Brain adaptation following various unilateral vocal fold paralysis treatments: A magnetic resonance imaging based longitudinal case series.

Autor:	Dedry M; Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium., Dricot L; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium., Van Parys V; Neuromuscular Reference Center, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium., Boucquey D; Otolaryngology, Head and Neck Surgery Department, Voice and Swallowing Clinic, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium., Delinte N; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.; Institute of Information and Communication Technologies, Electronics and Applied Mathematics (ICTM), Université catholique de Louvain, Louvain-la-Neuve, Belgium., van Lith-Bijl J; ENT Department, Flevoziekenhuis, Almere, Netherlands., Szmalec A; Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium.; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.; Department of Experimental Psychology, Faculty of Psychology and Educational Science, Ghent University, Ghent, Belgium., Maryn Y; Department of Otorhinolaryngology and Head and Neck Surgery, European Institute for ORL-HNS, Sint-Augustinus (GZA), Antwerp, Belgium.; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.; Faculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium.; Phonanium, Lokeren, Belgium., Desuter G; Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.; Otolaryngology, Head and Neck Surgery Department, Voice and Swallowing Clinic, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Jazyk:	angličtina
Zdroj:	Frontiers in neuroscience [Front Neurosci] 2022 Oct 05; Vol. 16, pp. 947390. Date of Electronic Publication: 2022 Oct 05 (Print Publication: 2022).
DOI:	10.3389/fnins.2022.947390
Abstrakt:	Aim: Examination of central compensatory mechanisms following peripheral vocal nerve injury and recovery is essential to build knowledge about plasticity of the neural network underlying phonation. The objective of this prospective multiple-cases longitudinal study is to describe brain activity in response to unilateral vocal fold paralysis (UVFP) management and to follow central nervous system adaptation over time in three patients with different nervous and vocal recovery profiles. Materials and Methods: Participants were enrolled within 3 months of the onset of UVFP. Within 1 year of the injury, the first patient did not recover voice or vocal fold mobility despite voice therapy, the second patient recovered voice and mobility in absence of treatment and the third patient recovered voice and vocal fold mobility following an injection augmentation with hyaluronic acid in the paralyzed vocal fold. These different evolutions allowed comparison of individual outcomes according to nervous and vocal recovery. All three patients underwent functional magnetic resonance imaging (fMRI task and resting-state) scans at three (patient 1) or four (patients 2 and 3) time points. The fMRI task included three conditions: a condition of phonation and audition of the sustained [a:] vowel for 3 s, an audition condition of this vowel and a resting condition. Acoustic and aerodynamic measures as well as laryngostroboscopic images and laryngeal electromyographic data were collected. Results and Conclusion: This study highlighted for the first time two key findings. First, hyperactivation during the fMRI phonation task was observed at the first time point following the onset of UVFP and this hyperactivation was related to an increase in resting-state connectivity between previoulsy described phonatory regions of interest. Second, for the patient who received an augmentation injection in the paralyzed vocal fold, we subsequently observed a bilateral activation of the voice-related nuclei in the brainstem. This new observation, along with the fact that for this patient the resting-state connectivity between the voice motor/sensory brainstem nuclei and other brain regions of interest correlated with an aerodynamic measure of voice, support the idea that there is a need to investigate whether the neural recovery process can be enhanced by promoting the restoration of proprioceptive feedback. Competing Interests: YM was employed by company Phonanium. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2022 Dedry, Dricot, Van Parys, Boucquey, Delinte, van Lith-Bijl, Szmalec, Maryn and Desuter.)
Databáze:	MEDLINE
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