PMID- 21838728
OWN - NLM
STAT- MEDLINE
DCOM- 20111227
LR  - 20110815
IS  - 1365-2982 (Electronic)
IS  - 1350-1925 (Linking)
VI  - 23
IP  - 9
DP  - 2011 Sep
TI  - Non-invasive magnetic stimulation of the human cerebellum facilitates 
      cortico-bulbar projections in the swallowing motor system.
PG  - 831-e341
LID - 10.1111/j.1365-2982.2011.01747.x [doi]
AB  - 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+/-5.9muV, 
      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.
CI  - (c) 2011 Blackwell Publishing Ltd.
FAU - Jayasekeran, V
AU  - Jayasekeran V
AD  - Inflammation Sciences Research Group, Manchester Academic Health Sciences Centre, 
      University of Manchester, Manchester, UK.
FAU - Rothwell, J
AU  - Rothwell J
FAU - Hamdy, S
AU  - Hamdy S
LA  - eng
GR  - G0400979/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Neurogastroenterol Motil
JT  - Neurogastroenterology and motility
JID - 9432572
SB  - IM
CIN - Nat Rev Gastroenterol Hepatol. 2011 Oct;8(10):538. PMID: 21970963
MH  - Adult
MH  - Animals
MH  - Brain Stem/*physiology
MH  - Cerebellum/*physiology
MH  - Deglutition/*physiology
MH  - Electromyography
MH  - Evoked Potentials, Motor/physiology
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Motor Cortex/*physiology
MH  - Neural Pathways/*physiology
MH  - Pharynx/innervation/physiology
MH  - Transcranial Magnetic Stimulation/instrumentation/*methods
MH  - Young Adult
EDAT- 2011/08/16 06:00
MHDA- 2011/12/28 06:00
CRDT- 2011/08/16 06:00
PHST- 2011/08/16 06:00 [entrez]
PHST- 2011/08/16 06:00 [pubmed]
PHST- 2011/12/28 06:00 [medline]
AID - 10.1111/j.1365-2982.2011.01747.x [doi]
PST - ppublish
SO  - Neurogastroenterol Motil. 2011 Sep;23(9):831-e341. doi: 
      10.1111/j.1365-2982.2011.01747.x.