Altered cortical swallowing processing in patients with functional dysphagia: a preliminary study

Area of Science:

• Neuroscience
• Gastroenterology
• Neurology

Background:

• Functional dysphagia lacks a clear organic cause, prompting investigation into neurobiological models.
• Neuroimaging reveals objective neuronal correlates for psychogenic symptoms, shifting focus from psychological to biological explanations.
• Understanding the pathogenetic mechanisms of functional dysphagia is crucial for developing effective treatments.

Purpose of the Study:

• To investigate cortical swallow-related activation patterns in patients with functional dysphagia.
• To compare brain activity during swallowing between functional dysphagia patients and healthy controls.
• To identify potential neurobiological underpinnings of functional dysphagia.

Main Methods:

• Magnetoencephalography (MEG) was used to measure cortical activity during swallowing.
• Source localization of brain activation was performed using synthetic aperture magnetometry.
• Non-parametric permutation tests compared activation maps between patient and control groups.

Main Results:

• Swallowing task performance was similar between functional dysphagia patients and healthy controls.
• Patients displayed altered cortical activation, with increased activity in the right insula, prefrontal, premotor, and parietal areas.
• Reduced activation was observed in the left medial primary sensory cortex and right medial sensorimotor cortex.

Conclusions:

• Functional dysphagia is associated with distinct alterations in swallow-related cortical activation patterns.
• These changes may involve overactive vigilance, self-monitoring, and salience networks interfering with sensorimotor control.
• Findings support a neurobiological model for functional dysphagia, moving beyond purely psychological explanations.