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Diesseits Der „pattern Generators“

S. Meyer, M. Ptok
Published 2010 · Medicine

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ZusammenfassungHintergrundDer neurophysiologische Verlauf des Schluckakts steht seit einigen Jahren wieder im Blickpunkt des Interesses. Besonders das Wissen um die kortikale Beteiligung ist mit der Hoffnung verbunden, Dysphagien zukünftig mittels kortikaler Stimulation therapieren zu können.MethodikÜbersichtsarbeit nach selektiver Literaturrecherche in PubMed.ErgebnisseEine Beteiligung des Kortex gilt nicht nur für die Schluckinitiierung, sondern auch während der pharyngealen und ösophagealen Phase als gesichert. Zudem scheint eine Hemisphärendominanz für den Schluckakt und seine einzelnen Phasen vorzuliegen.DiskussionNach bisherigen Ergebnissen muss die Theorie der völligen Autonomie der „pattern generators“ aufgegeben werden, sie stehen vielmehr unter kortikalem Einfluss. Im Genesungsprozess unilateraler Hirnschädigungen scheint der gesunden Hemisphäre aufgrund kortikaler Reorganisationsprozesse eine bedeutende Rolle zuzukommen. Einige Studienergebnisse weisen darauf hin, dass die repetitive transkranielle Magnetstimulation und damit die Modulation kortikaler Areale zur Dysphagietherapie nutzbringend eingesetzt werden kann.AbstractBackgroundSwallowing as a neurophysiological process has recently attracted much interest. Knowledge of cortical involvement in particular has raised hope that a novel form of dysphagia therapy might be possible by means of cortical stimulation.MethodFor this systematic review a selective literature research in PubMed has been carried out.ResultsThe cortex is not only involved in the initiation of swallowing, but also during pharyngeal and esophageal phases. In addition, there appears to be a hemispheric dominance both for swallowing and its individual phases.DiscussionIn light of recent study results, the theory of the pattern generators’ autonomy must be abandoned, since pattern generators seem to be influenced rather by the cortex. During the recovery of unilateral impairments, the intact hemisphere seems to play a significant role due to cortical reorganisation processes. Several studies indicate that repetitive transcranial stimulation, and thereby modulation of cortical areas as a means of dysphagia therapy, could be beneficial.
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