Artificial Manipulation of Voice in the Human by an Implanted Stimulator:

Voice therapy: From the past to the present from a phoniatrician's perspective (Voice of Experience Keynote, PEVOC 2013, Prague)

The roots of voice therapy can be traced back to the professional use of the voice in antiquity. During the Baroque period, aspects of the singers' voice came to the fore, and in the beginning of the twentieth century, physiologic and medical perspectives concentrating on the peripheral areas of phonation were introduced. In parallel, holistic approaches stressed psychological and behavioral conditions. A vast amount of specific methods and strategies has been developed, but so far there has been no clear evidence revealing which of the approaches provides the best efficacy. According to the experience of the author, rather than the method itself, it is the clinician using the methods who makes the difference. The general guide-line for the choice of an appropriate treatment should be the Hippocratic imperative: primum nil nocere--first do no harm.

Dramatic first words spoken in 2 children after vagus nerve stimulation

Vagus nerve stimulation has become an accepted adjunctive treatment for refractory epilepsy with more recent FDA approval in the treatment of depression. Many "positive" effects have been noted in patients with epilepsy namely increased alertness, improved cognition, behavior and mood. These changes appear to be independent of seizure reduction and antiepileptic drug decrease. We present two children (aged 8 and 9 years) who were non-verbal and spoke their first words shortly after vagus nerve stimulators were implanted. The mechanism is unclear although vagus nerve stimulation has been clearly shown to induce neuronal, chemical and perfusion changes in both subcortical and cortical regions of the brain. There is likely a combined effect on primary speech areas as well subcortical and mamillothalamic tracts, and possibly even stimulation and changes at the local vocal cord level contributing to this phenomenon. Our observation has important implications in encephalopathic patients both with and without epilepsy.