The role of the cerebral cortex in swallowing

Abstract

This paper reviews clinical, neuroanatomical, and neurophysiological studies that have implicated the cerebral cortex in the initiation and/or regulation of swallowing as well as related functions such as mastication. Cortical dysfunction has been reported to result in a variety of swallowing impairments. Furthermore, swallowing can be evoked and/or modulated by stimulation applied to restricted regions of the cortex. Neuroanatomical investigations and single neuron recording studies also provide some insights into the cortical structures, pathways, and mechanisms that may mediate deglutition.

Avaliação videofluoroscópica da mastigação e deglutição em indivíduos com disfunção temporomandibular (DTM)

“…Such technique also enables the finding of compensatory movements during chewing, arising from the TMD 6 . The scientific literature has reports on alterations in tongue position and the presence of compensatory neck movements to aid mastication in TMD patients 7 , calling the attention of healthcare professionals concerning the presence of choking during mastication and deglutition 8,9 . Insofar as the assessment of mastication goes, studies have recorded the presence of unbalance in the chewing muscles, in which there is only one side working (chewing), requiring changes in food consistence, and pain during the execution of such task 10,11 .…”

Noninvasive Monitoring of Breathing and Swallowing Interaction

“…The central neural control of swallowing is also divided between the cortex and brainstem. Cortical centers in conjunction with afferent feedback from the musculature initiate and modulate the volitional swallow (Sumi 1969;Car and Roman 1970;Martin and Sessle 1993), whereas the brainstem swallowing CPG generates the sequence of reflex swallowing via the nuclei of the Vth, IXth, and XIIth cranial nerves. Normal swallowing requires coordinated interactions among these outputs.…”

“…Any disruption in the process of coordination leads to swallowing dysfunction. The importance of suprabulbar influences in regulating swallowing has been established in animal models in which cortical swallowing regions are disrupted by lesion induction, anesthesia, or cooling (Sumi 1969;Martin and Sessle 1993). In humans, the development of functional magnetic resonance imaging (fMRI) has allowed the identification of the cortical regions involved in voluntary swallowing.…”

Information, information transfer, and information processing

“…However, the organization and learning-associated plasticity specifically of the face sensorimotor cortex and associated cortical regions have received little attention in the primate, although findings in humans and monkeys and subprimates attest to the plasticity or progressive return of function of face sensorimotor cortex following cortical damage or trauma to peripheral tissues (see Buonomano & Merzenich 1998;Chen et al 2002;Martin & Sessle 1993;Sanes & Donoghue 2000;Weinberger 1995;Yamamura et al 2002) and its participation in some aspects of speech (Bookheimer et al 2000;Cabeza & Nyberg 2000;Price 2000;Rumsey et al 1997). We have recently begun investigating the possible role and plasticity of the face sensorimotor cortex in the monkey's acquisition of orofacial motor skills, building on our earlier findings from intracortical microstimulation (ICMS) mapping and recording of neuronal activity in the awake monkey's face MI.…”