Stuttered swallowing: electric stimulation of the right insula interferes with water swallowing. A case report

• Published in: BMC neurology Vol. 11; no. 1; p. 20
• Main Authors: Sörös, Peter, Al-Otaibi, Faisal, Wong, Savio W H, Shoemaker, J Kevin, Mirsattari, Seyed M, Hachinski, Vladimir, Martin, Ruth E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 05.02.2011; BioMed Central; BMC
• Subjects: Analysis; Case Report; Case studies; Cerebral Cortex - physiology; Cerebral hemispheres; Deep Brain Stimulation - methods; Deglutition; Deglutition - physiology; Electric stimulation; Electrodes, Implanted; Electroencephalography; Humans; Male; Neural circuitry; Physiological aspects; Water - administration & dosage; Young Adult
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/1471-2377-11-20

Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear. Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA) was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity. These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.