基于fNIRS的吞咽相关任务中皮层激活：对吞咽困难康复的启示——一项范围综述

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中文摘要

背景： 吞咽是一种复杂的感觉运动功能，需要皮层和皮层下控制的协调，并且在神经系统疾病中经常受损。功能性近红外光谱（fNIRS）已成为一种有前景的非侵入性神经影像学方法，用于研究吞咽相关的皮层活动；然而，其在吞咽困难研究中的应用在方法学上仍存在异质性。本范围综述旨在梳理关于fNIRS在吞咽和吞咽困难康复中应用的现有证据，并识别当前的主流概念和知识空白。方法：本综述遵循乔安娜布里格斯研究所方法和PRISMA-ScR指南。对MEDLINE、Embase、Scopus和Web of Science进行了从数据库建库至2025年9月的电子检索。纳入涉及成年参与者、采用任务或干预为基础的fNIRS评估吞咽相关皮层活动的研究。结果：21项涉及健康成人和吞咽困难患者的研究符合纳入标准。吞咽一致激活了一个分布式的额叶-感觉运动皮层网络，其激活模式受感觉刺激、运动需求和神经调控的调节。在研究设计、任务范式、光极放置和分析方法方面观察到相当大的异质性，限制了跨研究的可比性。结论：总体而言，fNIRS在实验和临床情境中评估吞咽相关皮层活动方面显示出可行性和敏感性。然而，方法学变异性和对临床人群纳入有限，限制了当前研究结果的解释和推广。制定标准化方案和具有临床相关性的结局指标，对于将fNIRS转化为常规吞咽困难评估和康复至关重要。

英文摘要

Swallowing is a complex sensorimotor function requiring coordinated cortical and subcortical control and is frequently impaired in neurological disorders. Functional near-infrared spectroscopy (fNIRS) has emerged as a promising non-invasive neuroimaging modality for investigating swallowing-related cortical activity; however, its application in dysphagia research remains methodologically heterogeneous. This scoping review aimed to map existing evidence on the use of fNIRS in swallowing and dysphagia rehabilitation and to identify prevailing concepts and knowledge gaps. The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Electronic searches of MEDLINE, Embase, Scopus, and Web of Science were conducted from database inception to September 2025. Studies involving adult participants and task- or intervention-based fNIRS assessment of swallowing-related cortical activity were included. Twenty-one studies involving healthy adults and patients with dysphagia met the inclusion criteria. Swallowing consistently activated a distributed fronto-sensorimotor cortical network, with activation patterns modulated by sensory stimulation, motor demands, and neuromodulation. Considerable heterogeneity was observed in study design, task paradigms, optode placement, and analytical approaches, limiting cross-study comparability. Overall, fNIRS demonstrates feasibility and sensitivity for assessing swallowing-related cortical activity in both experimental and clinical contexts. However, methodological variability and the limited inclusion of clinical populations restrict the interpretation and generalizability of current findings. The development of standardized protocols and clinically relevant outcome measures will be essential for translating fNIRS into routine dysphagia assessment and rehabilitation.