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Deep Brain and Vagal Nerve Stimulation

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Neurologic and Neurodegenerative Diseases of the Larynx

Abstract

Deep brain stimulation (DBS) and vagal nerve stimulation (VNS) are forms of electrical neuromodulation that elicit a downstream neurological change to the brainstem and midbrain via central and peripheral approaches. Despite the critical role of the brainstem/midbrain and the vagus nerve in regulating voice and swallowing function, there has been little systemic study on the effects of neurostimulation on the larynx.

Vagal nerve stimulation has shown adverse effects on laryngeal function ranging from temporary movement problems that affect cough, voice, and swallowing to permanent vocal fold paralysis. Rates of voice and swallowing problems after VNS implantation are imprecise but in small cases series reported to be from 25% to 50%.

Deep brain stimulation consequences are dependent on the clinical indication, target, and CNS placement. DBS for treatment of essential tremor has demonstrated to consistently improve vocal tremor. However, current targets for DBS with Parkinson disease (PD) and generalized dystonia do not seem to improve voice and speech consistently. Clinical trials for DBS treatment in spasmodic dysphonia are underway. These devices have shown both beneficial and negative effects on voice and swallowing, and further study is warranted.

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Authors and Affiliations

  1. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA

    Sungjin A. Song & Phillip C. Song

  2. Department of Otolaryngology, Harvard Medical School, Boston, MA, USA

    Sungjin A. Song & Phillip C. Song

  3. UMass Memorial Medical Center, University of Massachusetts Medical School, Worcester, MA, USA

    Pawan Mathew

  4. Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, MA, USA

    Farid Hamzei-Sichani

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  1. Sungjin A. Song
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  2. Pawan Mathew
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  3. Farid Hamzei-Sichani
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  4. Phillip C. Song
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Correspondence to Sungjin A. Song .

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  1. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Philip A. Weissbrod

  2. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, USA

    David O. Francis

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Song, S.A., Mathew, P., Hamzei-Sichani, F., Song, P.C. (2020). Deep Brain and Vagal Nerve Stimulation. In: Weissbrod, P., Francis, D. (eds) Neurologic and Neurodegenerative Diseases of the Larynx. Springer, Cham. https://doi.org/10.1007/978-3-030-28852-5_29

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