) has been commonly used effectively in the treatment of PSD, but the therapeutic mechanism is still under exploration at present. We aim to investigate the effect of the nucleus tractus solitarus (NTS) on the treatment of PSD by EA at Lianquan (CV23) through the primary motor cortex (M1).MethodsC57 male mice were used to construct a PSD mouse model using photothrombotic technique, and the swallowing function was evaluated by electromyography (EMG) recording. C‐Fos‐positive neurons and types of neurons in the NTS were detected by immunofluorescence. Optogenetics and chemical genetics were used to regulate the NTS, and the firing rate of neurons was recorded via multichannel recording.ResultsThe results showed that most of the activated neurons in the NTS were excitatory neurons, and multichannel recording indicated that the activity levels of both pyramidal neurons and interneurons in the NTS were regulated by M1. This process was involved in the EA treatment. Furthermore, while chemogenetic inhibition of the NTS reduced the EMG signal associated with the swallowing response induced by activation of M1 in PSD mice, EA rescued this signal.ConclusionOverall, the NTS was shown to participate in the regulation of PSD by EA at CV23 through M1.

Systematic review and meta-analysis of the efficacy and safety of electroacupuncture for poststroke dysphagia

“…By comparing the effects of administering EA on CV23 and Neiguan (PC6), Ye QP et al found that administering EA on CV23 could regulate the swallowing function by activating swallowing-related interneurons in the ventrolateral medulla oblongata ( 37 ). In addition, in a recent study, Ye QP et al also demonstrated through optogenetics and chemogenetics that the NTS is involved in the regulation of EA on CV23 for PSD, revealing the role of the M1-NTS pathway in EA on CV23 ( 38 ). The latest research shows that in addition to the central nervous system, EA on CV23 can also have an impact on the peripheral nervous system and the local swallowing muscles.…”

The impact of physical therapy on dysphagia in neurological diseases: a review

“…Two parts make up the pattern generator of the swallowing center: (1) the dorsal region consisting of the nucleus tractus solitarius and peripheral neurons; (2) the nucleus and reticular formation surrounding the nucleus are located in the ventral region ( Jang and Kim, 2021 ). Nucleus ambiguous innervates the muscles of the oral cavity, larynx, and pharynx through the trigeminal, facial, glossopharyngeal, vagus, and accessory nerves ( Petko and Tadi, 2023 ; Chandran and Doucet, 2024 ), The nucleus tractus solitary can receive incoming information from the nucleus doubtful and then send efferent fibers to the corresponding muscles, but mainly integrates information from higher cortical centers and peripheral sensory afferents and regulates swallowing according to the nature of the food bolus ( Chandran and Doucet, 2024 ; Ye et al, 2024 ). Overall (see Figure 1 ), the swallowing central pattern generator is responsible for the formation and regulation of swallowing motor sequences, processing incoming information, generating preprogrammed swallowing responses, and distributing appropriate signals to the motor nuclei of cranial nerves and their axons, which are ultimately transmitted to the many muscles involved in swallowing ( Yamamoto et al, 2022 ).…”

“…The nucleus tractus solitary can receive incoming information from the nucleus doubtful and then send efferent fibers to the corresponding muscles, but mainly integrates information from higher cortical centers and peripheral sensory afferents and regulates swallowing according to the nature of the food bolus (Chandran and Doucet, 2024;Ye et al, 2024). Overall (see Figure 1), the swallowing central pattern generator is responsible for the formation and regulation of swallowing motor sequences, processing incoming information, generating preprogrammed swallowing responses, and distributing appropriate signals to the motor nuclei of cranial nerves and their axons, which are ultimately transmitted to the many muscles involved in swallowing (Yamamoto et al, 2022).…”

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“…The nucleus tractus solitary can receive incoming information from the nucleus doubtful and then send efferent fibers to the corresponding muscles, but mainly integrates information from higher cortical centers and peripheral sensory afferents and regulates swallowing according to the nature of the food bolus (Chandran and Doucet, 2024;Ye et al, 2024). Overall (see Figure 1), the swallowing central pattern generator is responsible for the formation and regulation of swallowing motor sequences, processing incoming information, generating preprogrammed swallowing responses, and distributing appropriate signals to the motor nuclei of cranial nerves and their axons, which are ultimately transmitted to the many muscles involved in swallowing (Yamamoto et al, 2022).…”