Pacemaker for spasmodic dysphonia
View Patent ↗A stimulation system and method for treating to a human subject having spasmodic dysphonia includes a sensing electrode configured to detect voice activity of a vocalizing muscle of the subject and to generate a first signal, and a processor configured to receive the first signal from the sensing electrode and to generate at least one stimulation parameter based on the first signal. The system further includes a mechanical actuator configured to receive the stimulation parameter from the processor and to activate a glottic closure reflex of the subject in response to the stimulation parameter and a stimulating electrode configured to receive the stimulation parameter from the processor and stimulate the recurrent laryngeal nerve or the vagus nerve of the subject based on the stimulation parameter.
1. A method of treating a human subject having spasmodic dysphonia, the method comprising:
providing a sensing electrode configured to detect voice activity of the subject and to generate a first signal;
generating at least one stimulation parameter, using a processor, in response to receiving the first signal, the at least one stimulation parameter being based on the first signal; and
activating a glottic closure reflex by electrical stimulation, mechanical stimulation or a combination thereof, in response to receiving the at least one stimulation parameter in order to selectively activate vocal cord adductor muscles.
2. A method according to claim 1 , wherein the activating includes stimulating internal superior laryngeal nerve, glossopharyngeal nerve, or a combination thereof by electrical stimulation.
3. A method according to claim 1 , wherein the sensing electrode is configured to detect electromyographic (EMG) activity of a vocalizing muscle.
4. A method according to claim 1 , wherein the sensing electrode is configured to detect movement related to voice production.
5. A method according to claim 1 , wherein the sensing electrode is a microphone that detects acoustic signals related to voice production.
6. A method according to claim 1 , wherein the sensing electrode is an impedance sensor that detects changes of impedances related to voice production.
7. A method according to claim 1 , wherein the sensing electrode is a pressure sensor that detects changes in pressure related to voice production.
8. A method according to claim 1 , wherein the activating includes providing a current pulse having a duration of about 0.01 msec to 20 msec and a magnitude in the range of about 0.05 mA to 20 mA.
9. A method according to claim 1 , wherein the at least one stimulation parameter includes a stimulation frequency that is approximately reciprocal to a contraction time of a vocal cord adductor of the subject.
10. A method according to claim 1 , further comprising:
determining when the voice activity has reached a predetermined level, wherein the sensing electrode responds by generating the first signal when the predetermined level is reached.
11. A method according to claim 1 , further comprising
stimulating a recurrent laryngeal nerve or vagus nerve by electrical stimulation in response to receiving the at least one stimulation parameter contemporaneously with activating the glottic closure reflex.
12. A method according to claim 11 , wherein the at least one stimulation parameter includes a stimulation frequency that is above a reciprocal of a contraction time of a vocal cord abductor of the subject.
13. A method according to claim 11 , wherein the at least one stimulation parameter includes a stimulation voltage that is above a threshold for activation of vocal cord abductor muscles of the subject.
14. A method according to claim 11 , wherein the at least one stimulation parameter includes a stimulation voltage that is above a threshold for activation of vocal cord adductor muscles of the subject.
15. A method according to claim 11 , wherein the at least one stimulation parameter includes a stimulation voltage that is above a threshold for activation of vocal cord adductor muscles of the subject and below a threshold for activation of vocal cord abductor muscles of the subject.
16. A method according to claim 11 , wherein the at least one stimulation parameter includes a stimulation voltage that is above a threshold for activation of vocal cord abductor muscles of the subject and above a threshold for activation of vocal cord adductor muscles of the subject.
17. A method according to claim 11 , wherein the at least one stimulation parameter includes a stimulation voltage so that a net force for activation of adductor muscles is higher than a net force for activation of abductor muscles of the subject.
18. A method according to claim 11 , wherein stimulating the recurrent laryngeal nerve or vagus nerve stimulates the abductor muscle.
19. A method according to claim 11 , wherein stimulating the recurrent laryngeal nerve or vagus nerve stimulates the adductor muscles.