Identification of the cerebral loci processing human swallowing function: A H2O15 pet activation study

Mapping the Spatial and Temporal Dynamics of Sensorimotor Integration During the Perception and Performance of Wallowing

“…Using imaging techniques such as fMRI, PET, TMS, and MEG, clear evidence shows that swallowing is represented by an extensive distributed network of cortical sensory and motor regions (Erteken & Aydogdu, 2003;Hamdy, 1999;Martin 2002;Miller, 1999;Soros, Inamoto, & Martin, 2009). However, the functional dynamics of the cortical contributions to swallowing remain unclear.…”

“…However, the functional dynamics of the cortical contributions to swallowing remain unclear. Even the question of hemispheric lateralization remains debated with some studies reporting bilateral patterns of hemispheric activity in the primary motor cortex, primary somatosensory cortex, insula, cingulate cortex, frontal operculum, superior temporal sulcus, and medial frontal gyrus (Hamdy et al, 1999;Martin et al, 1999), while others demonstrate patterns of hemispheric laterality in specific neural regions such as the insula, anterior cingulate cortex, parieto-occipital cortex, and superior temporal sulcus (Martin et al, 2001;Mosier et al, 1999). Furthermore, MEG and TMS studies have reported temporal shifts in hemispheric lateralization with the left hemisphere preferentially activating during the more voluntary oral phase of swallowing followed by an increase in right hemisphere activity during the more reflexive pharyngeal phase of swallowing (Dweizas et al, 2003;Teismann, Dweizas, Steinstraeter, & Pantev, 2009).…”

“…Motor areas are responsible for planning and executing swallowing movements, while sensory areas predict the outcomes of movements, provide on-line adjustments for movements, and provide feedback from previously executed movements (Humbert 2011). Coordination of cortical sensory and motor contributions to swallowing is achieved through the process of 'sensorimotor integration' (SMI) (Hamdy et al, 1999;Miller, 2002;Zald & Pardo, 1999). SMI is defined as the neurophysiological process that detects, associates, and integrates multimodal sensory information, derived from the body and/or environment, which determines, elicits, and shapes on-line motor behavior (Ayers, 1972;1989).…”

“…Swallowing is achieved by precisely coordinating the contraction and relaxation of more than 50 muscles during the oral, pharyngeal, and esophageal phases of swallowing (Ertekin & Aydogdu, 2003;Shaw & Martino, 2013;Hamdy, 2013). In order to successfully perform the necessary action sequences in an efficient manner, high level neuromuscular control is required, continuously integrating sensory (e.g., thermal, gustatory, proprioceptive, and somatosensory) information with the execution of muscle movements (Ertekin & Aydogdu, 2003;Hamdy et al, 1999;Langmore, 2001;Mosier & Bereznaya, 2001;Furlong et al, 2004;Logemann, 1998;Shaw & Martino).…”

“…These include the premotor cortex (PMC) and supplementary motor area (Brodmann's area (BA 6), the primary motor cortex, the primary somatosensory cortex (BA 1, 2, 3), the superior temporal sulcus (BA 22 ), the parietal sensory association areas (BA 5 and 7), the insula (BA 14,16 ), the cingulate cortex (BA 24), the basal ganglia, the cerebellum, and the brain stem (Ertekin & Aydogdu, 2003;Hamdy et al, 1999;Martin, Goodyear, Gati, Mennon, 2000;Zald & Pardo, 1999). The functional contributions of these regions to swallowing are less wellunderstood, especially with regards to the timing of activity across the oral and pharyngeal phases of swallowing.…”