Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Long-term reorganization of human motor cortex driven by short-term sensory stimulation


Removal of sensory input can induce changes in cortical motor representation that reverse when sensation is restored. Here we ask whether manipulation of sensory input can induce long-term reorganization in human motor cortex that outlasts the initial conditioning. We report that for at least 30 minutes after pharyngeal stimulation, motor cortex excitability and area of representation for the pharynx increased, while esophagus representation decreased, without parallel changes in the excitability of brainstem-mediated reflexes. Therefore increased sensory input can drive long-term cross-system changes in motor areas of the cerebral cortex, which suggests that sensory stimulation might rehabilitate dysphagia, a frequent consequence of cerebral injury.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1: Changes in cortical swallowing motor pathway excitability by pharyngeal stimulation.
Figure 2: The reflex pharyngeal and esophageal EMG responses evoked by trigeminal nerve stimulation in one individual, before and after pharyngeal stimulation.
Figure 3: Changes in swallowing motor representation by pharyngeal stimulation.
Figure 4: MRI co-registration of scalp maps.


  1. Wang, X., Merzenich, M. M., Sameshima, K. & Jenkins, W. M. Remodelling of hand representation in adult cortex determined by timing of tactile stimulation . Nature 378, 71–75 (1995)

    Article  CAS  Google Scholar 

  2. Jenkins, W. M., Merzenich, M. M., Ochs, M., Allard, T. T. & Guic-Robles, E. Functional reorganization of primary somatosensory cortex in adult owl monkeys after behaviourally controlled tactile stimulation. J. Neurophysiol. 63, 82–104 (1990)

    Article  CAS  Google Scholar 

  3. Nudo, R. J., Milliken, G. W., Jenkins, W. M. & Merzenich, M. M. Use-dependent alterations of movement representations in primary motor cortex of adult squirrel monkeys. J. Neurosci. 16, 785– 807 (1996)

    Article  CAS  Google Scholar 

  4. Donoghue, J. P., Suner, S. & Sanes, J. N. Dynamic organization of primary motor cortex output to target muscles in adult rats. II.Rapid reorganization following motor nerve lesions. Exp. Brain Res. 79, 492– 503 (1990)

    Article  CAS  Google Scholar 

  5. Sanes, J. N., Wang, J. & Donoghue, J. P. Immediate and delayed changes of rat motor cortical output representation with new forelimb configurations. Cereb. Cortex 2, 141–152 (1992)

    Article  CAS  Google Scholar 

  6. Brasil-Neto, J. P. et al. Rapid modulation of human cortical motor outputs following ischaemic nerve block. Brain 116, 511–525 (1993)

    Article  Google Scholar 

  7. Ridding, M. C. & Rothwell, J. C. Stimulus/response curves as method of measuring motor cortex excitability in man. Electroencephalogr. Clin. Neurophysiol. 105, 340–344 (1997)

    Article  CAS  Google Scholar 

  8. Ziemann U., Corwell, B. & Cohen, L. G. Modulation of plasticity in human motor cortex after forearm ischemic nerve block. J. Neurosci. 18, 1115– 1123 (1998)

    Article  CAS  Google Scholar 

  9. Cohen, L. G., Brasil-Neto, J. P., Pascual-Leone, A. & Hallett, M. Plasticity of cortical motor output organization following deafferentation, cerebral lesions, and skill acquisition. Adv. Neurol. 63, 187–200 (1993)

    CAS  Google Scholar 

  10. Miller, A. J. Deglutition . Physiol. Rev. 62, 129– 184 (1982)

    Article  CAS  Google Scholar 

  11. Jean, A. in Neurophysiology of the Jaws and Teeth (ed. Taylor, A.) 294–321 (Macmillan,London, 1990)

    Book  Google Scholar 

  12. Mansson, I. & Sandberg, N. Effects of surface anesthesia on deglutition in man. Laryngoscope 84, 427 –437 (1974)

    Article  CAS  Google Scholar 

  13. Hamdy, S. et al. The cortical topography of human swallowing musculature in health and disease. Nature Med. 2, 1217–1224 (1996)

    Article  CAS  Google Scholar 

  14. Hamdy, S. et al. Cranial nerve modulation of human cortical swallowing motor pathways. Am. J. Physiol. 272, G802–808 (1997)

    CAS  Google Scholar 

  15. Rothwell, J. C. Techniques and mechanisms of action of transcranial stimulation of the human motor cortex . J. Neurosci. Methods 74, 113– 122 (1997)

    Article  CAS  Google Scholar 

  16. Sumi, T. Reticular ascending activation of frontal cortical neurons in rabbits, with special reference to the regulation of deglutition. Brain Res. 46, 43–54 (1972)

    Article  CAS  Google Scholar 

  17. Martin, R. E. & Sessle B. J. The role of the cerebral cortex in swallowing. Dysphagia 8, 195– 202 (1993)

    Article  CAS  Google Scholar 

  18. Barer, D. H. The natural history and functional consequences of dysphagia after hemispheric stroke . J. Neurol. Neurosurg. Psychiatry 52, 236 –241 (1989)

    Article  CAS  Google Scholar 

  19. Singh, K. D., Hamdy, S., Aziz, Q. & Thompson, D. G. Topographic mapping of transcranial magnetic stimulation data on surface rendered MR images of the brain. Electroencephalogr. Clin. Neurophysiol. 105, 345–351 (1997)

    Article  CAS  Google Scholar 

Download references


The authors thank Mr A. Hobson and Ms J. Barlow in the Gastrointestinal Physiology Laboratory at Hope Hospital, Mr S. Larkin in the Manchester Visualization Centre, Manchester Computing, University of Manchester and Professor A. T. Smith in the Department of Psychology at the Royal Holloway College. KDS is funded by the Wellcome Trust. SH is a Medical Research Council Clinical Training Fellow.

Author information

Authors and Affiliations


Corresponding author

Correspondence to David G. Thompson.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Hamdy, S., Rothwell, J., Aziz, Q. et al. Long-term reorganization of human motor cortex driven by short-term sensory stimulation. Nat Neurosci 1, 64–68 (1998).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing