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1 Laryngeal and Speech, NINDS, Bethesda, Maryland, United States
2 Laryngeal and Speech, NINDS, Bethesda, Maryland, United States; Bethesda, Maryland, United States
3 Department of Communication Sciences and Disorders, Howard University, Washington, District of Columbia, United States
4 Washington, District of Columbia, United States; Department of Communication Sciences and Disorders, Howard University, Washington, District of Columbia, United States
5 Office of the Clinical Director, NINDS, Bethesda, Maryland, United States
6 Department of Rehabilitation of the Clinical Center, NIH, Bethesda, Maryland, United States
* To whom correspondence should be addressed. E-mail: ludlowc{at}ninds.nih.gov.
Surface electrical stimulation is currently used in therapy for swallowing problems, although little is known about its physiological effects on neck muscles or swallowing. Previously, when one surface electrode placement was used in dysphagic patients at rest, it lowered the hyo-laryngeal complex. Here we examined the effects of nine other placements in normal volunteers to determine: 1) if movements induced by surface stimulation using other placements differ, and 2) if lowering the hyo-laryngeal complex by surface electrical stimulation interfered with swallowing in healthy adults. Ten bipolar surface electrode placements overlying the submental and laryngeal regions were tested. Maximum tolerated stimulation levels were applied at rest while participants held their mouths closed. Videofluoroscopic recordings were used to measure hyoid bone and subglottic air column (laryngeal) movements from resting position and while swallowing 5ml of liquid barium with and without stimulation. Videofluoroscopic recordings of swallows were rated blind to condition using the NIH-Swallowing Safety Scale (NIH-SSS). Significant (p<0.0001) laryngeal and hyoid descent occurred with stimulation at rest. During swallowing, significant (p< 0.01) reductions in both the larynx and hyoid bone peak elevation occurred during stimulated swallows. The stimulated swallows were also judged less safe than non-stimulated swallows using the NIH-SSS (p=0.0275). Because surface electrical stimulation reduced hyo-laryngeal elevation during swallowing in normal volunteers, our findings suggest that surface electrical stimulation will reduce elevation during swallowing therapy for dysphagia.
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  H. Clark, C. Lazarus, J. Arvedson, T. Schooling, and T. Frymark Evidence-Based Systematic Review: Effects of Neuromuscular Electrical Stimulation on Swallowing and Neural Activation Am J Speech Lang Pathol, November 1, 2009; 18(4): 361 - 375. [Abstract] [Full Text] [PDF]
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 J. Robbins, S. G. Butler, S. K. Daniels, R. Diez Gross, S. Langmore, C. L. Lazarus, B. Martin-Harris, D. McCabe, N. Musson, and J. Rosenbek Swallowing and Dysphagia Rehabilitation: Translating Principles of Neural Plasticity Into Clinically Oriented Evidence J Speech Lang Hear Res, February 1, 2008; 51(1): S276 - S300. [Abstract] [Full Text] [PDF]
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