Journal articles on the topic 'Genioglossus'
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Dotan, Yaniv, Giora Pillar, Alan R. Schwartz, and Arie Oliven. "Asynchrony of lingual muscle recruitment during sleep in obstructive sleep apnea." Journal of Applied Physiology 118, no. 12 (June 15, 2015): 1516–24. http://dx.doi.org/10.1152/japplphysiol.00937.2014.
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Pharyngeal collapsibility during sleep increases primarily due to decline in dilator muscle activity. However, genioglossus EMG is known to increase during apneas and hypopneas, usually without reversing upper airway obstruction or inspiratory flow limitation. The present study was undertaken to test the hypothesis that intense activation of the genioglossus fails to prevent pharyngeal obstruction during sleep, and to evaluate if sleep-induced changes in tongue muscle coordination may be responsible for this phenomenon. We compared genioglossus and tongue retractors EMG activity in 13 obstructive sleep apnea (OSA) patients during wakefulness, while breathing through inspiratory resistors, to the activity observed at the end of apneas and hypopneas after 25 mg of brotizolam, before arousal, at equal esophageal pressure. During wakefulness, resistive breathing triggered increases in both genioglossus and retractor EMG. Activation of agonist tongue muscles differed considerably from that of the arm, as both genioglossus and retractors were activated similarly during all tongue movements. During sleep, flow limitation triggered increases in genioglossal EMG that could reach more than twofold the level observed while awake. In contrast, EMGs of the retractors reached less than half the wakefulness level. In sleeping OSA patients, genioglossal activity may increase during obstructed breathing to levels that exceed substantially those required to prevent pharyngeal collapse during wakefulness. In contrast, coactivation of retractors is deficient during sleep. These findings suggest that sleep-induced alteration in tongue muscle coordination may be responsible for the failure of high genioglossal EMG activity to alleviate flow limitation.
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Anker, A. R., A. Ali, H. E. Arendt, S. P. Cass, L. A. Cotter, B. J. Jian, B. Tamrazi, and B. J. Yates. "Use of electrical vestibular stimulation to alter genioglossal muscle activity in awake cats." Journal of Vestibular Research 13, no. 1 (September 1, 2003): 1–8. http://dx.doi.org/10.3233/ves-2003-13101.
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Prior work has shown that the vestibular system contributes to regulating activity of upper airway muscles including the tongue protruder muscle genioglossus. The goal of the present experiments was to determine whether electrical vestibular stimulation could potentially be used to alter genioglossal activity in awake animals. Six adult cats were instrumented for recording of EMG activity from genioglossus, abdominal musculature, and triceps. In addition, a silver ball electrode was implanted on the round window for stimulation of vestibular afferents. Subsequently, stimulation and recordings were conducted while animals were awake. In all cases, stimulation using single shocks or trains of pulses > 100 μA in intensity produced responses in all muscles, including genioglossus. The latency of the genioglossal response was approximately 12 msec, and delivering continuous current trains to the labyrinth chronically elevated the muscle's activity. Although a number of muscles were affected by the stimulus, animals experienced no obvious distress or balance disturbances. Vestibular stimulation remained effective in producing genioglossal responses until experiments were discontinued 1–2 months following onset. These data suggest that electrical vestibular stimulation could potentially be used therapeutically to alter upper airway muscle activity.
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Saboisky, Julian P., Amy S. Jordan, Danny J. Eckert, David P. White, John A. Trinder, Christian L. Nicholas, Shiva Gautam, and Atul Malhotra. "Recruitment and rate-coding strategies of the human genioglossus muscle." Journal of Applied Physiology 109, no. 6 (December 2010): 1939–49. http://dx.doi.org/10.1152/japplphysiol.00812.2010.
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Single motor unit (SMU) analysis provides a means to examine the motor control of a muscle. SMUs in the genioglossus show considerable complexity, with several different firing patterns. Two of the primary stimuli that contribute to genioglossal activation are carbon dioxide (CO2) and negative pressure, which act through chemoreceptor and mechanoreceptor activation, respectively. We sought to determine how these stimuli affect the behavior of genioglossus SMUs. We quantified genioglossus SMU discharge activity during periods of quiet breathing, elevated CO2 (facilitation), and continuous positive airway pressure (CPAP) administration (inhibition). CPAP was applied in 2-cmH2O increments until 10 cmH2O during hypercapnia. Five hundred ninety-one periods (each ∼3 breaths) of genioglossus SMU data were recorded using wire electrodes( n = 96 units) from 15 awake, supine subjects. Overall hypercapnic stimulation increased the discharge rate of genioglossus units (20.9 ± 1.0 vs. 22.7 ± 0.9 Hz). Inspiratory units were activated ∼13% earlier in the inspiratory cycle, and the units fired for a longer duration (80.6 ± 5.1 vs. 105.3 ± 4.2% inspiratory time; P < 0.05). Compared with baseline, an additional 32% of distinguishable SMUs within the selective electrode recording area were recruited with hypercapnia. CPAP led to progressive SMU inhibition; at ∼6 cmH2O, there were similar numbers of SMUs active compared with baseline, with peak frequencies of inspiratory units close to baseline, despite elevated CO2 levels. At 10 cmH2O, the number of units was 36% less than baseline. Genioglossus inspiratory phasic SMUs respond to hypercapnic stimulation with changes in recruitment and rate coding. The SMUs respond to CPAP with derecruitment as a homogeneous population, and inspiratory phasic units show slower discharge rates. Understanding upper airway muscle recruitment/derecruitment may yield therapeutic targets for maintenance of pharyngeal patency.
