The cortical topography of human swallowing musculature in health and disease

Hamdy, Shaheen; Aziz, Qasim; Rothwell, John C.; Singh, Krish Devi; Barlow, J; Hughes, David G.; Tallis, Raymond; Thompson, David G.

doi:10.1038/nm1196-1217

Cited by 441 publications

(368 citation statements)

References 24 publications

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“…1 The striated muscles of mastication, tongue and face are innervated by the trigeminal, facial and hypoglossal nerves. The neurons of the larynx are mainly present in the vagal nerve.…”

Section: Physiology Of Mastication and Swallowingmentioning

confidence: 99%

Dysphagia in patients with acute cervical spinal cord injury

Wolf

Meiners

2003

Spinal Cord

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Study design: Longitudinal observational. Objectives: (a) To establish a reliable and feasible method to indicate the presence and severity of dysphagia and (b) to establish a course of treatment in individuals presenting with cervical spinal cord injury (CSCI). Setting: Spinal Cord Injury Center, Werner Wicker Klinik, Bad Wildungen, Germany. Patients and methods: This is a cross-sectional study of 51 patients consecutively admitted to the Intensive Care Unit of the SCI in-patient service. They were subjected to neurological and fiberoptic endoscopic examination of swallowing (FEES). Data concerning artificial respiration, presence of tracheostomy, oral or non-oral feeding were obtained from the medical charts. Statistics were carried out by a calculation of a nonparametric correlation (Spearman). Results: Five levels of dysphagia could be distinguished. At levels 1 and 2, patients presented with a severe impairment of swallowing, in level 3 aspiration was met by a powerful coughing reflex, level 4 comprised a laryngeal edema and/or a mild aspiration of fluids only and at level 5 laryngeal function was not compromised. On admission, 20 patients with CSCI presented with mild (level 4), eight with moderate (level 3) and 13 with severe dysphagia (levels 1 and 2). In 10 no signs of dysphagia could be detected. After treatment, level 1 was no longer detected, one patient showed level 2, two patients showed level 3, all other patients showed only mild or no signs of dysphagia any longer. Conclusions: Dysphagia of various severities was present in the majority of these patients with CSCI together with respiratory insufficiency. FEES allows for the detection and classification of dysphagia as well as for an evaluation of the therapeutic management. Under interdisciplinary treatment the prognosis of dysphagia is good.

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“…1 The striated muscles of mastication, tongue and face are innervated by the trigeminal, facial and hypoglossal nerves. The neurons of the larynx are mainly present in the vagal nerve.…”

Section: Physiology Of Mastication and Swallowingmentioning

confidence: 99%

Dysphagia in patients with acute cervical spinal cord injury

Wolf

Meiners

2003

Spinal Cord

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“…These investigations have characteristically started with a disordered neurologic group (i.e., poststroke population) and combined both anatomical brain-imaging techniques (still pictures of the brain) such as computerized tomography (CT) and/or magnetic resonance imaging (MRI) with a swallowing assessment to correlate damaged brain areas with the presence or type of dysphagia observed. The vast majority of clinical studies have focused on the effects of stroke on swallowing [2][3][4][5][6][7][8][9][10][11][12][13][14][15] This systematic review summarizes studies that have explored the neurophysiology of swallowing in healthy adults using fMRI. The goal of a systematic review is to gather and present objectively the current status of research in a particular area of interest.…”

