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.
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References
Carpenter DO: Central nervous system mechanisms in deglutition and emesis. In: Schultz SG (ed):Handbook of Physiology. Gastrointestinal System. II. Washington, DC: American Physiological Society, 1989, sect 6, vol 1, pp 685–714
Doty RW: Neural organization of swallowing. In: Code CF (ed.):Handbook of Physiology. Alimentary Canal. Washington, DC: American Physiological Society, 1968, sect 6, vol IV, pp 1861–1902
Dubner R, Sessle BJ, Storey AT:The Neural Basis of Oral and Facial Function. New York: Plenum Press, 1978
Miller AJ: Deglutition.Physiol Rev 62:129–184, 1982
Miller AJ: Neurophysiological basis of swallowing.Dysphagia 1:91–100, 1986
Sessle BJ, Henry JL: Neural mechanisms of swallowing: neurophysiological and neurochemical studies on brain stem neurons in the solitary tract region.Dysphagia 4:61–75, 1989
Humphrey T: Reflex activity in the oral and facial area of the human fetus. In: Bosma IF (ed.):Second Symposium on Oral Sensation and Perception. Springfield, Illinois: Thomas, 1970, pp 195–233
Brin MF, Younger D: Neurological disorders and aspiration.Otolaryngol Clin North Am 21:691–699, 1988
Buchholz D: Neurologic causes of dysphagia.Dysphagia 1:152–156, 1987
Logemann JA:Evaluation and Treatment of Swallowing Disorders. Boston: College-Hill Press, 1983
Pape KE, Wigglesworth JS: Patterns of intracranial haemmorhage and ischemia in the newborn and their economic importance. In:Haemorrhage, Ischemia and the Perinatal Brain. Suffolk: Spastics International Medical Publications, 1979, pp 1–10
Wiklund LM, Uvebrant P, Flodmark O: Computed tomography as an adjunct in etiological analysis of hemiplegic cerebral palsy: I. Children born preterm.Neuropediatrics 22:50–61, 1991
Wiklund LM, Uvebrant P, Flodmark O: Computed tomography as an adjunct in etiological analysis of hemiplegic cerebral palsy: II. Children born to term.Neuropediatrics 22:121–128, 1991
Kenny DJ, Casas MJ, McPherson KA: Correlation of ultrasound imaging of oral swallow with ventilatory alterations in cerebral palsied and normal children: preliminary observationsDysphagia 4:112–117, 1989
Love RJ, Hagerman EL, Taimi EG: Speech performance, dysphagia and oral reflexes in cerebral palsy.J Speech Hearing Disord XLV:59–75, 1980
Sochaniwskyj AE, Koheil RM, Bablich K, Milner M, Kenny DJ: Oral motor functioning, frequency of swallowing and drooling in normal children and children with cerebral palsy.Arch Phys Med Rehab 67:866–874, 1986
Alberts MJ, Horner J, Gray L, Brazer SR: Aspiration after stroke: lesion analysis by brain MRI.Dysphagia 7:170–173, 1992
Barer DH: Lower cranial nerve motor function in unilateral vascular lesions of the cerebral hemisphere.Br Med J 289:1622, 1984
Barer DH: The natural history and functional consequences of dysphagia after hemispheric stroke.J Neurol Neurosurg Psychiatry 52:236–241, 1989
Celifarco A, Gerard G, Faegenburg D, Burakoff R: Dysphagia as the sole manifestation of bilateral strokes.Am J Gastroenterol 85:610–613, 1990
Chen MYM, Ott DJ, Peele VN, Gelfand DW: Oropharynx in patients with cerebrovascular disease: evaluation with videoflu oroscopy.Radiology 176:641–643, 1990
Gordon C, Hewer RL, Wade DT: Dysphagia in acute stroke.Br Med J 295:411–414, 1987
Johnson ER, McKenzie SW, Rosenquist CJ, Leiberman JS, Sievers AE: Dysphagia following stroke: quantitative evaluation of pharyngeal transit times.Arch Phys Med Rehab 73:419–423, 1992
Horner J, Massey EW: Silent aspiration following stroke.Neurology 38:317–319, 1988
Horner J, Massey EW, Riski JE, Lathrop DL, Chase KN: Aspiration following stroke: clinical correlates and outcome.Neurology 38:1359–1362, 1988
Robbins JA, Levine RL: Swallowing after unilateral stroke of the cerebral cortex: preliminary experience.Dysphagia 3:11–17, 1988
Veis SL, Logemann JA: Swallowing disorders in persons with cerebrovascular accident.Arch Phys Med Rehab 66:372–375, 1985
Bastian HC:A Treatise on Aphasia and Other Speech Defects. London: Lewis, 1898, pp 87
Meadows J: Dysphagia in unilateral cerebral lesions.J Neurol Neurosurg Psychiatry 36:853–860, 1973
Weber J, Roman C, Hannequin D, Onnient Y, Beuret-Blauquart F, Mihout B, Denis P: Esophageal manometry in patients with unilateral hemispheric cerebrovascular accidents or idopathic parkinsonism.J Gastrointest Motil 3:98–106, 1991