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Leiter, J. C. "Analysis of pharyngeal resistance and genioglossal EMG activity using a model of orifice flow." Journal of Applied Physiology 73, no. 2 (August 1, 1992): 576–83. http://dx.doi.org/10.1152/jappl.1992.73.2.576.
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A model of orifice flow has been used to analyze the relationships among pressure, flow, and genioglossal electromyographic activity in the human pharynx during inspiration. The orifice flow model permits one to assess the character of airflow (laminar or turbulent) and to estimate the cross-sectional area of the orifice from pressure and flow measurements. On the basis of other data (J. Appl. Physiol. 73: 584–590, 1992), this analysis suggests that pharyngeal airflow is turbulent. Furthermore the area of the pharynx appears to increase as flow increases, but the actual change in pharyngeal diameter necessary to fit the pressure-flow data is quite small (0.11–0.87 cm, depending on the assumptions in the model). The flow-related increase in orifice area can be attributed, in part, to the activation of the genioglossus muscle. However, other flow-related factors may also contribute to pharyngeal dilation as airflow increases. Different airway shapes (circular and elliptical) and orientations (major axis anteroposterior and lateral) were incorporated into the model calculations; these factors modify considerably the apparent efficiency of genioglossal electromyographic activity. Genioglossal muscle shortening increases pharyngeal area and reduces pharyngeal resistance more effectively when the pharynx is elliptical, with the long axis of the ellipse oriented laterally. Hence the genioglossus may operate at a significant mechanical disadvantage in those patients with obstructive sleep apnea with a small sagittally oriented pharyngeal lumen.
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Kang, Jing, and Ming-Xian Li. "Effects of Habenular Stimulation Frequencies on Obstructive Sleep Apnea Induced by Stimulation of Insular Cortex." Canadian Respiratory Journal 2018 (2018): 1–5. http://dx.doi.org/10.1155/2018/9060678.
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Objective. To investigate the effects of high-frequency stimulation of the habenula (Hb) on obstructive sleep apnea (OSA) induced by stimulation of the insular cortexMethod. After OSA was induced by stimulating the insular cortex (Ic) with concentric stimulating electrodes at 100 Hz in rats, the Hb was stimulated at different frequencies (50 Hz, 120 Hz, 130 Hz, and 280 Hz). The changes of apnea events and electromyography (EMG) of the genioglossus were compared before and after stimulation of the Hb.Results. With stimulation of the Ic at 100 Hz, apnea events were successfully induced with disappearance of EMG of the genioglossus. After stimulation of the Hb at 130 Hz, apnea events disappeared with significantly increased genioglossal EMG. However, such a change failed to be found at the stimulation frequencies of 50 Hz, 120 Hz, and 280 Hz.Conclusion. Stimulation of the Hb at the frequency of 130 Hz could effectively inhibit OSA events induced by stimulation of the Ic.
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Sha, B. F. Bu, S. J. England, R. A. Parisi, and R. J. Strobel. "Force production of the genioglossus as a function of muscle length in normal humans." Journal of Applied Physiology 88, no. 5 (May 1, 2000): 1678–84. http://dx.doi.org/10.1152/jappl.2000.88.5.1678.
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Resting muscle length affects both maximum force production and force maintenance. The strength and force maintenance characteristics of the genioglossus as a function of resting muscle length have not been described. We hypothesized that genioglossus optimum length ( L o) could be defined in vivo and that the ability of the genioglossus to sustain a given workload would decrease as resting length deviated from L o. To test this, 11 normal men repeated maximal isometric genioglossus protrusions at different muscle lengths to determine L o. L o was also obtained by using submaximal efforts while simultaneously recording electromyographic activity of the genioglossus, with L o defined as the length at which the force-to-genioglossus electromyographic activity ratio was maximum. Both methods provided similar results. Force maintenance was measured at four muscle lengths on separate days. Target efforts representing 60% of each subject's maximum at L o and lasting 5 s were performed at 12-s intervals. Time limit of endurance of the genioglossus was defined as the time from trial onset at which 90% of the target could not be maintained for three consecutive efforts. Time limit of endurance was greatest at L o and fell to 47.5% at L o + 1 cm, 53.8% at L o − 1 cm, and 47.4% at L o − 1.5 cm. We conclude that L o of the genioglossus can be determined in vivo and that force maintenance of the genioglossus is decreased when operating length deviates from L o.
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Carberry, Jayne C., Hanna Hensen, Lauren P. Fisher, Julian P. Saboisky, Jane E. Butler, Simon C. Gandevia, and Danny J. Eckert. "Mechanisms contributing to the response of upper-airway muscles to changes in airway pressure." Journal of Applied Physiology 118, no. 10 (May 15, 2015): 1221–28. http://dx.doi.org/10.1152/japplphysiol.01103.2014.
