BackgroundSensory input is crucial to the initiation and modulation of swallowing. From a clinical point of view, oropharyngeal sensory deficits have been shown to be an important cause of dysphagia and aspiration in stroke patients. In the present study we therefore investigated effects of functional oropharyngeal disruption on the cortical control of swallowing. We employed whole-head MEG to study cortical activity during self-paced volitional swallowing with and without topical oropharyngeal anesthesia in ten healthy subjects. A simple swallowing screening-test confirmed that anesthesia caused swallowing difficulties with decreased swallowing speed and reduced volume per swallow in all subjects investigated. Data were analyzed by means of synthetic aperture magnetometry (SAM) and the group analysis of the individual SAM data was performed using a permutation test.ResultsThe analysis of normal swallowing revealed bilateral activation of the mid-lateral primary sensorimotor cortex. Oropharyngeal anesthesia led to a pronounced decrease of both sensory and motor activation.ConclusionOur results suggest that a short-term decrease in oropharyngeal sensory input impedes the cortical control of swallowing. Apart from diminished sensory activity, a reduced activation of the primary motor cortex was found. These findings facilitate our understanding of the pathophysiology of dysphagia.

Synthetic aperture magnetometry (SAM) is a powerful MEG source localization method to analyze evoked as well as induced brain activity. To gain structural information of the underlying sources, especially in group studies, individual magnetic resonance images (MRI) are required for co-registration. During the last few years, the relevance of MEG measurements on understanding the pathophysiology of different diseases has noticeable increased. Unfortunately, especially in patients and small children, structural MRI scans cannot always be performed. Therefore, we developed a new method for group analysis of SAM results without requiring structural MRI data that derives its geometrical information from the individual volume conductor model constructed for the SAM analysis. The normalization procedure is fast, easy to implement and integrates seamlessly into an existing landmark based MEG-MRI co-registration procedure. This new method was evaluated on different simulated points as well as on a pneumatic index finger stimulation paradigm analyzed with SAM. Compared with an established MRI-based normalization procedure (SPM2) the new method shows only minor errors in single subject results as well as in group analysis. The mean difference between the two methods was about 4 mm for the simulated as well as for finger stimulation data. The variation between individual subjects was generally higher than the error induced by the missing MRIs. The method presented here is therefore sufficient for most MEG group studies. It allows accomplishing MEG studies with subject groups where MRI measurements cannot be performed.