4.5 Review

Cerebral control of swallowing: An update on neurobehavioral evidence

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DOI: 10.1016/j.jns.2022.120434

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Cerebral cortex; Neuroimaging; Neurophysiology; Rehabilitation; Swallowing

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This review provides an update on the current understanding of the cerebral control of swallowing. Studies have shown that swallowing is mediated by multiple cortical and subcortical regions, and lesions to these regions can result in dysphagia. There is functional connectivity between these regions within and between the hemispheres. Activation location and laterality of swallowing change between preparation and execution.
This review aims to update the current knowledge on the cerebral control of swallowing. We review data from both animal and human studies spanning across the fields of neuroanatomy, neurophysiology and neuroimaging to evaluate advancements in our understanding in the brain's role in swallowing. Studies have collectively shown that swallowing is mediated by multiple distinct cortical and subcortical regions and that lesions to these regions can result in dysphagia. These regions are functionally connected in separate groups within and between the two hemispheres. While hemispheric dominance for swallowing has been reported in most human studies, the laterality is inconsistent across individuals. Moreover, there is a shift in activation location and laterality between swallowing preparation and execution, although such activation changes are less well-defined than that for limb motor control. Finally, we discussed recent neurostimulation treatments that may be beneficial for dysphagia after brain injury through promoting the reorganization of the swallowing neural network.

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