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This study assessed the effects of inhaled lignocaine to reduce upper airway surface mechanoreceptor activity on 1) basal genioglossus and tensor palatini EMG, 2) genioglossus reflex responses to large pulses (∼10 cmH2O) of negative airway pressure, and 3) upper airway collapsibility in 15 awake individuals. Genioglossus and tensor palatini muscle EMG and airway pressures were recorded during quiet nasal breathing and during brief pulses (250 ms) of negative upper-airway pressure. Lignocaine reduced peak inspiratory (5.6 ± 1.5 vs. 3.8 ± 1.1% maximum; mean ± SE, P < 0.01) and tonic (2.8 ± 0.8 vs. 2.1 ± 0.7% maximum; P < 0.05) genioglossus EMG during quiet breathing but had no effect on tensor palatini EMG (5.0 ± 0.8 vs. 5.0 ± 0.5% maximum; P = 0.97). Genioglossus reflex excitation to negative pressure pulses decreased after anesthesia (60.9 ± 20.7 vs. 23.6 ± 5.2 μV; P < 0.05), but not when expressed as a percentage of the immediate prestimulus baseline. Reflex excitation was closely related to the change in baseline EMG following lignocaine ( r2 = 0.98). A short-latency genioglossus reflex to rapid increases from negative to atmospheric pressure was also observed. The upper airway collapsibility index (%difference) between nadir choanal and epiglottic pressure increased after lignocaine (17.8 ± 3.7 vs. 28.8 ± 7.5%; P < 0.05). These findings indicate that surface receptors modulate genioglossus but not tensor palatini activity during quiet breathing. However, removal of input from surface mechanoreceptors has minimal effect on genioglossus reflex responses to large (∼10 cmH2O), sudden changes in airway pressure. Changes in pressure rather than negative pressure per se can elicit genioglossus reflex responses. These findings challenge previous views and have important implications for upper airway muscle control.
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Hollowell, D. E., P. R. Bhandary, A. W. Funsten, and P. M. Suratt. "Respiratory-related recruitment of the masseter: response to hypercapnia and loading." Journal of Applied Physiology 70, no. 6 (June 1, 1991): 2508–13. http://dx.doi.org/10.1152/jappl.1991.70.6.2508.
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To test the hypothesis that a muscle that closes the jaw, the masseter, can be recruited by ventilatory stimuli, we studied the electromyographic activation of the masseter and genioglossus in seven normal awake males who were exposed in random order to progressive hyperoxic hypercapnia, inspiratory threshold loading (-40 cmH2O), and combined hypercapnia and loading. With hypercapnia, the masseter was generally recruited after the genioglossus had been activated. Once recruited, activation of both muscles increased linearly with increasing CO2. Combined hypercapnia and loading produced more activation than either stimulus alone. These data indicate that the masseter is activated by ventilatory stimuli that activate the genioglossus. Earlier recruitment of the genioglossus suggests that activation of the masseter serves to stabilize the mandible and allow the genioglossus to function as a more efficient dilator of the upper airway.
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Eikermann, Matthias, Atul Malhotra, Philipp Fassbender, Sebastian Zaremba, Amy S. Jordan, Shiva Gautam, David P. White, and Nancy L. Chamberlin. "Differential Effects of Isoflurane and Propofol on Upper Airway Dilator Muscle Activity and Breathing." Anesthesiology 108, no. 5 (May 1, 2008): 897–906. http://dx.doi.org/10.1097/aln.0b013e31816c8a60.
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Background Anesthesia impairs upper airway integrity, but recent data suggest that low doses of some anesthetics increase upper airway dilator muscle activity, an apparent paradox. The authors sought to understand which anesthetics increase or decrease upper airway dilator muscle activity and to study the mechanisms mediating the effect. Methods The authors recorded genioglossus electromyogram, breathing, arterial blood pressure, and expiratory carbon dioxide in 58 spontaneously breathing rats at an estimated ED50 (median effective dose) of isoflurane or propofol. The authors further evaluated the dose-response relations of isoflurane under different study conditions: (1) normalization of mean arterial pressure, or end-expiratory carbon dioxide; (2) bilateral lesion of the Kölliker-Fuse nucleus; and (3) vagotomy. To evaluate whether the markedly lower inspiratory genioglossus activity during propofol could be recovered by increasing flow rate, a measure of respiratory drive, the authors performed an additional set of experiments during hypoxia or hypercapnia. Results In vagally intact rats, tonic and phasic genioglossus activity were markedly higher with isoflurane compared with propofol. Both anesthetics abolished the genioglossus negative pressure reflex. Inspiratory flow rate and anesthetic agent predicted independently phasic genioglossus activity. Isoflurane dose-dependently decreased tonic and increased phasic genioglossus activity, and increased flow rate, and its increasing effects were abolished after vagotomy. Impairment of phasic genioglossus activity during propofol anesthesia was reversed during evoked increase in respiratory drive. Conclusion Isoflurane compared with propofol anesthesia yields higher tonic and phasic genioglossus muscle activity. The level of respiratory depression rather than the level of effective anesthesia correlates closely with the airway dilator muscle function during anesthesia.
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Eikermann, Matthias, Philipp Fassbender, Sebastian Zaremba, Amy S. Jordan, Carl Rosow, Atul Malhotra, and Nancy L. Chamberlin. "Pentobarbital Dose-dependently Increases Respiratory Genioglossus Muscle Activity while Impairing Diaphragmatic Function in Anesthetized Rats." Anesthesiology 110, no. 6 (June 1, 2009): 1327–34. http://dx.doi.org/10.1097/aln.0b013e3181a16337.