Section: Introductionmentioning

confidence: 99%

Normal Swallowing and Functional Magnetic Resonance Imaging: A Systematic Review

2007

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Unknowns about the neurophysiology of normal and disordered swallowing have stimulated exciting and important research questions. Previously, these questions were answered using clinical and animal studies. However, recent technologic advances have moved brain-imaging techniques such as functional magnetic resonance imaging (fMRI) to the forefront of swallowing neurophysiology research. This systematic review has summarized the methods and results of studies of swallowing neurophysiology of healthy adults using fMRI. A comprehensive electronic and hand search for original research was conducted, including few search limitations to yield the maximum possible number of relevant studies. The participants, study design, tasks, and brain image acquisition were reviewed and the results indicate that the primary motor and sensory areas were most consistently active in the healthy adult participants across the relevant studies. Other prevalent areas of activation included the anterior cingulate cortex and insular cortex. Review limitations and suggested future directions are also discussed. KeywordsDeglutition; Deglutition disorders; Functional magnetic resonance imaging An estimated 18 million adults have dysphagia, or swallowing disorders, in the United States [1]. Dysphagia is a condition that becomes more prevalent with increasing age and often results from neurologic damage or disorders such as stroke, Alzheimer's disease, and Parkinson's disease. As a result, much of the research on swallowing disorders has focused on understanding and delineating the neurophysiology of swallowing with the overall goal of increasing the efficacy and accuracy with which diagnosis and intervention procedures are employed.Data from clinical and animal studies have provided the earliest insight into the central control of swallowing. In particular, clinical studies have provided an evolving foundation of thought pertaining to the central control of swallowing. These investigations have characteristically started with a disordered neurologic group (i.e., poststroke population) and combined both anatomical brain-imaging techniques (still pictures of the brain) such as computerized tomography (CT) and/or magnetic resonance imaging (MRI) with a swallowing assessment to correlate damaged brain areas with the presence or type of dysphagia observed. The vast majority of clinical studies have focused on the effects of stroke on swallowing [2][3][4][5][6][7][8][9][10][11][12][13][14][15] This systematic review summarizes studies that have explored the neurophysiology of swallowing in healthy adults using fMRI. The goal of a systematic review is to gather and present objectively the current status of research in a particular area of interest. It presents an unbiased review of the relevant literature by describing the systematic methods for obtaining the relevant literature on this topic. Search Strategies ElectronicAn electronic database search was completed using Medline (Ovid and PubMed), CINAHL, DARE, ACP Journal Club, the Cochrane L...

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“…Magnetoencephalography has identified significantly greater activation of the left sensorimotor cortex during swallowing as compared with the right sensorimotor cortex, with the degree of lateralization dependent upon task complexity [12]. Studies that used transcranial magnetic stimulation and positron emission tomography (PET) suggest that swallowing is lateralized but representation of swallowing within subjects is asymmetrical [13][14][15]. That is, results suggest that swallowing is not lateralized to one specific hemisphere, but within individuals, one hemisphere tends to be more important than the other in mediating swallowing.…”

Section: Introductionmentioning

confidence: 99%

Clinical and cognitive predictors of swallowing recovery in stroke

Schroeder¹,

Daniels²,

McClain³

et al. 2006

JRRD

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Abstract-This retrospective study determined whether specific neurological features were associated with initial and final swallowing outcomes in acute stroke patients. A chart review of 65 acute stroke patients suggested that certain clinical and neurocognitive behaviors were associated with swallowing outcomes. Hemispatial neglect was significantly associated with initial nonoral dietary intake, whereas aphasia was not associated with swallowing outcome. Results from the initial clinical swallowing evaluations suggested that the presence of at least four of six clinical features (cough after swallow, voice change after swallow, abnormal volitional cough, abnormal gag reflex, dysphonia, and dysarthria) were associated with poor initial and final swallowing outcomes. Whether specific lesion location, size, or a combination of clinical neurological deficits are associated with poor initial and final swallowing outcomes is unclear. Prospective studies are warranted for further investigation of these relationships.

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The cortical topography of human swallowing musculature in health and disease

Cited by 441 publications

References 24 publications

Dysphagia in patients with acute cervical spinal cord injury

Dysphagia in patients with acute cervical spinal cord injury

Normal Swallowing and Functional Magnetic Resonance Imaging: A Systematic Review

Clinical and cognitive predictors of swallowing recovery in stroke

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