正常人吞咽活动激活脑皮质中枢的功能性磁共振定量分析  

Quantitative analysis of BOLD-fMRIs of the central swallowing cortex in normal adults

作　　者：周立富[1] 王淑娟[1] 元小冬[1] 赵艳生[2] 张亚杰[2] 马英[1] 王卓[2] 王小洁[1] 孔元 薛宝川 

机构地区：[1]河北联合大学附属开滦总医院神经内科,唐山063000 [2]河北联合大学附属开滦总医院核磁共振室,唐山063000 [3]唐山市医疗保险事业局 [4]玉田县妇幼保健院

出　　处：《中华物理医学与康复杂志》2015年第4期262-265,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的观察正常成人自主吞咽活动激活相关皮质中枢的分布情况及特征。方法对10例正常右利手成人志愿者在执行吞咽任务时进行血氧水平依赖功能性磁共振成像（BOLD—fMRI）脑功能扫描，记录激活的皮质中枢体积及激活强度。结果人选受试者执行吞咽任务时激活两侧BA4区体积有显著差异（P=0．04），而激活强度间无明显差异（P=0．20）；激活两侧BA6／8区和BA24区的体积及强度均无明显差异（P〉0．05）；激活两侧BA40区体积有明显差异（P=0．00），而激活强度问无明显差异（P=0．99）；激活两侧BA32区体积有明显差异（P=0．00），而激活强度间无明显差异（P=0．87）；激活两侧BAl3区体积有明显差异（P=0．02），而激活强度间无明显差异（P=0．19）。进一步分析发现，人选受试者执行吞咽任务时左侧半球激活体积明显大于右侧（P〈0．05），其偏侧性指数值（L1）为15．22％。结论脑岛BA13区和前扣带皮质BA24／32区是正常成人自主吞咽功能的重要启动中枢，缘上回BA40区和BA6／8区是自主吞咽功能的重要运动规划中枢，而口咽部初级运动皮质中枢是其重要的运动执行中枢，同时这种自主吞咽运动功能的皮质中枢调控具有明显的优势半球偏侧性。Objective To investigate the distribution and characteristics of the central swallowing cortex in normal adults. Methods Blood-oxygen level dependent functional MRIs （BOLD-fMRIs） were recorded from 10 normal, right-handed volunteers during swallowing. The volume of the central cortex activated and the activation intensity were recorded. Results During the experiment there were significant differences in volume but not in intensity between the BA4, BA40, BA32 and BA13 areas activated on the two sides. No significant differences were observed in either the volume or the intensity of the activated BA6/8 and BA24 areas. Moreover, significantly more areas in the left hemisphere were activated when swallowing than in the right hemisphere, with the laterality index value being 15.22%. Conclusion Normal adults＇ volitional swallowing is triggered in the BA13 area of the insula and the BA24/32 area of the anterior cingulate cortex. It is planned in the BA40 area of the supramarginal gyrus and the BA6 and 8 areas and implemented in the primary motor cortex of the pharynx oralis. One hemisphere clearly domi- nates in the cortical control of volitional swallowing.

关 键 词：吞咽 脑皮质中枢 偏侧性 调控 血氧水平依赖功能性磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R338[医药卫生—诊断学]