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Kirsch A, Gerstenberger C, Jakubaß B, Tschernitz M, Perkins JD, Groselj‐Strele A, Lanmüller H, Jarvis JC, Kniesburges S, Döllinger M, Gugatschka M. Bilateral Functional Electrical Stimulation for the Treatment of Presbyphonia in a Sheep Model. Laryngoscope 2024; 134:848-854. [PMID: 37597167 PMCID: PMC10952233 DOI: 10.1002/lary.30984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVES The aim of the study was to increase muscle volume and improve phonation characteristics of the aged ovine larynx by functional electrical stimulation (FES) using a minimally invasive surgical procedure. METHODS Stimulation electrodes were placed bilaterally near the terminal adduction branch of the recurrent laryngeal nerves (RLN). The electrodes were connected to battery powered pulse generators implanted subcutaneously at the neck region. Training patterns were programmed by an external programmer using a bidirectional radio frequency link. Training sessions were repeated automatically by the implant every other day for 1 week followed by every day for 8 weeks in the awake animal. Another group of animals were used as sham, with electrodes positioned but not connected to an implant. Outcome parameters included gene expression analysis, histological assessment of muscle fiber size, functional analysis, and volumetric measurements based on three-dimensional reconstructions of the entire thyroarytenoid muscle (TAM). RESULTS Increase in minimal muscle fiber diameter and an improvement in vocal efficiency were observed following FES, compared with sham animals. CONCLUSION This is the first study to demonstrate beneficial effects in the TAM of FES at molecular, histological, and functional levels. FES of the terminal branches of the RLN reversed the effects of age-related changes and improved vocal efficiency. LEVEL OF EVIDENCE NA Laryngoscope, 134:848-854, 2024.
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Affiliation(s)
- Andrijana Kirsch
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
| | - Claus Gerstenberger
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
| | - Bernhard Jakubaß
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Magdalena Tschernitz
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
| | | | - Andrea Groselj‐Strele
- Core Facility Computational Bioanalytics, Center for Medical ResearchMedical University of GrazGrazAustria
| | - Hermann Lanmüller
- Center of Medical Physics and Biomedical EngineeringMedical University of ViennaViennaAustria
| | - Jonathan C. Jarvis
- School of Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUK
| | - Stefan Kniesburges
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck SurgeryUniversity Hospital Erlangen, Friedrich‐Alexander‐Universität Erlangen‐NürnbergErlangenGermany
| | - Markus Gugatschka
- Division of Phoniatrics, ENT University HospitalMedical University of GrazGrazAustria
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Jakubaß B, Peters G, Kniesburges S, Semmler M, Kirsch A, Gerstenberger C, Gugatschka M, Döllinger M. Effect of functional electric stimulation on phonation in an ex vivo aged ovine model. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2023; 153:2803. [PMID: 37154554 DOI: 10.1121/10.0017923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 04/07/2023] [Indexed: 05/10/2023]
Abstract
With age, the atrophy of the thyroarytenoid muscle (TAM), and thus atrophy of the vocal folds, leads to decreased glottal closure, increased breathiness, and a loss in voice quality, which results in a reduced quality of life. A method to counteract the atrophy of the TAM is to induce hypertrophy in the muscle by functional electric stimulation (FES). In this study, phonation experiments were performed with ex vivo larynges of six stimulated and six unstimulated ten-year-old sheep to investigate the impact of FES on phonation. Electrodes were implanted bilaterally near the cricothyroid joint. FES treatment was provided for nine weeks before harvesting. The multimodal measurement setup simultaneously recorded high-speed video of the vocal fold oscillation, the supraglottal acoustic signal, and the subglottal pressure signal. Results of 683 measurements show a 65.6% lower glottal gap index, a 22.7% higher tissue flexibility (measured by the amplitude to length ratio), and a 473.7% higher coefficient of determination (R2) of the regression of subglottal and supraglottal cepstral peak prominence during phonation for the stimulated group. These results suggest that FES improves the phonatory process for aged larynges or presbyphonia.
