摘要目的 利用脑功能磁共振成像(fMRI)技术研究健康成人不同吞咽任务时激活脑区的特点.方法 8名健康志愿者参与实验性自主和反射性吞咽任务的fMRI研究.采用SPM2软件对功能成像数据进行处理及图像显示.配对t检验用于比较2种吞咽任务激活脑区的容积及信号值大小.结果 自主吞咽任务激活脑区有双侧初级感觉运动皮质、运动前区、前扣带回等.反射性吞咽任务相关脑区有双侧初级感觉皮层、双侧额盖、双侧顶后区.自主性吞咽激活双侧半球容积(体素)分别为1213±110(左)、1969±133(右).反射吞咽激活双侧半球容积(体素)分别为488±45(左)、398±35(右).自主性咽水双侧感觉运动区信号增加值分别为4.4±0.4(左)、4.1±0.2(右);双侧岛叶容积为1.2±0.5(左)、1.5±0.6(右).反射性咽水双侧感觉运动区信号增加值分别为2.6±0.3(左)、2.5±1.2(右);双侧岛叶信号增加值为0.6±0.4(左)、0.2±0.1(右).自主吞咽激活双侧半球容积、感觉运动区及岛叶信号值均大于反射性吞咽(均为P<0.05).两种吞咽任务的偏侧性指数(LI)值分别为(-16±9)%和(11±5)%.结论 自主吞咽任务激活脑区数量及容积大于反射性吞咽任务.两种吞咽任务激活脑区的不同与自主吞咽过程中计划、发动、情感等多种高级脑活动有关.

abstractsObjective To investigate the swallow-related brain areas in normal adults with different experimental swallow tasks using founctional MRI (fMRI). Methods Eight healthy volunteers received volitional and reflexive water swallowing during fMRI studies. SPM2 software was used to postprocess functional data and display activated brain mapping. Paired t-test was used to compare the activated brain volume and increased signal of each hemisphere in two swallowing tasks. Results Bilateral primary sensorimotor cortex, premotor cortex, anterior cingnlated gyrus, insular, prefrontal area, posterior parietal lobe, temporal gyms , basal ganglion and cerebellum were detected in volitional water swallowing. However, only few brain areas such as bilateral primary sensorimotor cortex, posterior parietal lobe, frontal opercnlum were activated in reflexive water swallowing task. Volitional swallowing tasks activated much more brain volumes [1213±110 (left) and 1969±133 (right) vs 488±45 (left) and 398±35 (right), in pixels] and increase in signals [4.4±0.4 (left) and 4.1±0.2 (right) vs 2.6±0.3 (left) and 2.5±1.2 (right) at sensorimotor areas, 1.2±0.5 (left) and 1.5±0.6 (right) vs 0.6±0.4 (left) and 0.2±0.1 (right) at insular lobes] than those in reflexive tasks. Different lateralization in activation brain area was observed in swallowing tasks. Lateral index was ( - 16 ±9) % and ( 11 ±5 ) % respectively in volitional and reflexive water swallowing tasks. Conclusions Volitional swallowing task activates much more brain regions and brain volumes as compared to reflexive tasks. The different activated regions between volitional and reflexive swallowing tasks maybe relate to brain activities such as intent, planning, urge and possibly passion during volitional swallowing.