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Deep Brain and Vagal Nerve Stimulation

  • Sungjin A. SongEmail author
  • Pawan Mathew
  • Farid Hamzei-Sichani
  • Phillip C. Song
Chapter
  • 49 Downloads

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.

Keywords

Deep brain stimulation Voice Vagal nerve stimulation Swallowing Neurostimulation 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Sungjin A. Song
    • 1
    • 2
    Email author
  • Pawan Mathew
    • 3
  • Farid Hamzei-Sichani
    • 4
  • Phillip C. Song
    • 1
    • 2
  1. 1.Department of OtolaryngologyMassachusetts Eye and Ear InfirmaryBostonUSA
  2. 2.Department of OtolaryngologyHarvard Medical SchoolBostonUSA
  3. 3.UMass Memorial Medical Center, University of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Department of Neurological SurgeryUniversity of Massachusetts Medical SchoolWorcesterUSA

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