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Background Anesthetics depress both ventilatory and upper airway dilator muscle activity and thus put the upper airway at risk for collapse. However, these effects are agent-dependent and may involve upper airway and diaphragm muscles to varying degrees. The authors assessed the effects of pentobarbital on upper airway dilator and respiratory pump muscle function in rats and compared these results with the effects of normal sleep. Methods Tracheostomized rats were given increasing doses of pentobarbital to produce deep sedation then light and deep anesthesia, and negative pressure airway stimuli were applied (n = 11). To compare the effects of pentobarbital with those of natural sleep, the authors chronically instrumented rats (n = 10) with genioglossus and neck electromyogram and electroencephalogram electrodes and compared genioglossus activity during wakefulness, sleep (rapid eye movement and non-rapid eye movement), and pentobarbital anesthesia. Results Pentobarbital caused a dose-dependent decrease in ventilation and in phasic diaphragmatic electromyogram by 11 +/- 0.1%, but it increased phasic genioglossus electromyogram by 23 +/- 0.2%. Natural non-rapid eye movement sleep and pentobarbital anesthesia (10 mg/kg intraperitoneally) decreased respiratory genioglossus electromyogram by 61 +/- 29% and 45 +/- 35%, respectively, and natural rapid eye movement sleep caused the greatest decrease in phasic genioglossus electromyogram (95 +/- 0.3%). Conclusions Pentobarbital in rats impairs respiratory genioglossus activity compared to the awake state, but the decrease is no greater than seen during natural sleep. During anesthesia, in the absence of pharyngeal airflow, phasic genioglossus activity is increased in a dose-dependent fashion.
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Doble, E. A., J. C. Leiter, S. L. Knuth, J. A. Daubenspeck, and D. Bartlett. "A noninvasive intraoral electromyographic electrode for genioglossus muscle." Journal of Applied Physiology 58, no. 4 (April 1, 1985): 1378–82. http://dx.doi.org/10.1152/jappl.1985.58.4.1378.
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We have developed an intraoral bipolar surface electrode for the genioglossus muscle. The electrode, made from an athletic mouthguard and dental impression material, was fitted to the lower teeth. Electrode wires, bared at the tip, were positioned on the bottom of the mouthpiece to lie in contact with the superior surface of the genioglossus just behind the teeth. The electromyographic activity of the genioglossus, simultaneously obtained from the surface electrode and conventional intramuscular electrodes, was compared during quiet breathing, CO2 rebreathing, and a variety of tongue movements. The two types of electrodes recorded similar patterns of muscle activity, and spectral analyses of the signals revealed similar and highly coherent frequency spectra. We conclude that the surface electrode satisfactorily reflects the bioelectrical activity of the genioglossus. The mouthpiece electrode has the further advantage that quantitative comparisons can be made among recordings made in different experimental sessions, since the fit of the mouthpiece to the teeth assures a constant relationship of the electrode to the genioglossus muscle.
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Eikermann, Matthias, Martina Grosse-Sundrup, Sebastian Zaremba, Mark E. Henry, Edward A. Bittner, Ulrike Hoffmann, and Nancy L. Chamberlin. "Ketamine Activates Breathing and Abolishes the Coupling between Loss of Consciousness and Upper Airway Dilator Muscle Dysfunction." Anesthesiology 116, no. 1 (January 1, 2012): 35–46. http://dx.doi.org/10.1097/aln.0b013e31823d010a.
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Background Procedural sedation is frequently performed in spontaneously breathing patients, but hypnotics and opioids decrease respiratory drive and place the upper airway at risk for collapse. Methods In a randomized, controlled, cross-over, pharmaco-physiologic study in 12 rats, we conducted acute experiments to compare breathing and genioglossus electromyogram activity at equianesthetic concentrations of ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist that combines potent analgesic with hypnotic action effects, versus propofol. In 10 chronically instrumented rats resting in a plethysmograph, we measured these variables as well as electroencephalography during five conditions: quiet wakefulness, nonrapid-eye-movement sleep, rapid eye movement sleep, and low-dose (60 mg/kg intraperitoneally) and high-dose ketamine anesthesia (125 mg/kg intraperitoneally). Results Ketamine anesthesia was associated with markedly increased genioglossus activity (1.5 to fivefold higher values of genioglossus electromyogram) compared with sleep- and propofol-induced unconsciousness. Plethysmography revealed a respiratory stimulating effect: higher values of flow rate, respiratory rate, and duty-cycle (effective inspiratory time, 1.5-to-2-fold higher values). During wakefulness and normal sleep, the δ (f = 6.51, P = 0.04) electroencephalogram power spectrum was an independent predictor of genioglossus activity, indicating an association between electroencephalographic determinants of consciousness and genioglossus activity. Following ketamine administration, electroencephalogram power spectrum and genioglossus electroencephalogram was dissociated (P = 0.9 for the relationship between δ/θ power spectrum and genioglossus electromyogram). Conclusions Ketamine is a respiratory stimulant that abolishes the coupling between loss-of-consciousness and upper airway dilator muscle dysfunction in a wide dose-range. Ketamine compared with propofol might help stabilize airway patency during sedation and anesthesia.