Willoughby EW, Anderson NE: Lower cranial nerve motor function in unilateral vascular lesions of the cerebral hemisphere.Br Med J 289:791–794, 1984
Kertez A, Black S, Nicholson L, Carr T: The sensitivity and specificity of MRI in stroke.Neurology 37:1580–1585, 1987
Kim WS, Buchholz D, Kumar AJ, Donner MW, Rosenbaum AE: magnetic resonance imaging for evaluating neurogenic dysphagia.Dysphagia 2:40–45, 1987
Tuch BE, Nielsen JM: apraxia of swallowing.Bull LA Neurol Soc 6:52–54, 1941
Cappa SF, Giudotti M, Papagno G, Vignolo LA: Speechlessness with occasional vocalizations after bilateral opercular lesions: a case study.Aphasiology 1:35–39, 1987
Mao CC, Coull BM, Golper LAC, Rau MT: Anterior operculum syndrome.Neurology 39:1169–1172, 1989
Huang C-S, Hiraba H, Sessle BJ: Topographical distribution and functional properties of cortically induced rhythmical jaw movements in the monkey (Macaca fascicularis).J Neurophysiol 61:635–650, 1989
Hamlet SL: Dynamic aspects of lingual propulsive activity in swallowing.Dysphagia 4:136–145, 1989
Martin RE: A comparison of lingual movement in swallowing and speech production. Unpublished doctoral dissertation, University of Wisconsin, Madison, Wisconsin, 1991
Dodds WJ, Man KM, Cook IJ, Kahrilas PJ, Stewart ET, Kern MK: Influence of bolus volume on swallow-induced hyoid movement in normal subjects.Am J Roentol 150:1307–1309, 1988
Ekberg O, Olsson R, Sundgren-Borgstrom P: Relation of bolus size and pharyngeal swallow.Dysphagia 3:69–72, 1988
Kahrilas PJ, Dodds WJ, Dent J, Logemann JA, Shaker R: Upper esophageal sphincter function during deglutition.Gastroenterology 95:52–62, 1988
Huang C-S, Hiraba H, Sessle BJ: Input-output relationships of the primary face motor cortex in the monkey (Macaca fascicularis).J Neurophysiol 61:350–362, 1989
Jones EG: Ascending inputs to, and internal organization of, cortical motor areas. In:Motor Areas of the Cerebral Cortex (CIBA Foundation Symposium 132). Chichester: Wiley, 1987, pp 21–39
Murray GM, Sessle BJ: Functional properties of single neurons in the face primary motor cortex of the primate. I. Input and output features of tongue motor cortex.J Neurophysiol 67:747–758, 1992
Lazzara G, Lazarus C, Logemann JA: Impact of thermal stimulation on the triggering of the swallowing reflex.Dysphagia 1:73–77, 1986
Rosenbek JC, Robbins JA, Fishback B, Levine RL: Effects of thermal application on dysphagia after stroke.J Speech Hearing Res 34:1257–1268, 1991
Larson CR, Byrd KE, Garthwaite CR, Luschei ES: Alterations in the pattern of mastication after ablation of the lateral precentral cortex in rhesus macaques.Exper Neurol 70:638–651, 1980
Luschei ES, Goodwin GM: Role of monkey precentral cortex in control of voluntary jaw movements.J Neurophysiol 38:146–157, 1975
Lund JP, Lamarre Y: Activity of neurons in the lower precentral cortex during voluntary and rhythmical jaw movements in the monkey.Exper Brain Res 19:282–299, 1974
Enomoto S, Shwartz G, Lund JP: The effects of cortical ablation on mastication in the rabbit.Neurosci Lett 82:162–166, 1987
Sumi T: Role of the pontine reticular formation in the neural organization of deglutition.Jpn J Physiol 22:295–314, 1972
Murray GM, Lin L-D, Moustafa E, Sessle BJ: Effects of reversible inactivation by cooling of the primate face motor cortex on the performance of a trained tongue-protrusion task and a trained biting task.J Neurophysiol 65:511–530, 1991
Jackson JH:Clinical and Physiological Localization of Movements in the Brain. (Selected Writings, Vol. 1, pp 37–67). London: Churchill, 1875
Pritchard TC, Hamilton RB, Morse JR, Norgren R: Projections of thalamic gustatory and lingual areas in the monkey, Macaca fascicularis.J Comp Neurol 244:213–228, 1986
Scott TR, Yaxley S, Sienkiewicz ZJ, Rolls ET: Gustatory responses in the frontal opercular cortex of the alert cynomolgus monkey.J Neurophysiol 56:876–890, 1986
Car A: La commande corticale du centre deglutiteur bulbaire.J Physiol Paris 62:361–386, 1970
Miller AJ, Bowman JP: Precentral cortical modulation of mastication and swallowing.J Dent Res 56:1154, 1977
Penfield W, Rasmussen T:The Cerebral Cortex of Man. New York: MacMillan, 1950
Sumi T: Some properties of cortically evoked swallowing and chewing in rabbits.Brain Res 15:107–120, 1969
Tsukamoto S: Studies in brain mechanisms of jaw movements. I. Analysis of jaw movements from the cortical jaw motor area and amygdala in the rabbit.J Physiol Soc Jpn 25:12–24, 1963
