PubMed · 8129151
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D O'Flaherty, A P Adams. 1994. Pacemaker failure and peripheral nerve stimulation.. https://doi.org/10.1111/j.1365-2044.1994.tb03410.x
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OBJECTIVES: To determine the motor responses resulting from direct electrical stimulation of the hypoglossal (HG) nerve and to correlate these responses to changes in upper airway patency during sleep. DESIGN: The motor effects of direct electrical stimulation of the main trunk of the HG nerve and the branch that supplies the genioglossus muscle during anesthesia and wakefulness were assessed visually. Responses in airflow during sleep to HG nerve stimulation were assessed with standard polysomnographic techniques. SETTING: University medical center. PATIENTS: Fifteen patients undergoing a surgical procedure that involved the neck that exposed the HG nerve and 5 volunteer patients with obstructive sleep apnea constituted the study population. INTERVENTIONS: The main trunk (n = 3) and genioglossus branch (n = 2) of the HG nerve were stimulated electrically with a half-cuff tripolar electrode. RESULTS: Stimulation of the branch of the HG nerve that innervates the genioglossus muscle caused protrusion and contralateral deviation of the tongue. Stimulation of the main trunk of the HG nerve caused slight ipsilateral deviation and retrusion of the tongue. The arousal threshold for stimulation exceeded the motor recruitment threshold by 0.8 +/- 0.4 V. Inspiratory airflow increased in all patients by 184.5 +/- 61.7 mL/s (mean +/- SD; P = .02, analysis of variance) with stimulation. CONCLUSION: Direct HG nerve stimulation below the arousal threshold can improve airflow in patients with obstructive sleep apnea.
Evacuation of urine in paraplegics without the need for catheters would be possible when voiding could be induced by eliciting a bladder contraction. A challenging option to obtain detrusor contraction is electrical stimulation of the detrusor muscle or its motor nerves. This article reviews the 4 possible stimulation sites where stimulation would result in a detrusor contraction: the bladder wall, the pelvic nerves, the sacral roots, and the spinal cord. With respect to electrode application, sacral root stimulation is most attractive. However, in general, sacral root stimulation results in simultaneous activation of both the detrusor muscle and the urethral sphincter, leading to little or no voiding. Several methods are available to overcome the stimulation-induced detrusor-sphincter dyssynergia and allow urine evacuation. These methods, including poststimulus voiding, fatiguing of the sphincter, blocking pudendal nerve transmission, and selective stimulation techniques that allow selective detrusor activation by sacral root stimulation, are reviewed in this paper.
There are still no clear biophysical models for Associative Long-Term Potentiation (LTP) and Depression (LTD) in the hippocampus, where two populations of synapses targeted to the same receptive field are involved. Here we propose a model that allows an interpretation of the experiments in terms of the molecular processes that may be involved in associative memory. The model suggests that retrograde messengers could have a critical role in the induction and maintenance of associative LTP and LTD, by controlling the coupling between the two populations of synapses.