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Cheng, Allen. "Genioglossus and Genioplasty Advancement." Atlas of the Oral and Maxillofacial Surgery Clinics 27, no. 1 (March 2019): 23–28. http://dx.doi.org/10.1016/j.cxom.2018.11.008.
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Silverstein, Keith, Bernard J. Costello, Helen Giannakpoulos, and Barry Hendler. "Genioglossus muscle attachments: An anatomic analysis and the implications for genioglossus advancement." Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 90, no. 6 (December 2000): 686–88. http://dx.doi.org/10.1067/moe.2000.111187.
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Pittman, Lora J., and E. Fiona Bailey. "Genioglossus and Intrinsic Electromyographic Activities in Impeded and Unimpeded Protrusion Tasks." Journal of Neurophysiology 101, no. 1 (January 2009): 276–82. http://dx.doi.org/10.1152/jn.91065.2008.
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Eight muscles invest the human tongue: four extrinsic muscles have external origins and insert into the tongue body and four intrinsic muscles originate and terminate within the tongue. Previously, we noted minimal activation of the genioglossus tongue muscle during impeded protrusion tasks (i.e., having subjects push the tongue against a force transducer), suggesting that other muscles play a role in the production of tongue force. Accordingly, we sought to characterize genioglossus tongue muscle activities during impeded and unimpeded protrusion tasks (i.e., having subjects slowly and smoothly move the tongue out of their mouth). Electromyographic (EMG) and single motor-unit potentials of the extrinsic genioglossus muscle were recorded with tungsten microelectrodes and EMG activities of intrinsic tongue muscles were recorded with hook-wire electrodes inserted into the anterior tongue body. Tongue position was detected by an isotonic transducer coupled to the tongue tip. Protrusive force was detected by a force transducer attached to a rigid bar. Genioglossus and intrinsic tongue muscles were simultaneously active in both impeded and unimpeded protrusion tasks. Genioglossus whole muscle EMG and single motor-unit activities changed faithfully as a function of tongue position, with increased discharge associated with protrusion and decreased discharge associated with retraction back to the rest position. In contrast, during the impeded protrusion task drive the genioglossus muscle remained constant as protrusion force increased. Conversely, intrinsic tongue muscle activities appropriately followed changes in both tongue position and force. Importantly, we observed significantly higher levels of intrinsic muscle activity in the impeded protrusion task. These observations suggest that protrusion of the human tongue requires activation of the genioglossus and intrinsic protrudor muscles, with the former more important for establishing anterior–posterior tongue location and the latter playing a greater role in the generation of protrusive force. A biomechanical model of these actions is provided and discussed.
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Nishikawa, K. C., W. M. Kier, and K. K. Smith. "Morphology and mechanics of tongue movement in the African pig-nosed frog Hemisus marmoratum: a muscular hydrostatic model." Journal of Experimental Biology 202, no. 7 (April 1, 1999): 771–80. http://dx.doi.org/10.1242/jeb.202.7.771.
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The goal of this study was to investigate morphological adaptations associated with hydrostatic elongation of the tongue during feeding in the African pig-nosed frog Hemisus marmoratum. Whereas previous studies had suggested that the tongue of H. marmoratum elongates hydraulically, the anatomical observations reported here favour a muscular hydrostatic mechanism of tongue elongation. H. marmoratum possesses a previously undescribed compartment of the m. genioglossus (m. genioglossus dorsoventralis), which is intrinsic to the tongue and whose muscle fibres are oriented perpendicular to the long axis of the tongue. On the basis of the arrangement and orientation of muscle fibres in the m. genioglossus and m. hyoglossus, we propose a muscular hydrostatic model of tongue movement in which contraction of the m. genioglossus dorsoventralis, together with unfolding of the intrinsic musculature of the tongue, results in a doubling in tongue length. Electron micrographs of sarcomeres from resting and elongated tongues show that no special adaptations of the sarcomeres are necessary to accommodate the observed doubling in tongue length during feeding. Rather, the sarcomeres of the m. genioglossus longitudinalis are strikingly similar to those of anuran limb muscles. The ability to elongate the tongue hydrostatically, conferred by the presence of the m. genioglossus dorsoventralis, is associated with the appearance of several novel aspects of feeding behaviour in H. marmoratum. These include the ability to protract the tongue slowly, thereby increasing capture success, and the ability to aim the tongue in azimuth and elevation relative to the head. Compared with other frogs, the muscular hydrostatic system of H. marmoratum allows more precise, localized and diverse tongue movements. This may explain why the m. genioglossus of H. marmoratum is composed of a larger number of motor units than that of other frogs.
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Kuna, S. T., and J. Smickley. "Response of genioglossus muscle activity to nasal airway occlusion in normal sleeping adults." Journal of Applied Physiology 64, no. 1 (January 1, 1988): 347–53. http://dx.doi.org/10.1152/jappl.1988.64.1.347.
