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Article
Nature Medicine  2, 1217 - 1224 (1996)
doi:10.1038/nm1196-1217

The cortical topography of human swallowing musculature in health and disease

Shaheen Hamdy1, Qasim Aziz1, John C. Rothwell2, Krishna D. Singh3, 6, Josephine Barlow1, David G. Hughes4, Raymond C. Tallis5 & David G. Thompson1, 7

  1Department of Gastroenterology, Hope Hospital University of Manchester, Manchester M6 8HD, UK

  2Medical Research Council Human Movement and Balance Unit, Institute of Neurology, Queen Square, London WC1N 3BG, UK

  3Department of Vision Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK

  4Department of Neuroradiology, Hope Hospital University of Manchester, Manchester M6 8HD, UK

  5Department of Geriatric Medicine, Hope Hospital University of Manchester, Manchester M6 8HD, UK

  6Department of Psychology, Royal Holloway College, University of London, Egham, Surrey TW20 OEX, UK

  7Correspondence should be addressed to D.G.T. at University Department of Medicine, Hope Hospital.

Because no detailed information exists regarding the topographic representation of swallowing musculature on the human cerebral cortex in health or disease, we used transcranial magnetic stimulation to study the cortical topography of human oral, pharyngeal and esophageal musculature in 20 healthy individuals and the topography of pharyngeal musculature in two stroke patients, one with and one without dysphagia. Our results demonstrate that swallowing musculature is discretely and somatotopically represented on the motor and premotor cortex of both hemispheres but displays interhemispheric asymmetry, independent of handedness. Following stroke, dysphagia appeared to be associated with smaller pharyngeal representation on the intact hemisphere, which increases in size with recovery of swallowing.

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ISSN: 1078-8956
EISSN: 1546-170X
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