Functional electrical stimulation following nerve injury in a large animal model

Cercone, Marta; Jarvis, Jonathan C.; Ducharme, Norm G.; Perkins, Justin; Piercy, Richard J.; Willand, Michael P.; Mitchell, Lisa M.; Sledziona, Michael; Soderholm, L. V.; Cheetham, Jonathan

doi:10.1002/mus.26460

Cited by 10 publications

(10 citation statements)

References 62 publications

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“…As a result, the total NGGA during inspiration was not altered substantially. A similar observation was reported previously in horses over a longer period of time following injury of an RLn, 21 and in a dog with subclinical left-side LP. 11 The compensatory increase in arytenoid abduction on the uninjured side probably mitigates the effects of unilateral LP until paradoxical adduction occurs, or until the disease progresses on the contralateral side.…”

Section: Discussionsupporting

confidence: 90%

A model of transient laryngeal hemiplegia in dogs through conduction blockade of the recurrent laryngeal nerve

Martin‐Flores

Sakai

Campoy

et al. 2022

ajvr

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OBJECTIVE To create a model of transient unilateral laryngeal paralysis (LP) that will allow the study of cricoarytenoideus dorsalis dysfunction and a method for quantification of varying degrees of LP in dogs. ANIMALS 5 castrated male research Beagles. PROCEDURES Between January and February 2018, dogs were anesthetized and instrumented with a laryngeal mask airway and a flexible endoscope to record the rima glottidis. The left or right recurrent laryngeal nerve (RLn) was localized using ultrasonography and electrical stimulation, then conduction blockade was induced with perineural lidocaine. The normalized glottal gap area (NGGA) was measured before and every 15 minutes after the block. Inspired 10% carbon dioxide (CO2) was administered for 1 minute at each sampling time. The inspiratory increase in NGGA (total and each side) was measured at peak inspiration. The change in hemi-NGGA for the control side versus the anesthetized side was evaluated with a mixed-effect model. RESULTS During CO2 stimulation, the increase in inspiratory hemi-NGGA was consistently less (P < .001) for the treated side (–8% to 13%) versus the control side (49% to 82%). A compensatory increase (larger than at baseline) in the control hemi-NGGA was observed. The total NGGA remained unaffected. CLINICAL RELEVANCE Unilateral local anesthesia of the RLn produced transient unilateral LP with a compensatory increase in the hemi-NGGA for the contralateral side. This model could facilitate the evaluation of respiratory dynamics, establishment of a grading system, and collection of other important information that is otherwise difficult to obtain in dogs with LP.

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Section: Discussionsupporting

confidence: 90%

A model of transient laryngeal hemiplegia in dogs through conduction blockade of the recurrent laryngeal nerve

Martin‐Flores

Sakai

Campoy

et al. 2022

ajvr

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“…In the experiment of horses with recurrent laryngeal nerve injury, FES was implanted into the ipsilateral posterior cricoarytenoid muscle (PCA) after 20 weeks of ES, which improved muscle strength and laryngeal function (88).…”

Section: Animal Modelsmentioning

confidence: 99%

Electrical stimulation therapy for peripheral nerve injury

Zhao²,

Zhao³

et al. 2023

Front. Neurol.

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Peripheral nerve injury is common and frequently occurs in extremity trauma patients. The motor and sensory impairment caused by the injury will affect patients' daily life and social work. Surgical therapeutic approaches don't assure functional recovery, which may lead to neuronal atrophy and hinder accelerated regeneration. Rehabilitation is a necessary stage for patients to recover better. A meaningful role in non-pharmacological intervention is played by rehabilitation, through individualized electrical stimulation therapy. Clinical studies have shown that electrical stimulation enhances axon growth during nerve repair and accelerates sensorimotor recovery. According to different effects and parameters, electrical stimulation can be divided into neuromuscular, transcutaneous, and functional electrical stimulation. The therapeutic mechanism of electrical stimulation may be to reduce muscle atrophy and promote muscle reinnervation by increasing the expression of structural protective proteins and neurotrophic factors. Meanwhile, it can modulate sensory feedback and reduce neuralgia by inhibiting the descending pathway. However, there are not many summary clinical application parameters of electrical stimulation, and the long-term effectiveness and safety also need to be further explored. This article aims to explore application methodologies for effective electrical stimulation in the rehabilitation of peripheral nerve injury, with simultaneous consideration for fundamental principles of electrical stimulation and the latest technology. The highlight of this paper is to identify the most appropriate stimulation parameters (frequency, intensity, duration) to achieve efficacious electrical stimulation in the rehabilitation of peripheral nerve injury.

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“…While left NGGA consistently decreased over time, we measured a slight increase in right NGAA between the first two measurements. There are several possible explanations for this finding: this phenomenon of compensatory hyperabduction has been previously observed in horses, where following induced LP the contralateral arytenoid demonstrated increase abduction, 14 and in early naturally occurring LP (recurrent laryngeal neuropathy), the right-sided CAD muscle hypertrophy has been observed. 15 These hyperabduction/hypertrophy effects are most likely due to increased negative pressure at the glottis, although this has not been documented.…”

Section: Learning Points/take Home Messagesmentioning

confidence: 59%

Quantitative assessment of progressive laryngeal hemiplegia in a 4‐year‐old beagle

Martin‐Flores

Sakai

Cheetham

2021

Vet Record Case Reports

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Progression of unilateral laryngeal paralysis (LP) was quantified in an asymptomatic 4year-old beagle during spontaneous breathing stimulated with inhaled 10% CO 2 . Laryngeal evaluation was performed sequentially to track progression of LP over an 18-month period. Videos of the larynx during CO 2 -stimulated breathing were obtained under propofol anaesthesia. Maximal inspiratory normalised glottal gap area (NGGA) was determined on each occasion for left and right hemiglottis. Left NGGA was smaller than the right side throughout the period of follow-up. After 18 months, LP had progressed to such a degree that the left arytenoid was completely paralysed with no movement during inspiration. This case report demonstrates the possibility of early detection of LP, and quantification of progression. Early detection may allow regenerative surgical strategies for LP to maintain glottic area and reduce postoperative complication rates.

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Functional electrical stimulation following nerve injury in a large animal model

Cited by 10 publications

References 62 publications

A model of transient laryngeal hemiplegia in dogs through conduction blockade of the recurrent laryngeal nerve

A model of transient laryngeal hemiplegia in dogs through conduction blockade of the recurrent laryngeal nerve

Electrical stimulation therapy for peripheral nerve injury

Quantitative assessment of progressive laryngeal hemiplegia in a 4‐year‐old beagle

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