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To determine the combined effect of increased subatmospheric upper airway pressure and withdrawal of phasic volume feedback from the lung on genioglossus muscle activity, the response of this muscle to intermittent nasal airway occlusion was studied in 12 normal adult males during sleep. Nasal occlusion at end expiration was achieved by inflating balloon-tipped catheters located within the portals of a nose mask. No seal was placed over the mouth. During nose breathing in non-rapid-eye-movement (NREM) sleep, nasal airway occlusion resulted in multiple respiratory efforts before arousal. Mouth breathing was not initiated until arousal. Phasic inspiratory genioglossus activity was present in eight subjects during NREM sleep. In these subjects, comparison of peak genioglossus inspiratory activity on the first three occluded efforts to the value just before occlusion showed an increase of 4.7, 16.1, and 28.0%, respectively. The relative increases in peak genioglossus activity were very similar to respective increases in peak diaphragm activity. Arousal was associated with a large burst in genioglossus activity. During airway occlusion in rapid-eye-movement (REM) sleep, mouth breathing could occur without a change in sleep state. In general, genioglossus responses to airway occlusion in REM sleep were similar in pattern to those in NREM sleep. A relatively small reflex activation of upper airway muscles associated with a sudden increase in subatmospheric pressure in the potentially collapsible segment of the upper airway may help compromise upper airway patency during sleep.
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Sturm, Joshua J., Oleg Modik, Ioannis Koutsourelakis, and Maria V. Suurna. "Contralateral Tongue Muscle Activation during Hypoglossal Nerve Stimulation." Otolaryngology–Head and Neck Surgery 162, no. 6 (April 28, 2020): 985–92. http://dx.doi.org/10.1177/0194599820917147.
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Objective The effectiveness of upper airway stimulation via hypoglossal nerve stimulation for obstructive sleep apnea depends upon the pattern of tongue muscle activation produced. This study investigated the nature of contralateral tongue muscle activation by unilateral hypoglossal nerve stimulation using intraoperative nerve integrity monitoring in conjunction with electromyography and explored the relationship between contralateral tongue muscle activation and polysomnographic measures of obstructive sleep apnea severity. Study Design Prospective case series. Setting Tertiary care medical center. Subjects and Methods Fifty-one patients underwent unilateral (right) hypoglossal nerve stimulator implantation for obstructive sleep apnea. Neurophysiological data included electromyographic responses in ipsilateral (right) and contralateral (left) genioglossus muscles in response to intraoperative bipolar probe stimulation (0.3 mA) of medial hypoglossal nerve branches. Clinical data included pre- and postoperative apnea-hypopnea indices and oxygen desaturation levels. Results A subset of patients (20/51, 39%) exhibited electromyographic responses in both the ipsilateral and contralateral genioglossus (bilateral), whereas the remaining patients (31/51, 61%) exhibited electromyographic responses only in the ipsilateral genioglossus (unilateral). The baseline characteristics of bilateral and unilateral responders were similar. Both groups exhibited significant and comparable improvements in apnea-hypopnea index and oxygen desaturations after hypoglossal nerve stimulation. Neither the amplitude nor the latency of contralateral genioglossus responses was predictive of clinical outcomes. Conclusion A subset of patients undergoing unilateral hypoglossal nerve stimulation exhibits activation of contralateral genioglossus muscles. Patients with unilateral and bilateral genioglossus responses exhibit comparable, robust improvements in apnea-hypopnea index and oxygen desaturation levels.
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Mathur, Rajat, Ian L. Mortimore, Mohammed A. Jan, and Neil J. Douglas. "Effect of Breathing, Pressure and Posture on Palatoglossal and Genioglossal Tone." Clinical Science 89, no. 4 (October 1, 1995): 441–45. http://dx.doi.org/10.1042/cs0890441.
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1. Patency of the upper airway is critical to respiration. Although about half of patients with the sleep apnoea/hypopnoea syndrome obstruct their upper airway at the retropalatal level, the respiratory actions of the palatal muscles have been little studied. We have therefore tested the hypothesis that the nasopharyngeal dilator muscle palatoglossus is activated during inspiration and by negative pressure. 2. Using intramuscular wire electrodes inserted perorally, we have compared the response of palatoglossus and genioglossus to breathing, posture change and airway negative pressure in 10 normal awake subjects before and after topical anaesthesia. The results are expressed as a percentage of maximal electromyogram. Data were analysed by repeated-measures analysis of variance. 3. Inspiratory activity was exhibited by both genioglossus [inspiratory, 10% ± 2% (SEM); expiratory, 6% ± 1%, P = 0.001] and palatoglossus (inspiratory, 16% ± 5%, expiratory, 10% ± 3%, P = 0.016), but only genioglossus exhibited increased activity on lying (supine 10% ± 2%, erect 6% ± 1% maximum, P = 0.01). 4. One hundred milliseconds after negative pressure application, activity increased in both genioglossus (7% ± 2% and 13% ± 3% respectively, P = 0.02) and palatoglossus (8% ± 2% and 23% ± 6% respectively, P < 0.001). After lignocaine surface anaesthesia to the nose and pharynx both genioglossus and palatoglossus still increased their activity in response to negative upper airway pressure, the extent of the increase being decreased for palatoglossus (P = 0.02) but not for genioglossus. 5. Thus, palatoglossus has respiratory activity and is activated by negative upper airway pressure.
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Kobayashi, I., A. Perry, J. Rhymer, B. Wuyam, P. Hughes, K. Murphy, J. A. Innes, J. McIvor, A. D. Cheesman, and A. Guz. "Inspiratory coactivation of the genioglossus enlarges retroglossal space in laryngectomized humans." Journal of Applied Physiology 80, no. 5 (May 1, 1996): 1595–604. http://dx.doi.org/10.1152/jappl.1996.80.5.1595.
