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颏下敏感经皮电刺激对口腔咽皮质虚拟损伤的影响。

Effect of submental sensitive transcutaneous electrical stimulation on virtual lesions of the oropharyngeal cortex.

机构信息

Service de MPR, centre hospitalier Arcachon, 33260 La Teste de Buch, France; Service de MPR, CHU de Bordeaux, 33076 Bordeaux, France; EA 4136, université de Bordeaux, 33000 Bordeaux, France.

Service de physiologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.

出版信息

Ann Phys Rehabil Med. 2016 Apr;59(2):94-9. doi: 10.1016/j.rehab.2015.10.010. Epub 2015 Dec 21.

Abstract

OBJECTIVE

The aim of this study was to assess the effect of submental sensitive transcutaneous electrical stimulation (SSTES) on pharyngeal cortical representation after the creation of an oropharyngeal cortical virtual lesion in healthy subjects.

METHODS

Motor-evoked potential amplitude of the mylohyoid muscles was measured with transcranial magnetic stimulation (TMS), the oropharyngeal cortex was mapped by cartography, and videofluoroscopic parameters of swallowing function were measured before and after SSTES (at the end of SSTES [0 min] and at 30 and 60 min), after the creation of a cortical virtual lesion (repetitive TMS, 1 Hz, 20 min on the dominant swallowing hemisphere).

RESULTS

Nine subjects completed the study. After 20 min of SSTES, motor-evoked potential amplitude increased (P<0.05), as did swallow reaction time after repetitive TMS, as seen on videofluoroscopy, which was reversed after electrical stimulation. On cortical mapping, the number of points with a cortical response increased in the dominant lesioned hemisphere (P<0.05), remaining constant at 60 min (P<0.05).

CONCLUSION

SSTES may be effective for producing cortical plasticity for mylohyoid muscles and reverses oropharyngeal cortical inhibition in healthy subjects. It could be a simple non-invasive way to treat post-stroke dysphagia.

摘要

目的

本研究旨在评估颏下敏感经皮电刺激(SSTES)对健康受试者口咽皮质虚拟病变形成后咽皮质代表区的影响。

方法

采用经颅磁刺激(TMS)测量下颌舌骨肌运动诱发电位幅度,通过映射图绘制口咽皮质,并在 SSTES 前后(SSTES 结束时[0 分钟]和 30 分钟和 60 分钟)、皮质虚拟病变形成后(重复 TMS,1Hz,优势吞咽半球 20 分钟)测量吞咽功能的视频荧光透视参数。

结果

9 名受试者完成了这项研究。20 分钟的 SSTES 后,运动诱发电位幅度增加(P<0.05),重复 TMS 后的吞咽反应时间也增加,视频荧光透视可见,刺激后反应逆转。在皮质映射中,优势病变半球的皮质反应点数量增加(P<0.05),60 分钟时保持不变(P<0.05)。

结论

SSTES 可能对面肌产生皮质可塑性,逆转健康受试者口咽皮质抑制作用。它可能是一种简单的非侵入性治疗中风后吞咽困难的方法。

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