Zealear David, Li Yike, Huang Shan
Department of Otolaryngology, Vanderbilt University Medical Center;
Department of Otolaryngology, Vanderbilt University Medical Center.
J Vis Exp. 2020 Apr 21(158). doi: 10.3791/60345.
Electromyography (EMG) measures the muscle response to electrical stimulation or spontaneous activity of motor units and plays an important role in assessing neuromuscular function. Chronic recording of EMG activity reflecting a muscle's reinnervation status after nerve injury has been limited, due to the invasive nature of traditional EMG recording techniques. In this regard, an implantable system is designed for long-term, in vivo EMG recording and nerve stimulation. It has been applied and tested in a study on reinnervation of laryngeal muscles. This system consists of 1) two bipolar electrode nerve cuffs and leads for stimulating each of two nerves: the recurrent laryngeal nerve (RLN) and internal branch of the superior laryngeal nerve (SLN); 2) two EMG recording electrodes and leads for each of the two laryngeal muscles: posterior cricoarytenoid (PCA) muscle and thyroarytenoid-lateral cricoarytenoid (TA-LCA) muscle complex; and 3) a skin receptacle interfacing all implanted lead terminals to an external recording preamplifier and stimulator using a connection cable. The wire leads are Teflon-coated, multi-filament, type 316 stainless steel. They are coiled and can stretch during body movement of the awake animal to prevent lead breakage and electrode migration. This system is implanted during an aseptic surgery. Afterwards, baseline EMG recordings are performed before the RLN is transected in the second surgery to study muscle reinnervation. Throughout the study, multiple physiological sessions are conducted in the anesthetized animal to obtain evoked and spontaneous EMG activity that reflects the reinnervation status of laryngeal muscles. The system is compact, free of infection over the course of the study, and highly durable. This implantable system can provide a reliable platform for research in which long-term recording or nerve stimulation is required in an anesthetized or freely moving animal.
肌电图（EMG）可测量肌肉对电刺激或运动单位自发活动的反应，在评估神经肌肉功能方面发挥着重要作用。由于传统肌电图记录技术具有侵入性，长期记录反映神经损伤后肌肉再支配状态的肌电图活动一直受到限制。在这方面，设计了一种可植入系统用于长期体内肌电图记录和神经刺激。该系统已在一项关于喉肌再支配的研究中得到应用和测试。该系统包括：1）两个双极电极神经袖套及用于刺激两条神经（喉返神经（RLN）和喉上神经内支（SLN））的导线；2）用于两条喉肌（环杓后肌（PCA）和甲杓肌-环杓侧肌（TA-LCA）复合体）的两个肌电图记录电极及导线；3）一个皮肤接收器，通过连接电缆将所有植入的导线端子与外部记录前置放大器和刺激器相连。导线采用聚四氟乙烯涂层、多丝316型不锈钢材质。它们呈螺旋状，在清醒动物身体移动时可伸展，以防止导线断裂和电极移位。该系统在无菌手术期间植入。之后，在第二次手术切断喉返神经之前进行基线肌电图记录，以研究肌肉再支配情况。在整个研究过程中，对麻醉动物进行多次生理实验，以获取反映喉肌再支配状态的诱发和自发肌电图活动。该系统结构紧凑，在研究过程中无感染，且耐用性高。这种可植入系统可为需要在麻醉或自由活动动物中进行长期记录或神经刺激的研究提供可靠平台。