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To investigate the relationship between the electrical activity of the genioglossus (GG-EMG) and associated tongue movement, seven laryngectomized subjects breathing through a tracheal stoma (without pressure or flow change in the upper airway) were studied in the supine position. Tongue movement, with the use of lateral fluoroscopy, and GG-EMG expressed as a percentage of maximum voluntary genioglossal activation were monitored simultaneously during 1) spontaneous inspiration (SI), 2) resistive loaded inspiration (LI), and 3) rapid inspiration (RI). Tongue position during each maneuver was compared with its position during spontaneous expiration. Peak GG-EMG during the three maneuvers was significantly different from each other (SI: 5.4 +/- 1.6, LI: 11.9 +/- 1.8, and RI: 51.6 +/- 9.4 (SE) %, respectively). Associated forward movement of the posterior aspect of the tongue was minimum during SI; however, significant movement was observed during LI, and this was increased during RI. Significant covariance existed between peak GG-EMG and this movement. Genioglossal coactivation with inspiration enlarges the glossopharyngeal airway, particularly in its caudal part. In subjects with intact upper airways, this activation may protect or enhance upper airway patency in an effort-dependent manner.
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Borel, Jean-Christian, Cesar Augusto Melo-Silva, Simon Gakwaya, and Frédéric Sériès. "Influence of CO2 on upper airway muscles and chest wall/diaphragm corticomotor responses assessed by transcranial magnetic stimulation in awake healthy subjects." Journal of Applied Physiology 112, no. 5 (March 1, 2012): 798–805. http://dx.doi.org/10.1152/japplphysiol.00713.2011.
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Rationale: functional interaction between upper airway (UA) dilator muscles and the diaphragm is crucial in the maintenance of UA patency. This interaction could be altered by increasing respiratory drive. The aim of our study was to compare the effects of hypercapnic stimulation on diaphragm and genioglossus corticomotor responses to transcranial magnetic stimulation (TMS). Methods: 10 self-reported healthy men (32 ± 9 yr; body mass index = 24 ± 3 kg/m−2) breathed, in random order, room air or 5% and then 7% FiCO2, both balanced with pure O2. Assessments included ventilatory variables, isoflow UA resistance (at 300 ml/s), measurement of lower chest wall/diaphragm (LCW/diaphragm), and genioglossus motor threshold (MT) and motor-evoked potential (MEP) characteristics. TMS twitches were applied during early inspiration and end expiration at stimulation intensity 30% above LCW/diaphragm and genioglossus MT. Results: compared with room air, CO2 inhalation significantly augmented minute ventilation, maximal inspiratory flow, tidal volume, and tidal volume/respiratory time ratio. UA resistance was unchanged with CO2 inhalation. During 7% CO2 breathing, LCW/diaphragm MT decreased by 9.6 ± 10.1% whereas genioglossus MT increased by 7.2 ± 9%. CO2-induced ventilatory stimulation led to elevation of LCW/diaphragm MEP amplitudes during inspiration but not during expiration. LCW/diaphragm MEP latencies remained unaltered both during inspiration and expiration. Genioglossus MEP latencies and amplitudes were unchanged with CO2. Conclusion: in awake, healthy subjects, CO2-induced hyperventilation is associated with heightened LCW/diaphragm corticomotor activation without modulating genioglossus MEP responses. This imbalance may promote UA instability during increased respiratory drive.
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Simons, Jeroen C. P., Eric Pierce, Daniel Diaz-Gil, Sanjana A. Malviya, Matthew J. Meyer, Fanny P. Timm, Janne B. Stokholm, Carl E. Rosow, Robert M. Kacmarek, and Matthias Eikermann. "Effects of Depth of Propofol and Sevoflurane Anesthesia on Upper Airway Collapsibility, Respiratory Genioglossus Activation, and Breathing in Healthy Volunteers." Anesthesiology 125, no. 3 (September 1, 2016): 525–34. http://dx.doi.org/10.1097/aln.0000000000001225.
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Abstract Background Volatile anesthetics and propofol impair upper airway stability and possibly respiratory upper airway dilator muscle activity. The magnitudes of these effects have not been compared at equivalent anesthetic doses. We hypothesized that upper airway closing pressure is less negative and genioglossus activity is lower during deep compared with shallow anesthesia. Methods In a randomized controlled crossover study of 12 volunteers, anesthesia with propofol or sevoflurane was titrated using a pain stimulus to identify the threshold for suppression of motor response to electrical stimulation. Measurements included bispectral index, genioglossus electromyography, ventilation, hypopharyngeal pressure, upper airway closing pressure, and change in end-expiratory lung volume during mask pressure drops. Results A total of 393 attempted breaths during occlusion maneuvers were analyzed. Upper airway closing pressure was significantly less negative at deep versus shallow anesthesia (−10.8 ± 4.5 vs. −11.3 ± 4.4 cm H2O, respectively [mean ± SD]) and correlated with the bispectral index (P < 0.001), indicating a more collapsible airway at deep anesthesia. Respiratory genioglossus activity during airway occlusion was significantly lower at deep compared with light anesthesia (26 ± 21 vs. 35 ± 24% of maximal genioglossus activation, respectively; P < 0.001) and correlated with bispectral index (P < 0.001). Upper airway closing pressure and genioglossus activity during airway occlusion did not differ between sevoflurane and propofol anesthesia. Conclusions Propofol and sevoflurane anesthesia increased upper airway collapsibility in a dose-dependent fashion with no difference at equivalent anesthetic concentrations. These effects can in part be explained by a dose-dependent inhibiting effect of anesthetics on respiratory genioglossus activity.
