High‐frequency focal repetitive cerebellar stimulation induces prolonged increases in human pharyngeal motor cortex excitability

作者：Dipesh Harshvadan Vasant, Emilia Michou, Satish Mistry, John C. Rothwell, Shaheen Hamdy · 发表于：The Journal of Physiology · 年份：2015 · DOI：10.1113/jp270817 · 被引用次数：64 · 研究领域：Dysphagia Assessment and Management、Cervical and Thoracic Myelopathy、Temporomandibular Joint Disorders

KEY POINTS: Neurostimulation is a rapidly emerging approach to swallowing rehabilitation, but cerebellar stimulation has not been explored as a treatment. Such proposed therapies for post-stroke dysphagia have required confirmation of physiological effects and optimisation of parameters in healthy humans prior to translational progression into patient groups. There is strong evidence for a role of the cerebellum in swallowing physiology, but this relationship has been under-explored. Recently, single pulses of cerebellar magnetic stimulation have been shown to directly evoke responses from pharyngeal musculature and produce short-term enhancement of cortico-pharyngeal motor evoked potentials, suggesting the feasibility of a cerebellar approach to neurostimulation in the swallowing system. We therefore examined multiple parameters of repetitive cerebellar magnetic stimulation and have described the optimal settings to provoke longer-lasting changes in swallowing neurophysiology. Based on evidence from the post-stroke dysphagia neurostimulation literature, these changes may have a therapeutic potential for swallowing rehabilitation. ABSTRACT: Brain neurostimulation has been shown to modulate cortical swallowing neurophysiology in post-stroke dysphagia with therapeutic effects which are critically dependent on the stimulation parameters. Cerebellar neurostimulation is, however, a novel, unexplored approach to modulation of swallowing pathways as a prelude to therapy for dysphagi...