Chronic intermittent stimulation of the thyroarytenoid muscle maintains dynamic control of glottal adduction

Ludlow, Christy L.; Bielamowicz, Steven; Rosenberg, Marci Daniels; Ambalavanar, Ranjinidevi; Rossini, Katia; Gillespie, Michael; Hampshire, Victoria; Testerman, Roy; Erickson, Donald J.; Carraro, Ugo

doi:10.1002/(sici)1097-4598(200001)23:1<44::aid-mus6>3.0.co;2-e

Cited by 23 publications

(22 citation statements)

References 40 publications

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“…The treatment groups showed improvements in swallow score, and 98% of the patients treated with the electrical stimulations showed some improvement. More recently, Ludlow et al [25] reported that chronic intermittent thyroarytenoid stimulation has the potential to improve airway protection in dysphagia. In another study, Leelamanit et al [22] linked the delivery of an electrical stimulus to the onset of floor-of-mouth muscle activity for swallowing.…”

Section: Discussionmentioning

confidence: 99%

Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic Patients

et al. 2009

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Oropharyngeal dysphagia is frequent in stroke patients and increases mortality, mainly because of pulmonary complications. We hypothesized that sensitive transcutaneous electrical stimulation applied submentally during swallowing could help rehabilitate post-stroke oropharyngeal dysphagia by improving cortical sensory motor circuits. Eleven patients were recruited for the study (5 females, 68 ± 11 years). They all suffered from recent oropharyngeal dysphagia (>eight weeks) induced by a hemispheric (n = 7) or brainstem (n = 4) stroke, with pharyngeal residue and/or laryngeal aspiration diagnosed by videofluoroscopy. Submental electrical stimulations were performed for 1 h every day for 5 days (electrical trains: 5 s every minute, 80 Hz, under motor threshold). During the electrical stimulations, the patients were asked to swallow one teaspoon of paste or liquid. Swallowing was evaluated before and after the week of stimulations using a dysphagia handicap index questionnaire, videofluoroscopy, and cortical mapping of pharyngeal muscles. The results of the questionnaire showed that oropharyngeal dysphagia symptoms had improved (p < 0.05), while the videofluoroscopy measurements showed that laryngeal aspiration (p < 0.05) and pharyngeal residue (p < 0.05) had decreased and that swallowing reaction time (p < 0.05) had improved. In addition, oropharyngeal transit time, pharyngeal transit time, laryngeal closure duration, and cortical pharyngeal muscle mapping after the task had not changed. These results indicated that sensitive submental electrical stimulations during swallowing tasks could help to rehabilitate post-stroke swallowing dysphagia by improving swallowing coordination. Plasticity of the sensory swallowing cortex is suspected.

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Section: Discussionmentioning

confidence: 99%

Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic Patients

et al. 2009

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“…Can the rat TA be made to express slow MyHC by cross‐innervation or electrical stimulation? Ludlow et al. (2000) stimulated dog TA at 60 Hz, for 5 s on and 5 s off, over 8 h, 5 days per week.…”

Section: Neural Control Of Laryngeal Muscle Fibresmentioning

confidence: 99%

Laryngeal muscle fibre types

Hoh

2005

Acta Physiologica Scandinavica

130

148

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The internal laryngeal muscles have evolved to subserve the highly specialized functions of airways protection, respiration, and phonation. Their contractile properties, histochemistry, biochemical properties, myosin heavy chain (MyHC) expression and their regulation by nerves and hormones are reviewed and compared with limb muscle fibres. Cricothyroid, the vocal cord tensor, is limb-like in MyHC composition and fibre type properties, while the vocal fold abductor and adductors are allotypically different, with capacity for expressing an isoform of MyHC that is kinetically faster than the fastest limb MyHC. In rats and rabbits the faster isoform is the extraocular (EO) MyHC, while in carnivores, it is the IIB MyHC. These adaptations enable the abductor and adductor muscles to remain always faster than the cricothyroid as the latter changes in speed during evolution to match changing metabolic and respiratory rates in relation to scaling with body mass. Such phylogenetic plasticity is vital to the airways protection and respiratory functions of these muscles. The posterior cricoarythenoid, the abductor muscle, is tonically driven during expiration, and consequently has a slower fibre type profile than the principal adductor, the thyroarythenoid. The human thyroarythenoid appears not to express EO or IIB MyHC significantly, but is unique in expressing the slow-tonic MyHC. The concepts of allotype and phylogenetic plasticity help to explain differences in fibre type between limb and laryngeal muscles and between homologous laryngeal muscles in different species. Laryngeal muscle fibres exhibit physiological plasticity as do limb muscles, being subject to neural and hormonal modulation.

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“…For the rehabilitation of dysphagia, various treatment methods have been used to improve the swallowing function of patients, including sensory stimulation of the oral and facial areas, oral and pharyngeal muscle strengthening, compensatory techniques, and thermal tactile stimulation [4,5]. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive method of stimulating the brain, has been used recently as it is known to be effective in controlling the excitability of the cortex and in reducing the imbalance between the hemispheres after stroke [6,7].…”

Section: Introductionmentioning

confidence: 99%

Effect of Low-Frequency rTMS and NMES on Subacute Unilateral Hemispheric Stroke With Dysphagia

et al. 2014

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ObjectiveTo investigate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) and neuromuscular electrical stimulation (NMES) on post-stroke dysphagia.MethodsSubacute (<3 months), unilateral hemispheric stroke patients with dysphagia were randomly assigned to the conventional dysphagia therapy (CDT), rTMS, or NMES groups. In rTMS group, rTMS was performed at 100% resting motor threshold with 1 Hz frequency for 20 minutes per session (5 days per week for 2 weeks). In NMES group, electrical stimulation was applied to the anterior neck for 30 minutes per session (5 days per week for 2 weeks). All three groups were given conventional dysphagia therapy for 4 weeks. We evaluated the functional dysphagia scale (FDS), pharyngeal transit time (PTT), the penetration-aspiration scale (PAS), and the American Speech-Language Hearing Association National Outcomes Measurement System (ASHA NOMS) swallowing scale at baseline, after 2 weeks, and after 4 weeks.ResultsForty-seven patients completed the study; 15 in the CDT group, 14 in the rTMS group, and 18 in the NMES group. Mean changes in FDS and PAS for liquid during first 2 weeks in the rTMS and NMES groups were significantly higher than those in the CDT group, but no significant differences were found between the rTMS and NMES group. No significant difference in mean changes of FDS and PAS for semi-solid, PTT, and ASHA NOMS was observed among the three groups.ConclusionThese results indicated that both low-frequency rTMS and NMES could induce early recovery from dysphagia; therefore, they both could be useful therapeutic options for dysphagic stroke patients.

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Chronic intermittent stimulation of the thyroarytenoid muscle maintains dynamic control of glottal adduction

Cited by 23 publications

References 40 publications

Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic Patients

Sensory Transcutaneous Electrical Stimulation Improves Post-Stroke Dysphagic Patients

Laryngeal muscle fibre types

Effect of Low-Frequency rTMS and NMES on Subacute Unilateral Hemispheric Stroke With Dysphagia

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