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Affiliation(s)
- Bernhard Jakubaß
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany
| | - Gregor Peters
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany
| | - Stefan Kniesburges
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany
| | - Marion Semmler
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany
| | - Andrijana Kirsch
- Division of Phoniatrics, ENT University Hospital Graz, Medical University of Graz, Auenbruggerplatz 26, Graz 8036, Austria
| | - Claus Gerstenberger
- Division of Phoniatrics, ENT University Hospital Graz, Medical University of Graz, Auenbruggerplatz 26, Graz 8036, Austria
| | - Markus Gugatschka
- Division of Phoniatrics, ENT University Hospital Graz, Medical University of Graz, Auenbruggerplatz 26, Graz 8036, Austria
| | - Michael Döllinger
- Division of Phoniatrics and Pediatric Audiology at the Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054 Erlangen, Germany
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Liu X, Su Z, Gao Q, Ping Y, Xie H, Yang Y, Wang D. Wireless-controlled cubic neural stimulator for free-moving animals. ROYAL SOCIETY OPEN SCIENCE 2023; 10:221116. [PMID: 36866076 PMCID: PMC9974298 DOI: 10.1098/rsos.221116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
An electrical stimulator transmitting information into selected neural circuits is a promising approach for neural prostheses or animal robots. However, traditional stimulators are based on rigid printed circuit board (PCB) technology; technological limitations hindered the development of stimulators, especially for experiments involving free-moving subjects. Here we described a small (1.6 × 1.8 × 1.6 cm), lightweight (4 g, including a 100 mA h lithium battery) and multi-channel (eight unipolar or four bipolar biphasic channels) cubic wireless electrical stimulator exploiting flexible PCB technology. In comparison with the traditional stimulator, an appliance of both flexible PCB and cube structure makes it smaller and lighter, and enhances its stability. Stimulation sequences can be constructed with 100 selectable current levels, 40 selectable frequency levels and 20 selectable pulse-width-ratio levels. Moreover, the distance of wireless communication can reach approximately 150 m. Both in vitro and in vivo results have demonstrated functionality of the stimulator. The feasibility of remote pigeon's navigation using the proposed stimulator was successfully verified.
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Affiliation(s)
- Xinyu Liu
- School of Intelligent Manufacturing, Huanghuai University, Zhumadian 463000, People's Republic of China
- School of Control Science and Engineering, Dalian University of Technology, Dalian 116024, People's Republic of China
- School of Mechanical and Electrical Engineering, Jiyuan Vocational and Technical College, Jiyuan 459000, People's Republic of China
| | - Zhenling Su
- School of Intelligent Manufacturing, Huanghuai University, Zhumadian 463000, People's Republic of China
| | - Qingran Gao
- School of Mechanical and Electrical Engineering, Jiyuan Vocational and Technical College, Jiyuan 459000, People's Republic of China
| | - Yanna Ping
- School of Intelligent Manufacturing, Huanghuai University, Zhumadian 463000, People's Republic of China
| | - Hang Xie
- School of Intelligent Manufacturing, Huanghuai University, Zhumadian 463000, People's Republic of China
| | - Yang Yang
- Department of Neurosurgery, Zhumadian Central Hospital, Zhumadian 463000, Henan, People's Republic of China
| | - Dongyun Wang
- School of Intelligent Manufacturing, Huanghuai University, Zhumadian 463000, People's Republic of China
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Viggars MR, Sutherland H, Lanmüller H, Schmoll M, Bijak M, Jarvis JC. Adaptation of the transcriptional response to resistance exercise over 4 weeks of daily training. FASEB J 2023; 37:e22686. [PMID: 36468768 DOI: 10.1096/fj.202201418r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/05/2022] [Accepted: 11/21/2022] [Indexed: 12/12/2022]
Abstract
We present the time course of change in the muscle transcriptome 1 h after the last exercise bout of a daily resistance training program lasting 2, 10, 20, or 30 days. Daily exercise in rat tibialis anterior muscles (5 sets of 10 repetitions over 20 min) induced progressive muscle growth that approached a new stable state after 30 days. The acute transcriptional response changed along with progressive adaptation of the muscle phenotype. For example, expression of type 2B myosin was silenced. Time courses recently synthesized from human exercise studies do not demonstrate so clearly the interplay between the acute exercise response and the longer-term consequences of repeated exercise. We highlight classes of transcripts and transcription factors whose expression increases during the growth phase and declines again as the muscle adapts to a new daily pattern of activity and reduces its rate of growth. Myc appears to play a central role.
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Affiliation(s)
- Mark R Viggars
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Department of Physiology and Aging, University of Florida, Gainesville, Florida, USA.,Myology Institute, University of Florida, Gainesville, Florida, USA
| | - Hazel Sutherland
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Hermann Lanmüller
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Martin Schmoll
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Manfred Bijak
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Jonathan C Jarvis
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Datta-Chaudhuri T. Closed-loop neuromodulation will increase the utility of mouse models in Bioelectronic Medicine. Bioelectron Med 2021; 7:10. [PMID: 34193309 PMCID: PMC8244222 DOI: 10.1186/s42234-021-00071-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/01/2021] [Indexed: 01/16/2023] Open
Abstract
Mouse models have been of tremendous benefit to medical science for the better part of a century, yet bioelectronic medicine research using mice has been limited to mostly acute studies because of a lack of tools for chronic stimulation and sensing. A wireless neuromodulation platform small enough for implantation in mice will significantly increase the utility of mouse models in bioelectronic medicine. This perspective examines the necessary functionality of such a system and the technical challenges needed to be overcome for its development. Recent progress is examined and the outlook for the future of implantable devices for mice is discussed.
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Affiliation(s)
- Timir Datta-Chaudhuri
- Institute of Bioelectronic Medicine, The Feinstein Institutes for Medical Research, Northwell Health, 350 Community Drive, Manhasset, NY, 11030, USA. .,Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 500 Hofstra University, Hempstead, NY, 11549, USA.
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