The Quantitative Research Of Bold-fMRI Of Cerebral Cortex In Central Dysphagia Patients

Objective To research the distribution and characteristics of swallowing associatedcortical hub in normal adult; To research characteristics of swallowing associated corticalhub dysfunction and compensatory reorganization in patients witn swallowingdysfunction caused by acute cerebral infarction and analyze clinical rehabilitationmechanisms of swallowing associated cortical hub dysfunction to provide a theoreticalbasis for effectively swallowing rehabilitation.Method We chose10healthy right-handed volunteers and multiple cerebal infarction onboth sides of the brain or brain pons confirmed by MRI (T1and T2) but only one newonset acute cerebral infarction confirmed by DWI; at the same time, we chose10patientswho had the difficulty of dysphagia for the first time and clinically confirmed that theywere central swallowing difficulty patients, using BOLD-fMRI scanning and collecttingthe original data when they were swallowing water, appling SPM5to process the postprocessing, then we could obtain the brain activation volume and intensity, and pursuestatistical analysis on brain activation changes in volume and intensity by Spss13.0.Results1The control group of independent swallowing test activated BA4area, BA13area, BA6/8area, BA40area BA24/32areas and other areas. Activation volume ofcontrols’ left hemisphere was larger than the right side (P＜0.05), its LI value was15.22%,the central gyrus’(BA4) LI value was13.49%, Insula was19.02%, supramarginal gyruswas10.89%.2Activation area of patient group mainly Focus on BA4,13,40area andBA6/8area. Activation area of bilateral BA24/32area was decrease. Meanwhile BA23/31,BA18/19, BA41, BA36area was activated. The left recurrent cerebral infarction grouphad been seen bilateral BA7area and cerebellum are activated significantly. Comparedwith the control group, the patient group ipsilateral cortex BA4and BA6/8area’sactivation volume and intensity decreased (P＜0.05). The Right recurrent cerebralinfarction group contralateral BA6/8area and the left recurrent cerebral infarction groupcontralateral BA4, MA6/8area’s activation volume increased (P＜0.05). While comparedwith the control group, there was no significant difference in activation strength.Conclusions1Cerebral cortex of the swallowing movement had obvious advantages in the hemispheric laterality characteristics. Delightful situation of appetite stimuli mightactivate the forebrain and anterior cingulated cortex to swallow the island campaign starthub, which activated the edge back and auxiliary motor area, swallowing motion planningfor implementation of the central and the swallowing movement of central, activationimplementation of the hub’s size was the important condition of normal deglutitionmovement.2Central dysphasia caused by rrecurrent acute cerebral infarction, swallowingmovement planning and execution had central activation reaction, but the activationintensity of acute lesions of the ipsilateral swallowing related central decreased, andintensity of activation on the side of swallowing related central had no obvious change; butappeared the compensatory brain functional reorganization of swallowing start central,such as theposterior cingulated gyros, prefrontal and visual, auditory cortex. The patientswere received appetite stimulation through visual and auditory channels could promote thecortex swallowing compensatory function recombination. So as to promote the recovery ofswallowing function, improve the rehabilitation effect of dysphasia.