Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

Sörös, Peter; Wong, Simon S.; Shoemaker, J. Kevin; Mirsattari, Seyed M.; Hachinski, Vladimir; Martin, Ruth Elwood

doi:10.1186/1471-2377-11-20

Cited by 12 publications

(7 citation statements)

References 32 publications

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“…For example, Singh et al have described a patient who presented with dysphagia after acute or subacute infarction involving the bilateral insular cortex [32]. In addition, Soros et al have reported that electrical stimulation of the right insular cortex results in irregular and delayed swallowing in a patient with epilepsy [33]. Similar to these reports, it was previously revealed that electrical stimulation of the insular cortex evokes swallowing in anaesthetized rats [34].…”

Section: Neural Circuit For Swallowingmentioning

confidence: 79%

Evaluation of the association between orofacial pain and dysphagia

Tsujimura

Inoue

2020

J Oral Sci

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Swallowing has a vital function in airway protection and is the next step after mastication. Swallowing impairment, which is known as dysphagia, is frequently accompanied by pain. Previous clinical studies have shown that orofacial pain affects swallowing function. Thus, it was hypothesized that orofacial noxious inputs may modulate swallowing function. Previous studies using anesthetized animals has proposed that the facial skin-nucleus tractus solitarii (NTS), masseter muscle-NTS, lingual muscle-NTS, and lingual muscle-paratrigeminal nucleus-NTS pathways may be involved in the inhibition of swallowing caused by facial, masseter, and lingual pain. Moreover, the activation of gamma-aminobutyric acidergic NTS neurons is involved in the inhibition of the swallowing reflex following trigeminal noxious inputs. This review focused on the recent management of dysphagia, neural mechanisms of swallowing, and relationship between orofacial pain and swallowing function. This and other future studies in this field can provide a better understanding of both normal and impaired swallowing and can help develop a new approach to treat patients with dysphagia and orofacial pain.

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Section: Neural Circuit For Swallowingmentioning

confidence: 79%

Evaluation of the association between orofacial pain and dysphagia

Tsujimura

Inoue

2020

J Oral Sci

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“…It is involved in cognitive, social–emotional, gustatory, and sensorimotor functions, among many others (Kurth et al 2010 ). Its involvement in swallowing behavior in both normal and abnormal swallowing is well‐established, although the particular insular regions thought to be most important have been somewhat inconsistent among reports (Martin et al 2001 ; Ludlow et al 2007 ; Humbert et al 2009 , 2010 ; Riecker et al 2009 ; Soros et al 2011 ). Our findings suggest that the insula is both consistently and broadly involved in swallowing, with strongest dynamic functional connectivity from the posterior and ventral anterior aspects.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, our previous investigations suggest that insular activity is modulated by both the swallowing task (e.g., saliva vs. water) and the sampled population (e.g., young, old, Alzheimer's patients; Humbert et al 2009 , 2010 , 2011 ; Humbert and Joel 2012 ). Understanding the role of the insula is imperative, given discrepancies in the literature regarding whether damage to a particular insular region is most significant for dysphagia (Daniels and Foundas 1997 ; Stickler et al 2003 ; Riecker et al 2009 ; Soros et al 2011 ). Previously, we compared the activation patterns of four swallowing conditions using functional magnetic resonance imaging (fMRI): a water bolus, a sour bolus, swallowing with visual biofeedback, and swallowing with surface electrical stimulation (e‐stim).…”

Section: Introductionmentioning

confidence: 99%

Differential psychophysiological interactions of insular subdivisions during varied oropharyngeal swallowing tasks

Humbert

McLaren

2014

Physiol Rep

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The insula is a highly integrated cortical region both anatomically and functionally. It has been shown to have cognitive, social–emotional, gustatory, and sensorimotor functions. Insular involvement in both normal and abnormal swallowing behavior is well established, yet its functional connectivity is unclear. Studies of context‐dependent connectivity, or the connectivity during different task conditions, have the potential to reveal information about synaptic function of the insula. The goal of this study was to examine the functional connectivity of specific insular regions (ventral anterior, dorsal anterior, and posterior) with distant cortical regions during four swallowing conditions (water, sour, e‐stim, and visual biofeedback) using generalized psychophysiological interactions (gPPI). In 19 healthy adults, we found that the visual biofeedback condition was associated with the most and strongest increases in functional connectivity. The posterior insula/rolandic operculum regions had the largest clusters of increases in functional connectivity, but the ventral anterior insula was functionally connected to a more diverse array of cortical regions. Also, laterality assessments showed left lateralized increases in swallowing functional connectivity. Our results are aligned with reports about the insula's interconnectivity and extensive involvement in multisensory and cognitive tasks.

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“…Tsujimura et al also showed that stimulation of A-area inhibited cortically-evoked swallows by stimulation of cortical swallowing area within the insular cortex, and the inhibitory effect was significantly more than that on SLN-evoked swallows [ 36 ]. In man, Sörös et al showed that stimulation of the right inferior posterior insular cortex at 4 mA induced irregular and delayed swallows with a perception of a “stutter in swallowing” in a 24-year-old patient with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma [ 37 ]. These findings reconfirmed that inhibitory inputs from higher brain to the swallowing CPG exist.…”

Section: Inhibitory Effects On Swallowing Induced By Brain Stimulatiomentioning

confidence: 99%

Guide to Enhancing Swallowing Initiation: Insights from Findings in Healthy Subjects and Dysphagic Patients

Yamamura

Kurose

2018

Curr Phys Med Rehabil Rep

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Purpose of ReviewDifficulty in initiating swallowing is one of the main symptoms of oropharyngeal dysphagia. Therefore, enhancing swallowing initiation is an important approach for the treatment of oropharyngeal dysphagia. This review aims to introduce recent approaches to enhancing swallowing and to discuss their therapeutic potential.Recent FindingsBoth central interventions such as non-invasive brain stimulation and peripheral interventions such as electrical stimulation to peripheral tissues are conducted to enhance swallowing. Recent studies have paid more attention to generating neuroplasticity to produce long-lasting facilitative effect on swallowing.SummaryTranscranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), pharyngeal electrical stimulation (PES), transcutaneous electrical stimulation, and somatic and chemical stimulation were introduced. Considerable evidence supports the therapeutic potential of TMS and PES. Other approaches need further studies to verify their efficacy (e.g., duration of the effect and a limit of effectiveness) and/or possible risk of adverse effects.

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Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

Cited by 12 publications

References 32 publications

Evaluation of the association between orofacial pain and dysphagia

Evaluation of the association between orofacial pain and dysphagia

Differential psychophysiological interactions of insular subdivisions during varied oropharyngeal swallowing tasks

Guide to Enhancing Swallowing Initiation: Insights from Findings in Healthy Subjects and Dysphagic Patients

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