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Cold thermal oral stimulation produces immediate excitability in human pharyngeal motor cortex
Ist Teil von
Neurogastroenterology and motility, 2018-10, Vol.30 (10), p.e13384-n/a
Ort / Verlag
England: Wiley Subscription Services, Inc
Erscheinungsjahr
2018
Link zum Volltext
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Background
Current strategies of swallowing therapy include facilitation of swallowing initiation by sensory modulation. Although thermal tactile oral stimulation is a common method to treat dysphagic patients to improve swallowing movement, little is known about the possible mechanisms. This study is aimed to investigate whether thermal oral (tongue) stimulation can modulate the cortico‐pharyngeal neural motor pathway in humans.
Methods
Eighteen healthy volunteers participated and were intubated with an intraluminal catheter for recording pharyngeal electromyography. Each participant underwent baseline transcranial magnetic stimulation (TMS) cortico‐pharyngeal motor evoked potential (MEP) measurements bilaterally. MEPs were then measured during thermal stimulation over the dorsal tongue, applied using the Peltier device at three different temperatures; 45°C, 37°C, and 15°C, in a pre‐ordered manner. Each of the three temperatures was given twice with a 5‐min resting time between each trial. Averaged MEP amplitude changes were analyzed using ANOVA and post‐hoc t‐tests.
Key Results
Two‐way repeated measures ANOVA with factors of Temperature × Trial in amplitude of MEP demonstrated a significant effect of Temperature both in the stronger (F2,34 = 5.775, P = .007) and weaker (F2,34 = 4.771, P = .017) pharyngeal hemispheres. Subsequent post‐hoc tests showed the significant increase in pharyngeal MEPs at 15° compared to 37° in both hemispheres (P < .05).
Conclusions & Inferences
Cold oral stimulation was able to induce significant changes in pharyngeal cortical excitability, demonstrating evidence for a sensorimotor interaction between oral and pharyngeal cortical areas.
Cold oral stimulation was able to induce significant excitability changes in pharyngeal motor cortex, which demonstrated not only a facilitatory effect of cold stimulation on swallowing function in dysphagic patients but an insight of a sensorimotor interaction between oral sensory input and pharyngeal motor pathway in human cortical areas.