Woolsey CN, Settlage PH, Meyer DR, Sencer W, Hamuy TP, Travis AM: Patterns of localization in precentral and “supplementary” motor areas and their relationship to the concept of a premotor area.Res Publ Assoc Res New Ment Dis 30:238–264, 1952
Iriki A, Nozaki S, Nakamura Y: Feeding behavior in mammals: corticobulbar projection is reorganized during conversion from sucking to chewing.Dev Brain Res 44:189–196, 1988
Doty R: Influence of stimulus pattern on reflex deglutition.Am J Physiol 166:142–158, 1951
Miller AJ: Significance of sensory inflow to the swallowing reflex.Brain Res 43:147–159, 1972
Sumi T: Activity in single hypoglossal fibers during cortically induced swallowing and chewing in rabbits.Pfluegers Arch 314:329–346, 1970
Amri M, Lamkadem M, Car A: Effects of lingual nerve and chewing cortex stimulation upon activity of the swallowing neurons located in the region of the hypoglossal motor nucleus.Brain Res 548:149–155, 1991
Car A: La commande corticale de la deglutition II. Point d'impact bulbaire de la voie corticifuge deglutitrice.J Physiol Paris 66:553–576, 1973
Jean A, Car A: Inputs to the swallowing medullary neurons from the peripheral afferent fibers and the swallowing cortical area.Brain Res 178:567–572, 1979
Jean A: Brainstem organization of the swallowing network.Brain Behav Evol 25:109–116, 1984
Lund JP, Enomoto S: The generation of mastication by the mammalian central nervous system. In: Cohen AH, Rossignol S, Grillner S (eds):Neural Control of Rhythmic Movements in Vertebrates. New York: Wiley, 1988, pp 41–72
Luschei ES, Goldberg LJ: Neural mechanisms of mandibular control: mastication and voluntary biting. In:Handbook of Physiology. The Nervous System. Motor Control Bethesda, MD: American Physiological Society, 1981, sect 1, vol II, pp 1237–1274
Car A: Etude macrophysiologique et microphysiologique de la zone deglutitrice du cortex frontal.J Physiol Paris 73:945–961, 1977
Sumi T: Reticular ascending activation of frontal cortical neurons in rabbits, with specific reference to the regulation of deglutition.Brain Res 46:43–54, 1972
Kuypers HGJM: Some projections from the peri-central cortex to the pons and lower brain stem in monkey and chimpanzee.J Comp Neurol 110:221–251, 1958
Kuypers HGJM: Corticobulbar connexions to the pons and lower brain-stem in man.Brain 81:364–388, 1958
Jenny AB, Saper CB: Organization of the facial nucleus and corticofacial projection in the monkey: a reconsideration of the upper motor neuron facial palsy.Neurology 37:930–939, 1987
Sirisko MA, Sessle BJ: Corticobulbar projections and orofacial and muscle afferent inputs of neurons in primate sensorimotor cerebral cortex.Exp Neural 82:716–720, 1983
Larson CR, Yoshida Y, Sessle BJ: Higher level motor and sensory organization. In: Titze IR (ed.):Vocal Fold Physiology: New Frontiers in Basic Science. San Diego: Singular Publishing Group (in press)
Hoffman DS, Luschei ES: Responses of monkey precentral cortical cells during a controlled jaw bite task.J Neurophysiol 44:333–348, 1980
Luschei ES, Garthwaite CR, Armstrong ME: Relationship of firing patterns of units in face area of monkey precentral cortex to conditioned jaw movements.J Neurophysiol 34:552–561, 1971
Murray GM, Sessle BJ: Functional properties of single neurons in the face primary motor cortex of the primate. II. Relations with trained orofacial motor behavior.J Neurophysiol 67:759–774, 1992
Kubota K, Niki H: Precentral cortical unit activity and jaw movement in chronic monkeys. In: Dubner R, Kawamura Y (eds.):Oral-Facial Sensory and Motor Mechanisms. New York: Appleton-Century-Crofts, 1971, pp 365–379
Martin RE, Murray GM, Sessle BJ: Firing patterns and properties of neurones in primate tongue motor cortex (MI) in relation to swallowing.Neurosci Abstr 17:309, 1991
Murray GM, Sessle BJ: Neurones in primate tongue motor cortex alter their firing rates during swallow.Neurosci Abstr 16:1221, 1990
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Studies referred to by the authors were supported by grant MT4918 to B.J.S. from the Medical Research Council of Canada
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Martin, R.E., Sessle, B.J. The role of the cerebral cortex in swallowing. Dysphagia 8, 195–202 (1993). https://doi.org/10.1007/BF01354538
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DOI: https://doi.org/10.1007/BF01354538