Abstract:
Pharyngeal electrical stimulation (PES) applies electrical stimulation to pharyngeal mucosa (PhM) and represents a useful approach to improve swallowing function in patients with dysphagia. To determine the optimal PES modality to treat dysphagia, the mechanism underlying the effects of PES on swallowing function must be elucidated. In this study, we evaluated how PES and electrical stimulation of the superior laryngeal nerve (SLN) modulate the initiation of swallowing in anesthetized rats. A swallow was evoked by electrical stimulation of the PhM, SLN, and nucleus of the solitary tract (nTS) and pharyngeal mechanical stimulation using a von Frey filament. A swallow was identified by electromyographic bursts in mylohyoid and thyrohyoid muscles. Bilateral SLN transection abolished the swallows evoked by PhM electrical stimulation. PhM and SLN electrical stimulation decreased swallowing frequency in a similar time-dependent manner. Intravenous administration of the GABAA receptor antagonist bicuculine did not affect the time-dependent change in swallowing frequency during SLN electrical stimulation. Continuous SLN electrical stimulation significantly inhibited pharyngeal mechanically and nTS-electrically evoked swallows compared with before and 5 min after stimulation. The present findings suggest that the SLN plays a primary role in PES-evoked swallows. Additionally, continuous SLN electrical stimulation inhibits the initiation of swallowing, and the modulation of central network associated with swallowing might be partially involved in this inhibition.
摘要:
咽部电刺激(PES)对咽粘膜(PhM)施加电刺激,是改善吞咽困难患者吞咽功能的有用方法。为了确定治疗吞咽困难的最佳PES模式,必须阐明PES对吞咽功能影响的潜在机制。在这项研究中,我们评估了PES和电刺激喉上神经(SLN)如何调节麻醉大鼠吞咽的启动.PhM的电刺激诱发了吞咽,SLN,以及使用vonFrey细丝的孤束核(nTS)和咽部机械刺激。通过舌骨和甲状舌骨肌肉的肌电图爆发确定了吞咽。双侧SLN横切消除了PhM电刺激诱发的吞咽。PhM和SLN电刺激以类似的时间依赖性方式降低吞咽频率。在SLN电刺激过程中,静脉给予GABAA受体拮抗剂bicuculine不会影响吞咽频率的时间依赖性变化。与刺激前后相比,持续的SLN电刺激显着抑制了咽部机械和nTS电诱发的吞咽。目前的发现表明,SLN在PES诱发的吞咽中起主要作用。此外,持续的SLN电刺激抑制了吞咽的开始,与吞咽相关的中央网络的调节可能部分参与了这种抑制。