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Method to test the long-term stability of functional electrical stimulation via multichannel electrodes (e.g., applicable for laryngeal pacing) and to define best points for stimulation: in vivo animal analysis

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The study aim was to identify and analyze intramuscular electrically sensitive points. Electrically sensitive points are herein defined as positions, which allow muscles stimulation with a minimum possible fatigue for a maximum amount of time. A multichannel array electrode was used which could be interesting to retain the function of larynx muscle after paralysis. Eight array electrodes were implanted in the triceps brachii muscle of four rats. While being under anesthesia, the animals were intramuscularly stimulated at 16 different positions. Sihler’s staining technique was used to make visible the nerves routes and the intramuscular position of the individual electrode plate. The positions of the motor end plates were determined by means of multichannel-electromyography. The positions that allow longest stimulation periods are located close to the points where the nerves enter the muscle. Stimulation at the position of the motor end plates does not result in stimulation periods above average. Locations initially causing strong muscle contractions are not necessarily identical to the ones allowing long stimulation periods. The animal model identified the stimulation points for minimal possible muscle fatigue stimulation as being located close to the points of entrance of the nerve into the muscle. Stimulation causing an initially strong contraction response is no indication of optimal location of the stimulation electrode in terms of chronic stimulation. The array electrode of this study could be interesting as a stimulation electrode for a larynx pacemaker.

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References

  1. Faenger B, Schumann NP, Arnold D, Grassme R, Guntinas-Lichius O, Scholle HC (2016) Development of a novel larynx pacemaker multichannel array electrode: in vivo animal analysis. Laryngoscope 126(2):429–436

    Article  PubMed  Google Scholar 

  2. Reid RW (1920) Motor points in relation to the surface of the body. J Anat 54(Pt 4):271–275

    CAS  PubMed  PubMed Central  Google Scholar 

  3. Botter A, Oprandi G, Lanfranco F, Allasia S, Maffiuletti NA, Minetto MA (2011) Atlas of the muscle motor points for the lower limb: implications for electrical stimulation procedures and electrode positioning. Eur J Appl Physiol 111(10):2461–2471

    Article  PubMed  Google Scholar 

  4. Kamen G, Gabriel DA (2009) Essentials of electromyography. Human Kinetics, Champaign, IL

    Google Scholar 

  5. Karu ZZ, Durfee WK, Barzilai AM (1995) Reducing muscle fatigue in FES applications by stimulating with N-let pulse trains. IEEE Trans Biomed Eng 42(8):809–817

    Article  CAS  PubMed  Google Scholar 

  6. Netter FH (1989) In: Colacino S (ed) Atlas of human anatomy. Ciba Geigy Corporation, New Jersey

  7. Warfel JH (1993) The extremities: muscles and motor points, 6th edn. Lea & Febiger, Philadelphia

    Google Scholar 

  8. Onders RP, Dimarco AF, Ignagni AR, Aiyar H, Mortimer JT (2004) Mapping the phrenic nerve motor point: the key to a successful laparoscopic diaphragm pacing system in the first human series. Surgery 136(4):819–826

    Article  PubMed  Google Scholar 

  9. Onders RP, Elmo M, Khansarinia S, Bowman B, Yee J, Road J, Bass B, Dunkin B, Ingvarsson PE, Oddsdóttir M (2009) Complete worldwide operative experience in laparoscopic diaphragm pacing: results and differences in spinal cord injured patients and amyotrophic lateral sclerosis patients. Surg Endosc 23(7):1433–1440

    Article  PubMed  Google Scholar 

  10. Onders RP, DiMarco AF, Ignagni AR, Mortimer JT (2005) The learning curve for investigational surgery: lessons learned from laparoscopic diaphragm pacing for chronic ventilator dependence. Surg Endosc 19(5):633–637

    Article  CAS  PubMed  Google Scholar 

  11. DiMarco AF, Onders RP, Kowalski KE, Miller ME, Ferek S, Mortimer JT (2002) Phrenic nerve pacing in a tetraplegic patient via intramuscular diaphragm electrodes. Am J Respir Crit Care Med 166(12 Pt 1):1604–1606

