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Effects of Functional Electrical Stimulation on Denervated Laryngeal Muscle in a Large Animal Model

机译:功能性电刺激对大型动物模型中神经支配的喉肌的影响

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摘要

Bilateral vocal fold paralysis (BVCP) is a life-threatening condition that follows injury to the Recurrent Laryngeal nerve (RLn) and denervation of the intrinsic laryngeal musculature. Functional electrical stimulation (FES) enables restoration and control of a wide variety of motor functions impaired by lower motor neuron lesions. Here we evaluate the effects of FES on the sole arytenoid abductor, the posterior cricoarytenoid (PCA) muscle in a large animal model of RLn injury. Ten horses were instrumented with two quadripolar intramuscular electrodes in the left PCA muscle. Following a 12-week denervation period, the PCA was stimulated using a once-daily training session for 8 weeks in seven animals. Three animals were used as unstimulated controls. Denervation produced a significant increase in rheobase (P<0.001). Electrical stimulation produced a 30% increase in fiber diameter in comparison with the unstimulated control group (33.9 +/- 2.6 mu m FES+, 23.6 +/- 4.2 mu m FES-, P=0.04). A trend toward a decrease in the proportion of type 1 (slow) fibers and an increase in type 2a (fast) fibers was also observed. Despite these changes, improvement in PCA function at rest was not observed. These data suggest that electrical stimulation using a relatively conservative set of stimulation parameters can reverse the muscle fiber atrophy produced by complete denervation while avoiding a shift to a slow (type 1) fiber type.
机译:双边声带麻痹(BVCP)是威胁生命的疾病,在喉返神经(RLn)受伤和固有喉肌组织失神经之后。功能性电刺激(FES)能够恢复和控制受下运动神经元病变损害的多种运动功能。在这里,我们评估了FES对RLn损伤的大型动物模型中唯一的ary突肌外展肌,环后ary突肌(PCA)肌肉的影响。十匹马在左PCA肌肉中装有两个四极肌内电极。经过12周的神经支配期后,每天对7只动物进行一次为期8周的训练,以刺激PCA。将三只动物用作未刺激的对照。去神经作用使流变碱显着增加(P <0.001)。与未刺激的对照组相比,电刺激可使纤维直径增加30%(33.9 +/- 2.6μmFES +,23.6 +/- 4.2μmFES-,P = 0.04)。还观察到类型1(慢)纤维比例减少和类型2a(快)纤维增加的趋势。尽管有这些变化,但未观察到静息时PCA功能的改善。这些数据表明,使用相对保守的一组刺激参数进行电刺激可以逆转完全去神经支配产生的肌肉纤维萎缩,同时避免转移到慢速(1型)纤维类型。

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