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J Neurophysiol 85: 938-950, 2001;
0022-3077/01 $5.00
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The Journal of Neurophysiology Vol. 85 No. 2 February 2001, pp. 938-950
Copyright ©2001 by the American Physiological Society

Cerebral Cortical Representation of Automatic and Volitional Swallowing in Humans

Ruth E. Martin,1,2 Bradley G. Goodyear,3 Joseph S. Gati,3 and Ravi S. Menon1,3,4

 1School of Communication Sciences and Disorders, Faculty of Health Sciences and  2Department of Physiology, University of Western Ontario, London, Ontario N6G 1H1;  3Laboratory for Functional Magnetic Resonance Research, John P. Robarts Research Institute, London, Ontario N6A 5K8; and  4Department of Diagnostic Radiology and Nuclear Medicine, University of Western Ontario, London, Ontario N6A 5A5, Canada

Martin, Ruth E., Bradley G. Goodyear, Joseph S. Gati, and Ravi S. Menon. Cerebral Cortical Representation of Automatic and Volitional Swallowing in Humans. J. Neurophysiol. 85: 938-950, 2001. Although the cerebral cortex has been implicated in the control of swallowing, the functional organization of the human cortical swallowing representation has not been fully documented. Therefore, the present study determined the cortical representation of swallowing in fourteen healthy right-handed female subjects using single-event-related functional magnetic resonance imaging (fMRI). Subjects were scanned during three swallowing activation tasks: a naïve saliva swallow, a voluntary saliva swallow, and a water bolus swallow. Swallow-related laryngeal movement was recorded simultaneously from the output of a bellows positioned over the thyroid cartilage. Statistical maps were generated by computing the difference between the magnitude of the voxel time course during 1) a single swallowing trial and 2) the corresponding control period. Automatic and volitional swallowing produced activation within several common cortical regions, the most prominent and consistent being located within the lateral precentral gyrus, lateral postcentral gyrus, and right insula. Activation foci within the superior temporal gyrus, middle and inferior frontal gyri, and frontal operculum also were identified for all swallowing tasks. In contrast, activation of the caudal anterior cingulate cortex was significantly more likely in association with the voluntary saliva swallow and water bolus swallow than the naïve swallow. These findings support the view that, in addition to known brain stem areas, human swallowing is represented within a number of spatially and functionally distinct cortical loci which may participate differentially in the regulation of swallowing. Activation of the insula was significantly lateralized to the right hemisphere for the voluntary saliva swallow, suggesting a functional hemispheric dominance of the insula for the processing of swallowing.




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