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Open Access Research article

Functional oropharyngeal sensory disruption interferes with the cortical control of swallowing

Inga K Teismann12*, Olaf Steinstraeter1, Kati Stoeckigt1, Sonja Suntrup1, Andreas Wollbrink1, Christo Pantev1 and Rainer Dziewas2

Author Affiliations

1 Institute for Biomagnetism and Biosignalanalysis, University of Muenster, Malmedyweg 15, 48149 Muenster, Germany

2 Department of Neurology, University of Muenster, Albert-Schweitzer-Str. 33, 48149 Munster, Germany

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BMC Neuroscience 2007, 8:62  doi:10.1186/1471-2202-8-62

Published: 2 August 2007

Abstract

Background

Sensory 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.

Results

The 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.

Conclusion

Our 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.