Targeting the sensory feedback within the swallowing network-Reversing artificially induced pharyngolaryngeal hypesthesia by central and peripheral stimulation strategies.
Adult
Brain
/ diagnostic imaging
Cross-Over Studies
Deglutition
/ physiology
Electric Stimulation
/ methods
Feedback, Sensory
/ physiology
Female
Humans
Hypesthesia
/ diagnostic imaging
Larynx
/ physiopathology
Magnetoencephalography
/ methods
Male
Nerve Net
/ diagnostic imaging
Pharynx
/ physiopathology
Transcranial Direct Current Stimulation
/ methods
Young Adult
dysphagia
neuromodulation
pharyngeal electrical stimulation
pharyngeal pneumatic stimulation
swallowing
transcranial direct current stimulation
Journal
Human brain mapping
ISSN: 1097-0193
Titre abrégé: Hum Brain Mapp
Pays: United States
ID NLM: 9419065
Informations de publication
Date de publication:
01 02 2021
01 02 2021
Historique:
received:
11
05
2020
revised:
21
08
2020
accepted:
29
09
2020
pubmed:
18
10
2020
medline:
15
12
2021
entrez:
17
10
2020
Statut:
ppublish
Résumé
Pharyngolaryngeal hypesthesia is a major reason for dysphagia in various neurological diseases. Emerging neuromodulation devices have shown potential to foster dysphagia rehabilitation, but the optimal treatment strategy is unknown. Because functional imaging studies are difficult to conduct in severely ill patients, we induced a virtual sensory lesion in healthy volunteers and evaluated the effects of central and peripheral neurostimulation techniques. In a sham-controlled intervention study with crossover design on 10 participants, we tested the potential of (peripheral) pharyngeal electrical stimulation (PES) and (central) transcranial direct current stimulation (tDCS) to revert the effects of lidocaine-induced pharyngolaryngeal hypesthesia on central sensorimotor processing. Changes were observed during pharyngeal air-pulse stimulation and voluntary swallowing applying magnetoencephalography before and after the interventions. PES induced a significant (p < .05) increase of activation during swallowing in the bihemispheric sensorimotor network in alpha and low gamma frequency ranges, peaking in the right premotor and left primary sensory area, respectively. With pneumatic stimulation, significant activation increase was found after PES in high gamma peaking in the left premotor area. Significant changes of brain activation after tDCS could neither be detected for pneumatic stimulation nor for swallowing. Due to the peripheral cause of dysphagia in this model, PES was able to revert the detrimental effects of reduced sensory input on central processing, whereas tDCS was not. Results may have implications for therapeutic decisions in the clinical context.
Identifiants
pubmed: 33068056
doi: 10.1002/hbm.25233
pmc: PMC7776007
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
427-438Informations de copyright
© 2020 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.
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