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Neuroscience of Swallowing: Strategies in Rehabilitation

Division of Orthodontics, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco
San Francisco, CA

The development of strategies to rehabilitate patients with dysphagia depends on an understanding of both the underlying neuroscientific principles that control normal swallowing and how a damaged central nervous system can respond. Strategies can incorporate the sensory and motor systems, as well as use the plasticity of the cortex and neuromuscular system. Treating dysphagia could involve stimulating the sensory system more often through the two primary nerves involved with swallowing, the glossopharyngeal and superior laryngeal nerves, as well as by enhancing the trigeminal sensory input. Enhancement of the motor system can occur by using muscles in special exercises or by electrically stimulating the target muscles directly. The cortex can be modified by increased sensory input, which will adapt the sensorimotor cortex. In addition, techniques of directly stimulating the cortex hold promise for rehabilitation.