Functional electrical stimulation following nerve injury in a large animal model.
Abstract: Controversy exists over the effects of functional electrical stimulation (FES) on reinnervation. We hypothesized that intramuscular FES would not delay reinnervation after recurrent laryngeal nerve (RLn) axonotmesis. RLn cryo-injury and electrode implantation in ipsilateral posterior cricoarytenoid muscle (PCA) were performed in horses. PCA was stimulated for 20 weeks in eight animals; seven served as controls. Reinnervation was monitored through muscle response to hypercapnia, electrical stimulation and exercise. Ultimately, muscle fiber type proportions and minimum fiber diameters, and RLn axon number and degree of myelination were determined. Laryngeal function returned to normal in both groups within 22 weeks. FES improved muscle strength and geometry, and induced increased type I:II fiber proportion (p = 0.038) in the stimulated PCA. FES showed no deleterious effects on reinnervation. Intramuscular electrical stimulation did not delay PCA reinnervation after axonotmesis. FES can represent a supportive treatment to promote laryngeal functional recovery after RLn injury. Muscle Nerve 59:717-725, 2019.
© 2019 Wiley Periodicals, Inc.
Publication Date: 2019-03-25 PubMed ID: 30815883DOI: 10.1002/mus.26460Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research discusses the overall impact of functional electrical stimulation (FES) on the reinnervation process following nerve injury in horses, with a specific analysis on the recovery of the recurrent laryngeal nerve (RLn).
Introduction to the Study
- The main objective of this research was to understand the implication of functional electrical stimulation (FES) on reinnervation, specifically following axonotmesis (a severe form of nerve injury) of the recurrent laryngeal nerve (RLn) inside the posterior cricoarytenoid muscle (PCA) of horses.
Conducting the Study
- The researchers induced a RLN injury and implanted an electrode in the PCA muscle of horses.
- Of the total 15 horses studied, FES was administered to eight for 20 weeks while the remaining seven served as controls.
- Reinnervation was observed by noting the response of the PCA muscle to high carbon dioxide levels (hypercapnia), electrical stimulation, and exercise.
Results of the Study
- Laryngeal function returned to normal in both FES-treated and control animals within approximately 22 weeks.
- FES had a positive impact on muscle strength and structure, increasing the proportion of type I:II fibers in the PCA muscle. The statistical significance of this change was noted (p=0.038).
- Importantly, FES did not show any detrimental effects on the nerve reinnervation process – the RLN’s reconnection in the PCA muscle was not delayed as a result of FES.
Conclusions from the Study
- Although there’s controversy over the effects of functional electrical stimulation on reinnervation, the study supports the beneficial effects of using FES for recovery from nerve injuries, successfully proving the initial hypothesis.
- The evidence points towards FES potentially serving as an ancillary treatment to expedite functional recovery of the larynx following a RLN injury.
Cite This Article
APA
Cercone M, Jarvis JC, Ducharme NG, Perkins J, Piercy RJ, Willand MP, Mitchell LM, Sledziona M, Soderholm L, Cheetham J.
(2019).
Functional electrical stimulation following nerve injury in a large animal model.
Muscle Nerve, 59(6), 717-725.
https://doi.org/10.1002/mus.26460 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
- John Moores University, Liverpool, UK.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Sciences and Services, Royal Veterinary College, London, UK.
- Comparative Neuromuscular Diseases Laboratory, Department of Clinical Sciences and Services, Royal Veterinary College, London, UK.
- Epineuron Technologies Inc., London, Ontario, Canada.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA.
MeSH Terms
- Animals
- Disease Models, Animal
- Electric Stimulation / methods
- Electric Stimulation Therapy
- Electrodes, Implanted
- Female
- Horses
- Laryngeal Muscles / innervation
- Laryngeal Muscles / physiopathology
- Male
- Muscle Denervation
- Muscle Strength
- Nerve Regeneration
- Recovery of Function
- Recurrent Laryngeal Nerve Injuries / physiopathology
- Recurrent Laryngeal Nerve Injuries / therapy
Citations
This article has been cited 7 times.- Ni L, Yao Z, Zhao Y, Zhang T, Wang J, Li S, Chen Z. Electrical stimulation therapy for peripheral nerve injury. Front Neurol 2023;14:1081458.
- Martin-Flores M, Sakai DM, Cheetham J. Quantitative assessment of progressive laryngeal hemiplegia in a 4-year-old beagle. Vet Rec Case Rep 2022 Mar;10(1).
- Otto S, Michler JK, Dhein S, Mülling CKW. Development of a constant pressure perfused ex vivo model of the equine larynx. PLoS One 2021;16(5):e0251530.
- Bazarek SF, Krenn MJ, Shah SB, Mandeville RM, Brown JM. Novel Technologies to Address the Lower Motor Neuron Injury and Augment Reconstruction in Spinal Cord Injury. Cells 2024 Jul 22;13(14).
- Walluks K, Hoffmann B, Svensson CM, Förster G, Müller AH, Jarvis J, Perkins J, Figge MT, Arnold D. Long-term stimulation by implanted pacemaker enables non-atrophic treatment of bilateral vocal fold paresis in a human-like animal model. Sci Rep 2024 May 7;14(1):10440.
- Arnold D, Thielker J, Klingner CM, Guntinas-Lichius O, Volk GF. Selective zygomaticus muscle activation by ball electrodes in synkinetically reinnervated patients after facial paralysis. Front Rehabil Sci 2023;4:1205154.
- Martin-Flores M, Sakai DM, Campoy L, Cheetham J. A model of transient laryngeal hemiplegia in dogs through conduction blockade of the recurrent laryngeal nerve. Am J Vet Res 2022 Jul 30;83(10).
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