Selective intraoperative stimulation of the human larynx

Broniatowski, Michael; Grundfest‐Broniatowski, Sharon; Hahn, Elizabeth C.; Hadley, Aaron J.; Tyler, Dustin J.; Tucker, Harvey M.

doi:10.1002/lary.23464

Cited by 7 publications

(9 citation statements)

References 23 publications

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“…The model reproduces quantitatively the charge collection patterns obtained with cryogenic Ge detectors operated in a wide range of biasing conditions, and also the time structure of the charge collection signals [13].…”

Section: Discussionmentioning

confidence: 96%

“…In this respect, the hypotheses of Nathan's model imply that the probability per unit time ν i for an electron to scatter out of the ith valley is a function of the field through the single parameter E eff ,i = |γ 1/2 i · E|, where γ i is the reciprocal effective mass tensor for the valley under consideration [12]. We derive the ν(E eff ) relationship directly from the fit of simulated charge collection patterns to the patterns obtained experimentally [13].…”

Section: Impurity Scattering and Electron Anisotropymentioning

confidence: 98%

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Carrier Anisotropy and Impurity Scattering in Ge at mK Temperatures: Modeling and Comparison to Experiment

Broniatowski

2012

J Low Temp Phys

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Improving upon the present background rejection capabilities of the cryogenic germanium detectors for direct dark matter search involves an in-depth comprehension of the charge collection process in these devices. Experimental data point to the combined effects of lattice and impurity scattering on the anisotropy of electron transport in Ge at mK temperatures. A Monte Carlo simulation code has been implemented to incorporate these features in a consistent model for charge collection. In a novel approach to carrier scattering by charged impurities in Ge at cryogenic temperatures, the scattering field of the impurities is treated statistically as a random contribution to the collection field, described by the Holtsmark distribution function with a single adjustable parameter, the mean density of the charged centers. Simulation of charge collection along these lines in devices different by their impurity content shows excellent agreement to experiment. Especially noteworthy is the fact that the strength of impurity scattering is reversed from the known concentration of dopant impurities in the crystals, as the crystal with the higher dopant concentration shows lower scattering at low field than the one with the lower concentration. This raises as an issue for further improvement of these devices, the question of the nature of the scattering centers in high-purity Ge crystals at cryogenic temperatures, associated presumably with deep level impurities or crystal defects. Fig. 1 (Color online) (a) Simulated carrier trajectories for a 60 keV energy deposit from a collimated 241 Am γ source facing the bottom surface of the detector crystal. See Ref. [1] for a full description of the device and of the geometry of the charge collection field especially. Detector bias V p = 2 V; T = 20 mK. Holes are in red and electrons in blue, black, green and magenta depending on their valley of belonging. (b) Same as (a), with the polarity of the electrode biases reversed so that holes instead of electrons are drifted across the full thickness of the detector crystal

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Section: Discussionmentioning

confidence: 96%

Section: Impurity Scattering and Electron Anisotropymentioning

confidence: 98%

Carrier Anisotropy and Impurity Scattering in Ge at mK Temperatures: Modeling and Comparison to Experiment

Broniatowski

2012

J Low Temp Phys

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“…A long sought‐after objective in medicine has been the implementation of neural control to define multiple independent measures of motor activities by orderly recruitment . Although this contribution does not focus on observed vocal fold motion, it expands our earlier human study, which demonstrated that human intrinsic laryngeal muscles could be individually and mutually manipulated by means of selected QT currents applied to the RLN. Such stimulating modality is attractive because contrary to square waves, it allows the expression of all ILMs including those innervated by smaller axons.…”

Section: Discussionmentioning

confidence: 99%

“…The next phase consisted in reproducing typically termed TA/PCA mutually exclusive natural relationships . We skipped specific CT manipulation at the time, because it had been the conventional wisdom that the muscle was exclusively innervated by the superior ELN and not the RLN.…”

Section: Discussionmentioning

confidence: 99%

“…Recruitment via QT pulses is, therefore, in line with Henneman's size principle, [3][4][5] which states that under normal physiological conditions of muscle activation, smaller fibers are activated first. QT stimulation also reduces nerve/muscle fatigue [6][7][8][9][10][11] through evoked orderly recruitment as proposed in earlier animal 12 and human 13 studies.…”

