Chapter 5--face sensorimotor cortex: its role and neuroplasticity in the control of orofacial movements

The range and complexity of orofacial movements require sophisticated neural circuitries that provide for the coordination and control of these movements and their integration with other motor patterns such as those associated with breathing and walking. This chapter is dedicated to Jim Lund whose many research studies have made major contributions to our knowledge of the role of brainstem and cerebral cortex in orofacial motor control. Our own investigations using intracortical microstimulation (ICMS), cortical cold block, and single neuron recordings have documented that the face primary motor area (MI) and primary somatosensory area (SI) are involved in the control not only of elemental and learned orofacial movements but also of the so-called semiautomatic movements such as mastication and swallowing, the control of which have been largely attributed in the past to brainstem mechanisms. Recent studies have also documented that neuroplasticity of the face sensorimotor cortex is a feature of humans and animals trained in a novel oral motor behavior, and that it reflects dynamic and adaptive events that can be modeled by behaviorally significant experiences, including pain and other alterations to the oral environment. Furthermore, our findings of the disruptive effects of the face sensorimotor cortex cold block indicate that the face MI and SI are also critical in the successful performance of an orofacial motor skill once it is learned. Future studies aimed at the further demonstration of such changes and at their underlying mechanisms and their sequence of appearance in the face sensorimotor cortex and associated cortical areas represent crucial steps for understanding the intracortical processes underlying neuroplasticity related to oral motor learning and adaptation. In view of the role that cortical neuronal ensembles play in motor execution, learning, and adaptation (Nicolelis and Lebedev, 2009), these studies should include the properties and plasticity of neuronal ensembles in several related cortical areas in addition to a specific focus on single neurones or efferent microzones within the face MI or SI. As recently noted (Martin, 2009; Sessle et al., 2007, 2009), such research approaches are also important for developing improved rehabilitative strategies to exploit these mechanisms in humans suffering from chronic orofacial pain or sensorimotor disorders.