    Article  PubMed  Google Scholar 

  12. Zwarts MJ, Stegeman DF (2003) Multichannel surface EMG: basic aspects and clinical utility. Muscle Nerve 28:1–17

    Article  PubMed  Google Scholar 

  13. Sihler G (1895) Über eine leichte und sichere Methode, die Nervenendigung an Muskelfasern und Gefässen nachzuweisen. Arch. f. mikrosk. Anatom.Verhandlungen der physiologischen Gesellschaft zu Berlin 28. December 1894. 46:709

  14. Wharton LR (1937) A technique for studying the innervation of organs. Anat Rec 67(4):469–475

    Article  Google Scholar 

  15. Williams TW (1943) A technique for the gross differential staining of peripheral nerves in cleared vertebrate tissue. Anat Rec Xlx:189–194

    Article  Google Scholar 

  16. Liu J, Kumar VP, Shen Y, Lau HK, Pereira BP, Pho RW (1997) Modified Sihler’s technique for studying the distribution of intramuscular nerve branches in mammalian skeletal muscle. Anat Rec 247(1):137–144

    Article  CAS  PubMed  Google Scholar 

  17. Liu J, Lau HK, Min WX, Pereira BP, Kumar VP, Pho RW (1995) Contractile characteristics on electrical stimulation of muscle with multiple motor points. An in vivo study in rabbits. Clin Orthop Relat Res 313:231–238

    Google Scholar 

  18. Wu BL, Sanders I (1992) A technique for demonstrating the nerve supply of whole larynges. Arch Otolaryngol Head Neck Surg 118(8):822–827

    Article  CAS  PubMed  Google Scholar 

  19. Kilgore KL, Peckham PH, Keith MW, Thrope GB (1990) Electrode characterization for functional application to upper extremity FNS. IEEE Trans Biomed Eng 37(1):12–21

    Article  CAS  PubMed  Google Scholar 

  20. Kilgore KL, Peckham PH, Thrope GB, Keith MW, Gallaher-Stone KA (1989) Synthesis of hand grasp using functional neuromuscular stimulation. IEEE Trans Biomed Eng 36(7):761–770

    Article  CAS  PubMed  Google Scholar 

  21. Grandjean PA, Mortimer JT (1986) Recruitment properties of monopolar and bipolar epimysial electrodes. Ann Biomed Eng 14(1):53–66

    Article  CAS  PubMed  Google Scholar 

  22. Zealear DL, Billante CR, Courey MS, Sant’Anna GD, Netterville JL (2002) Electrically stimulated glottal opening combined with adductor muscle botox blockade restores both ventilation and voice in a patient with bilateral laryngeal paralysis. Ann Otol Rhinol Laryngol 111(6):500–506

    Article  PubMed  Google Scholar 

  23. Katada A, Van Himbergen D, Kunibe I, Nonaka S, Harabuchi Y, Huang S, Billante CR, Zealear DL (2008) Evaluation of a deep brain stimulation electrode for laryngeal pacing. Ann Otol Rhinol Laryngol. 117(8):621–629

    Article  PubMed  Google Scholar 

  24. Kwon JY, Kim JS, Lee WI (2009) Anatomic localization of motor points of hip adductors. Am J Phys Med Rehabil 88(4):336–341

    Article  PubMed  Google Scholar 

  25. Park BK, Shin YB, Ko HY, Park JH, Baek SY (2007) Anatomic motor point localization of the biceps brachii and brachialis muscles. J Korean Med Sci 22(3):459–462

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The author would like to thank Ira Sanders for the advice concerning the use of Sihler’s staining, and Ms. Johanna Malcher for language assistance.

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Correspondence to Bernd Faenger.

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Faenger, B., Arnold, D., Schumann, N.P. et al. Method to test the long-term stability of functional electrical stimulation via multichannel electrodes (e.g., applicable for laryngeal pacing) and to define best points for stimulation: in vivo animal analysis. Eur Arch Otorhinolaryngol 274, 327–336 (2017). https://doi.org/10.1007/s00405-016-4202-3

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  • DOI: https://doi.org/10.1007/s00405-016-4202-3

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