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Non-invasive magnetic stimulation of the human cerebellum facilitates cortico-bulbar projections in the swallowing motor system.
Neurogastroenterol Motil. 2011 Sep; 23(9):831-e341.NM

Abstract

BACKGROUND

Animal and human brain imaging studies suggest that the cerebellum plays an important role in the control of swallowing. In this study, we probed the interaction between cerebellar and pharyngeal motor cortical activity with transcranial magnetic stimulation (TMS) to determine if the cerebellum can modulate cortical swallowing motor circuitry.

METHODS

Healthy volunteers (n=16, eight men, mean age=32, range 19-57years) underwent TMS measurements of pharyngeal electromyography (EMG) recorded from a swallowed intraluminal catheter to assess cortical and cerebellar excitability. Subjects then underwent a paired pulse paradigm, where active or sham TMS conditioning pulses over the cerebellum and control sites were followed by suprathreshold TMS over the cortical pharyngeal area. Paired pulses were delivered at varying inter-stimulus intervals (ISIs) with the cortical response amplitudes being assessed.

KEY RESULTS

Stimulation of the cerebellum over its midline or hemispheres evoked distinct pharyngeal EMG responses. There was no difference in EMG amplitudes following cerebellar hemispheric or midline stimulation (mean 55.5±6.9 vs 42.8±5.9μV, P=0.08). In contrast, after cerebellar preconditioning, the cortically evoked responses underwent maximal facilitation at ISIs of 50-200ms (P<0.05), an effect not seen with sham or trigeminal nerve preconditioning.

CONCLUSIONS & INFERENCES

Posterior fossa stimulation excites the cerebellum and evokes direct motor responses within the pharynx. When conditioned with TMS, the cerebellum strongly facilitates the cortical swallowing motor pathways. This finding suggests that the cerebellum exerts a modulatory effect on human swallowing and raises the possibility that excitatory neurostimulation of the cerebellum may be therapeutically useful in promoting recovery of dysphagia after neural damage.

Authors+Show Affiliations

Inflammation Sciences Research Group, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21838728

Citation

Jayasekeran, V, et al. "Non-invasive Magnetic Stimulation of the Human Cerebellum Facilitates Cortico-bulbar Projections in the Swallowing Motor System." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 23, no. 9, 2011, pp. 831-e341.
Jayasekeran V, Rothwell J, Hamdy S. Non-invasive magnetic stimulation of the human cerebellum facilitates cortico-bulbar projections in the swallowing motor system. Neurogastroenterol Motil. 2011;23(9):831-e341.
Jayasekeran, V., Rothwell, J., & Hamdy, S. (2011). Non-invasive magnetic stimulation of the human cerebellum facilitates cortico-bulbar projections in the swallowing motor system. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 23(9), 831-e341. https://doi.org/10.1111/j.1365-2982.2011.01747.x
Jayasekeran V, Rothwell J, Hamdy S. Non-invasive Magnetic Stimulation of the Human Cerebellum Facilitates Cortico-bulbar Projections in the Swallowing Motor System. Neurogastroenterol Motil. 2011;23(9):831-e341. PubMed PMID: 21838728.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-invasive magnetic stimulation of the human cerebellum facilitates cortico-bulbar projections in the swallowing motor system. AU - Jayasekeran,V, AU - Rothwell,J, AU - Hamdy,S, PY - 2011/8/16/entrez PY - 2011/8/16/pubmed PY - 2011/12/28/medline SP - 831 EP - e341 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol Motil VL - 23 IS - 9 N2 - BACKGROUND: Animal and human brain imaging studies suggest that the cerebellum plays an important role in the control of swallowing. In this study, we probed the interaction between cerebellar and pharyngeal motor cortical activity with transcranial magnetic stimulation (TMS) to determine if the cerebellum can modulate cortical swallowing motor circuitry. METHODS: Healthy volunteers (n=16, eight men, mean age=32, range 19-57years) underwent TMS measurements of pharyngeal electromyography (EMG) recorded from a swallowed intraluminal catheter to assess cortical and cerebellar excitability. Subjects then underwent a paired pulse paradigm, where active or sham TMS conditioning pulses over the cerebellum and control sites were followed by suprathreshold TMS over the cortical pharyngeal area. Paired pulses were delivered at varying inter-stimulus intervals (ISIs) with the cortical response amplitudes being assessed. KEY RESULTS: Stimulation of the cerebellum over its midline or hemispheres evoked distinct pharyngeal EMG responses. There was no difference in EMG amplitudes following cerebellar hemispheric or midline stimulation (mean 55.5±6.9 vs 42.8±5.9μV, P=0.08). In contrast, after cerebellar preconditioning, the cortically evoked responses underwent maximal facilitation at ISIs of 50-200ms (P<0.05), an effect not seen with sham or trigeminal nerve preconditioning. CONCLUSIONS & INFERENCES: Posterior fossa stimulation excites the cerebellum and evokes direct motor responses within the pharynx. When conditioned with TMS, the cerebellum strongly facilitates the cortical swallowing motor pathways. This finding suggests that the cerebellum exerts a modulatory effect on human swallowing and raises the possibility that excitatory neurostimulation of the cerebellum may be therapeutically useful in promoting recovery of dysphagia after neural damage. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/21838728/Non_invasive_magnetic_stimulation_of_the_human_cerebellum_facilitates_cortico_bulbar_projections_in_the_swallowing_motor_system_ L2 - https://doi.org/10.1111/j.1365-2982.2011.01747.x DB - PRIME DP - Unbound Medicine ER -