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Departments of 1 Gastroenterology and 3 Medical Imaging, Playfair Institute of Neuroscience, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada M5T 2S8; and 2 Department of Gastroenterology, Hope Hospital, Salford M6 8HD, United Kingdom
Functional magnetic resonance imaging (fMRI)
provides a safe, noninvasive method for studying task-related cortical
neuronal activity. Because the cerebral cortex is strongly implicated
in the control of human swallowing, we sought to identify its
functional neuroanatomy using fMRI. In 10 healthy volunteers, a swallow
event-related paradigm was performed by injecting 5 ml water bolus into
the oral cavity every 30 s. Whole brain functional magnetic
susceptibility 
-weighted
spiral imaging data were simultaneously acquired over 600 s on a 1.5-T
magnetic resonance scanner, utilizing the blood oxygenation
level-dependent technique, and correlation maps were generated using
both >99% percentile rank and spatial extent thresholding. We
observed areas of increased signal change consistently in caudal
sensorimotor cortex, anterior insula, premotor cortex, frontal
operculum, anterior cingulate and prefrontal cortex, anterolateral and
posterior parietal cortex, and precuneus and superiomedial temporal
cortex. Less consistent activations were also seen in posterior
cingulate cortex and putamen and caudate nuclei. Activations were
bilateral, but almost every region, particularly the premotor, insular,
and frontal opercular cortices, displayed lateralization to one or the
other hemisphere. Swallow-related cortical activity is
multidimensional, recruiting brain areas implicated in processing
motor, sensory, and attention/affective aspects of the task.
cerebral cortex; deglutition; esophagus; functional magnetic resonance imaging; lateralization; motility; pharynx
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