Physiology and Pathophysiology of the Swallowing Area of Human Motor Cortex

Swallowing problems can affect as many as one in three patients in the period immediately after stroke. Despite this, in the majority of cases, recovery usually occurs to a safe level after a month or two. In this review, we show. how the organization of the cortical projections to swallowing nuscles can account for many of the clinical observations on swallowing after stroke and explain why recovery is common in the long term. In addition, we examine approaches that may be useful in speeding up recovery of swallowing. Swallowing may be a useful model in which to study central nervous reorganization after injury.

[1]  Richard S. J. Frackowiak,et al.  The functional anatomy of motor recovery after stroke in humans: A study with positron emission tomography , 1991, Annals of neurology.

[2]  J C Rothwell,et al.  Recovery of swallowing after dysphagic stroke relates to functional reorganization in the intact motor cortex. , 1998, Gastroenterology.

[3]  R. N. Lemon,et al.  The contribution of fast corticospinal input to the voluntary activation of proximal muscles in normal subjects and in stroke patients , 1999, Experimental Brain Research.

[4]  D. Prakash.  Dysphagia in acute stroke. , 1987, British medical journal.

[5]  J. Rothwell,et al.  Explaining oropharyngeal dysphagia after unilateral hemispheric stroke , 1997, The Lancet.

[6]  J C Rothwell,et al.  Cranial nerve modulation of human cortical swallowing motor pathways. , 1997, The American journal of physiology.

[7]  G. Fleming,et al.  Somatic Motor and Sensory Representation in the Cerebral Cortex of Man as Studied by Electrical Stimulation. (Brain, vol. lx, p. 389, Dec., 1937.) Penfield, W., and Boldrey, E. , 1938 .

[8]  J. C. Meadows.  Dysphagia in unilateral cerebral lesions , 1973, Journal of neurology, neurosurgery, and psychiatry.

[9]  F. Bateman.  A Treatise on Aphasia and Other Speech Defects , 1898, Edinburgh Medical Journal.

[10]  W. Penfield,et al.  SOMATIC MOTOR AND SENSORY REPRESENTATION IN THE CEREBRAL CORTEX OF MAN AS STUDIED BY ELECTRICAL STIMULATION , 1937 .

[11]  John C. Rothwell,et al.  Long-term reorganization of human motor cortex driven by short-term sensory stimulation , 1998, Nature Neuroscience.

[12]  John C. Rothwell,et al.  The cortical topography of human swallowing musculature in health and disease , 1996, Nature Medicine.