A Preliminary Magnetoencephalography Study of the Voluntary Swallowing in
Dysphasia Patients after Stroke

Abstract

Abstract:

Objective To investigate the activation areas in brain in the dysphagia patients after stroke. Methods The 151 channel of Omega 2000 magnetoencephalography (MEG) was used to identify the magnetic field change of brain of 6 dysphagia patients after stroke during the 2500 ms before the swallowing burst of the submental electromyography. Subjects swallowed 1 ml water boluses after it was infused into their oral cavity through a plastic catheter placed in the midline in different interval times from 20 s, 25 s, 30 s, 35 s (randomized) and total 10 boluses were injected. Equivalent current dipole (ECD) analysis method was used to get activation of the associated areas of brain. All the patients had magnetic resonance imaging (MRI ) examination. The magnetic source imaging (MSI) was obtained by overlap MRI and MEG results. Results The data was obtained from 5 patients. The activation areas included insular, primary sensorimotor cortex, cingulate, thalamus and others. These areas were activated in certain period of time and form 3 neural circuits. Some areas are activated repeatedly in the circuits. Post cingulate was activated later than anterior cingulate and insular. Conclusion There were multiple and repeat activation areas, which might become some neural circuits. Post cingulate activation was lately activated possibly because of the injury in function of swallowing cortex.

Key words: Dysphagia; Swallowing cortex; Stroke; Magnetoencephalography

摘要：

目的探讨卒中后吞咽障碍患者皮质吞咽中枢在脑磁图中的激活情况，为吞咽皮质中枢的功能探讨提供资料。方法采用151通道Omega2000全头型生物磁仪（CTF.co，Canada）对6例卒中后吞咽障碍的患者进行脑磁信号的采集。以等电流偶极（equivalent current dipole，ECD）记录肌电信号开始前－2500 ms内激活脑区的部位及时间顺序。以每隔20 s、25 s、30 s、35 s时间不等的方式向受试者口腔注射室温纯净水0.5～1 ml共10次。所有检查者均行头颅磁共振成像（magnetic resonance imaging，MRI）检查，并与脑磁图的磁场变化结果融合，形成磁源性成像（magnetic source imaging，MSI）。结果 5例患者得到磁源性影像。所激活的脑区包括岛叶、初级运动感觉皮质、扣带、丘脑等。部分脑区呈现反复激活，脑内吞咽皮质激活存在3个相对较为固定的环路。中央前后回、岛叶、丘脑、扣带回持续稳定激活，其初次激活发生在一定时间段内。后扣带较前扣带回及岛叶激活较晚。结论吞咽皮质在处理吞咽信息中可能存在一定的环路。后扣带回激活较晚可能是由于卒中后吞咽皮质功能活动受损的表现。

关键词: 吞咽障碍; 吞咽皮质; 卒中; 脑磁图

ZHANG Jing, ZHANG Ning, QIAO Hui, et al.. A Preliminary Magnetoencephalography Study of the Voluntary Swallowing in
Dysphasia Patients after Stroke[J]. Chinese Journal of Stroke, 2014, 9(09): 751-756.

张婧，张宁，乔慧，等. 卒中后吞咽障碍患者脑磁图下吞咽皮质环路预探索研究[J]. 中国卒中杂志, 2014, 9(09): 751-756.

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