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Am J Physiol Gastrointest Liver Physiol (December 30, 2003). doi:10.1152/ajpgi.00323.2003
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Submitted on July 30, 2003
Accepted on December 23, 2003

Role of Primary Sensorimotor Cortex and Supplementary Motor Area in Volitional Swallowing: A Movement-related Cortical Potential Study

Takeshi Satow1, Akio Ikeda2*, Jun-ichi Yamamoto3, Tahamina Begum3, Dinh Ha Duy Thuy3, Masao Matsuhashi3, Tatsuya Mima3, Takashi Nagamine3, Koichi Baba4, Tadahiro Mihara4, Yushi Inoue4, Susumu Miyamoto5, Nobuo Hashimoto5, and Hiroshi Shibasaki6

1 Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan; Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
2 Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
3 Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
4 The National Epilepsy Center, Shizuoka Medical Institute for Neurological Disorders, Shizuoka, Shizuoka, Japan
5 Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan
6 Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan; Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Kyoto, Japan; NINDS,NIH, Bethesda, MD, USA

* To whom correspondence should be addressed. E-mail: akio{at}kuhp.kyoto-u.ac.jp.

The purpose of this study was to investigate the role of cerebral cortex, particularly the face/tongue area of the primary sensorimotor cortex (face/tongue SMI) and supplementary motor area (SMA), in volitional swallowing by recording movement-related cortical potentials (MRCPs). MRCPs with swallowing and tongue protrusion were recorded from scalp electrodes in 8 normal right-handed subjects and from implanted subdural electrodes in 6 epilepsy patients. The experiment by scalp electroencephalogram (EEG) in normal subjects revealed that pre-movement activity (BP) for swallowing was largest at the vertex and lateralized to either hemisphere in the central area. The experiment by epicortical EEG in patients confirmed that face/tongue SMI and SMA were commonly involved in swallowing and tongue protrusion with overlapping distribution and interindividual variability. BP amplitude showed no difference between swallowing and tongue movements, either at face/tongue SMI or at SMA, whereas post-movement potential (PMP) was significantly larger in tongue protrusion than in swallowing only at face/tongue SMI. BP occurred earlier in swallowing than in tongue protrusion. Comparison between face/tongue SMI and SMA did not show any difference with regard to BP and PMP amplitude or BP onset time in either task. Preparatory role of the cerebral cortex in swallowing was similar to that in tongue movement, except for the earlier activation in swallowing. Post-movement processing of swallowing was lesser than that of tongue movement in face/tongue SMI; probably suggesting that cerebral cortex does not play a significant role in post-movement processing of swallowing. SMA plays a supplementary role to face/tongue SMI both in swallowing and tongue movements.







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