Section: Progress In Functional Electrical Stimulation Of the Larynxmentioning

confidence: 99%

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Selective stimulation of human intrinsic laryngeal muscles: Analysis in a mathematical three‐dimensional space

Broniatowski

Grundfest‐Broniatowski

Schiefer

et al. 2019

The Laryngoscope

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Objectives/Hypothesis Standard stimulating methods using square waves do not appropriately restore physiological control of individual intrinsic laryngeal muscles (ILMs). To further explore our earlier study of evoked orderly recruitment by quasitrapezoidal (QT) currents, we integrated the contribution of the cricothyroideus (CT) with attention to mutual activation in an additional patient, based on recent studies of appropriate responses via strict recurrent laryngeal nerve (RLN) stimulation. Study Design Basic science study. Methods The patient received functional electrical stimulation (FES) with QT pulses at 5 Hz, 60 to 2,000 μAmp, 100 to 500 μs pulse width, 0 to 500 μs decay. Ipsilateral electromyography (EMG) responses were calculated using the average maximum amplitude, area under the curve, and the root mean square of the rectified amplitude waveforms. The thyroarytenoideus (TA), posterior cricoarytenoideus (PCA), lateral cricothyroideus (LCA), and the CT were each interrogated via two monopolar electrodes, values were recorded in MATLAB, exported to Excel, and analyzed. Individual and mutual recruitment configurations and activation delays with stimulation were explored using multiple regression and exploration factor analyses. Results A total of 868 EMG data points based on 18 trials and up to 11 subtrials were captured from each of the four ILMs. Various combinations of pulse amplitude, pulse width, and exponential decay were found to produce significant (P ≤ .001) individual ILM responses. CT mirrored the LCA, whereas the TA and PCA exhibited separate interactions along shared trajectories in a three‐dimensional space. Conclusions FES calibrated to individual and coupled ILMs offers promise for restoring normal and pathological contraction patterns via strict RLN stimulation. Level of Evidence 5 Laryngoscope, 130:967–973, 2020

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Motor organization of positive and negative emotional vocalization in the cat midbrain periaqueductal gray

Subramanian

Arun

Silburn

et al. 2015

J of Comparative Neurology

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Neurochemical microstimulation in different parts of the midbrain periaqueductal gray (PAG) in the cat generates four different types of vocalization, mews, howls, cries, and hisses. Mews signify positive vocal expression, whereas howls, hisses, and cries signify negative vocal communications. Mews were generated in the lateral column of the intermediate PAG and howls and hisses in the ventrolateral column of the intermediate PAG. Cries were generated in two regions, the lateral column of the rostral PAG and the ventrolateral column of the caudal PAG. To define the specific motor patterns belonging to mews, howls, and cries, the following muscles were recorded during these vocalizations: larynx (cricothyroid, thyroarytenoid, and posterior cricoarytenoid), tongue (genioglossus), jaw (digastric), and respiration (diaphragm, internal intercostal, external abdominal oblique, and internal abdominal oblique) muscles. Furthermore, the frequency, intensity, activation cascades, and turns and amplitude analyses of the electromyograms (EMGs) during these vocalizations were analyzed. The results show that each type of vocalization consists of a specific, circumscribed motor coordination. The nucleus retroambiguus (NRA) in the caudal medulla serves as the final premotor interneuronal output system for vocalization. NRA neurochemical microstimulation also generated vocalizations (guttural sounds). Analysis of the EMGs demonstrated that these vocalizations consist of only small parts of the emotional voalizations generated by neurochemical stimulation in the PAG. These results demonstrate that motor organization of positive and negative emotional vocal expressions are segregated in the PAG and that the PAG uses the NRA as a tool to gain access to the motoneurons generating vocalization.

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Selective intraoperative stimulation of the human larynx

Abstract: Our preliminary data on selective ILM manipulation offer promise for improved dynamic control of faulty laryngeal contraction patterns.

Cited by 7 publications

References 23 publications

Carrier Anisotropy and Impurity Scattering in Ge at mK Temperatures: Modeling and Comparison to Experiment

Carrier Anisotropy and Impurity Scattering in Ge at mK Temperatures: Modeling and Comparison to Experiment

Selective stimulation of human intrinsic laryngeal muscles: Analysis in a mathematical three‐dimensional space

Motor organization of positive and negative emotional vocalization in the cat midbrain periaqueductal gray

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