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.

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.

EMG analysis of the thenar muscles as a model for EMG-triggered larynx stimulation.

Paralysis of one or both sides of the larynx musculature compromises breathing and speech function. Currently there is no surgical remedy to restore adequate function of the larynx. A plausible alternative solution is triggered electrical stimulation of the paralysed larynx site using a laryngeal pacemaker. Triggering of the pacemaker succeeds via constant EMG measurement of the muscle activity of the healthy larynx side. The EMG data analysis described in this work is one possible approach for regulating pacemaker triggering. In this study we used EMG data from the thenar muscles as a model to calculate a trigger point.