## 4 Discussion
\begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline
**Cluster** & **Cluster Size** & **Brodman Area** & \multicolumn{3}{c}{**MNI Coordinates**} & \multirow{2}{*}{**Z Score**} & \multirow{2}{*}{**Structure**} \\ \cline{3-4} \cline{6-7}  & & x & & & \(\mathbf{y}\) & \(\mathbf{z}\) & \\ \hline
1 & 1637 & 1, 6 & \(-\)46 & \(-\)10 & 36 & 6.25 & L. PrecentralGyrus \\
2 & 231 & & \(-\)16 & \(-\)60 & \(-\)22 & 5.67 & L. Cerebellum \\
3 & 180 & & 26 & \(-\)62 & \(-\)22 & 5.56 & R. Cerebellum \\
4 & 1013 & 1, 6 & 52 & \(-\)8 & 26 & 5.43 & R. PrecentralGyrus \\
5 & 86 & 40 & \(-\)64 & \(-\)38 & 30 & 5.42 & L. Inferior Parietal Lobule \\
6 & 62 & & 22 & \(-\)4 & \(-\)10 & 5.31 & R. Lentiform Nucleus \\
7 & 261 & 3, 40 & \(-\)34 & \(-\)40 & 42 & 5.20 & L. Inferior Parietal Lobule \\
8 & 64 & 5 & 46 & \(-\)38 & 64 & 5.00 & R. PostcentralGyrus \\
9 & 19 & 40 & 54 & \(-\)26 & 30 & 4.55 & R. InferiorParietalLobule \\
10 & 14 & 1, 25 & 4 & 6 & \(-\)14 & 4.50 & R. AnteriorCingulate \\
11 & 16 & 13 & \(-\)48 & 10 & \(-\)8 & 4.50 & L. Insula \\
12 & 18 & 40 & 30 & \(-\)40 & 62 & 5.45 & R. InferiorParietal Lobule \\ \hline \hline \end{tabular}  
* Coordinates x, y, z represent the position of the voxel with peak activation level (One-sample \(t\)-test, uncorrected \(p<0.001\), corrected at the cluster level) with cluster (in mm) relative to the anterior commissure (AC) in the stereo-tactic space; XLateral distance from the midline (+right, –left); y: Anteriorposterior distance from the AC (+anterior, –posterior); and z: height relative to the AC line (+higher, –lower).  
\end{table} 
Table 2: Significant activation areas during elevation swallowing tasks. correct behavior during therapy. These findings support the hypothesis that the cerebellum is primarily involved in the early phase of motor sequence learning, as well as the basal ganglia, that can possibly contribute to an automatization phase [67; 68]. Since many precentral areas are recruited during tongue protrusion in deglutition, it may be posited that such a task involves neuromuscular compensations and therefore it can be considered part of a dysfunctional swallowing pattern. The activated areas we found lateralized to the left hemisphere during tongue protrusion, including part of the somatosensory cortex (postcentral gyrus), were less evident in the right lateralized activation during tongue elevation. Interestingly, there is evidence suggesting that the left postcentral cortex is specialized for oral sensorimotor functions [31]. We found that a number of cortical regions were activated only by tongue protrusion or by tongue elevation. Activation of the somatosensory gyrus, the posterior parietal cortex, the superior lobule and the inferior lobule, are related to attention, selection of stimuli, sensorimotor functions and integration, with different activation on the right and on the left hemisphere, as seen in the images 2 and 3. These activations have been confirmed in other studies [27; 28; 31; 69; 70] and suggest that the volitional nature of the tongue protrusion in this study, compared to the tongue elevation, combined with a larger compensatory recruitment of muscles activated in protrusion, is manifested in the activation of a larger network of neurons. The nature of the task with an auditory signal to change activity could have contributed to the activation of the posterior attention system of the parietal lobule. These findings have clinical application as they confirm the economy of brain activation, both cortical and subcortical, in the physiological tongue-palate interaction, which is promoted during oral myofunctional therapy and dysphagia therapy.