Abstract:
BACKGROUND:Neuromuscular electrical stimulation (NMES) of the muscles underlying the pharynx and faucial pillars affects the excitability of corticobulbar projections in a frequency- and duration-specific manner. The anterior hyomandibular (submental) muscles are primary targets for the clinical application of NMES to improve disordered swallowing, but the optimal NMES parameters for this application are unknown. OBJECTIVE:To determine the influence of NMES parameters on the excitability of corticobulbar projections to the submental musculature. METHODS:Transcranial magnetic stimulation (TMS) was used in event-related protocols, triggered by either volitional contraction of the submental muscles or pharyngeal swallowing, to assess corticobulbar excitability prior to, immediately following, and 30, 60, and 90 minutes post-NMES in 25 healthy volunteers. In the first 2 experiments, 4 stimulus frequencies (5, 20, 40, and 80 Hz) and 3 NMES dosages, manipulated through stimulus train durations or number of repetitions, were evaluated. The optimal excitatory NMES triggered by volitional swallowing (event-related NMES) was then replicated in a new sample and contrasted with non-event-related NMES (either discrete events or continuously for 1 hour). RESULTS:It was found that 80Hz NMES increased motor-evoked potential (MEP) amplitude at 30 minutes and 60 minutes poststimulation only after 60 repetitions of 4-s event-related NMES trains. Non-event-related and continuous NMES did not affect MEP amplitudes. No changes in MEP onset latencies were observed. CONCLUSIONS:Changes in corticobulbar excitability induced by NMES of the submental muscle group are frequency and dose dependent and only occur after NMES triggered by volitional swallowing. Underlying neural mechanisms are discussed.
journal_name
Neurorehabil Neural Repairjournal_title
Neurorehabilitation and neural repairauthors
Doeltgen SH,Dalrymple-Alford J,Ridding MC,Huckabee MLdoi
10.1177/1545968309360417subject
Has Abstractpub_date
2010-07-01 00:00:00pages
519-27issue
6eissn
1545-9683issn
1552-6844pii
1545968309360417journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Limited data are available about the effectiveness of early rehabilitation after stroke. OBJECTIVE:This is the 1st randomized controlled trial of constraint-induced movement therapy (CIMT) in subacute stroke to investigate neurophysiologic mechanisms and long-term outcome. METHODS:Within 2 weeks after stro...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Surface electrical stimulation of the abdominal muscles, with electrodes placed in the posterolateral position, combined with a voluntary cough can assist clearance of airway secretions in individuals with high-level spinal cord injury (SCI). OBJECTIVE:To determine whether an increase in stimulus intensity ...
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