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Zou, Ying, Wei Wang, Xinshi Nie, and Jian Kang. "Chronic Intermittent Hypoxia Induces the Long-Term Facilitation of Genioglossus Corticomotor Activity." Canadian Respiratory Journal 2018 (2018): 1–8. http://dx.doi.org/10.1155/2018/5941429.
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Obstructive sleep apnea (OSA) is characterized by the repetitive collapse of the upper airway and chronic intermittent hypoxia (CIH) during sleep. It has been reported that CIH can increase the EMG activity of genioglossus in rats, which may be related to the neuromuscular compensation of OSA patients. This study aimed to explore whether CIH could induce the long-term facilitation (LTF) of genioglossus corticomotor activity. 16 rats were divided into the air group (n=8) and the CIH group (n=8). The CIH group was exposed to hypoxia for 4 weeks; the air group was subjected to air under identical experimental conditions in parallel. Transcranial magnetic stimulation (TMS) was applied every ten minutes and lasted for 1 h/day on the 1st, 3rd, 7th, 14th, 21st, and 28th days of air/CIH exposure. Genioglossus EMG was also recorded at the same time. Compared with the air group, the CIH group showed decreased TMS latency from 10 to 60 minutes on the 7th, 14th, 21st, and 28th days. The increased TMS amplitude lasting for 60 minutes was only observed on the 21st day. Genioglossus EMG activity increased only on the 28th day of CIH. We concluded that CIH could induce LTF of genioglossus corticomotor activity in rats.
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Luu, Billy L., Silvia Muceli, Julian P. Saboisky, Dario Farina, Martin E. Héroux, Lynne E. Bilston, Simon C. Gandevia, and Jane E. Butler. "Motor unit territories in human genioglossus estimated with multichannel intramuscular electrodes." Journal of Applied Physiology 124, no. 3 (March 1, 2018): 664–71. http://dx.doi.org/10.1152/japplphysiol.00889.2017.
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The discharge patterns of genioglossus motor units during breathing have been well-characterized in previous studies, but their localization and territories are not known. In this study, we used two newly developed intramuscular multichannel electrodes to estimate the territories of genioglossus motor units in the anterior and posterior regions of the muscle. Seven healthy men participated. Each electrode contained fifteen bipolar channels, separated by 1 mm, and was inserted percutaneously below the chin, perpendicular to the skin, to a depth of 36 mm. Single motor unit activity was recorded with subjects awake, supine, and breathing quietly through a nasal mask for 180 s. Motor unit territories were estimated from the spike-triggered averages of the electromyographic signal from each channel. A total of 30 motor units were identified: 22 expiratory tonic, 1 expiratory phasic, 2 tonic, 3 inspiratory tonic, and 2 inspiratory phasic. Motor units appeared to be clustered based on unit type, with peak activities for expiratory units predominantly located in the anterior and superficial fibers of genioglossus and inspiratory units in the posterior region. Of these motor unit types, expiratory tonic units had the largest estimated territory, a mean 11.3 mm (SD 1.9). Estimated territories of inspiratory motor units ranged from 3 to 6 mm. In accordance with the distribution of motor unit types, the estimated territory of genioglossus motor units varied along the sagittal plane, decreasing from anterior to posterior. Our findings suggest that genioglossus motor units have large territories relative to the cross-sectional size of the muscle. NEW & NOTEWORTHY In this study, we used a new multichannel intramuscular electrode to address a fundamental property of human genioglossus motor units. We describe the territory of genioglossus motor units in the anterior and posterior regions of the muscle and show a decrease in territory size from anterior to posterior and that expiratory-related motor units have larger estimated territories than inspiratory-related motor units.
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Tantucci, Claudio, Selma Mehiri, Alexandre Duguet, Thomas Similowski, Isabelle Arnulf, Marc Zelter, Jean-Philippe Derenne, and Joseph Milic-Emili. "Application of negative expiratory pressure during expiration and activity of genioglossus in humans." Journal of Applied Physiology 84, no. 3 (March 1, 1998): 1076–82. http://dx.doi.org/10.1152/jappl.1998.84.3.1076.
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The application of negative expiratory pressure (NEP) at end expiration has been shown to cause reflex-mediated activation of the genioglossus muscle in awake humans. To test whether a reflex contraction of pharyngeal dilator muscles also occurs in response to NEP applied in early expiration, the effect on genioglossus muscle reflex activity of NEP pulses of 500 ms, given 0.2 s after the onset of expiration and during the end-expiratory pause, was assessed in 10 normal awake subjects at rest. The raw and integrated surface electromyogram of the genioglossus (EMGgg) was recorded with airflow and mouth pressure under control conditions and with NEP ranging from −3 to −10 cmH2O. Intraoral EMGgg was also recorded under the same experimental conditions in two subjects. The application of NEP at the end-expiratory pause elicited a consistent reflex response of EMGgg in seven subjects with a mean latency of 68 ± 5 ms. In contrast, when NEP was applied at the onset of expiration, EMGgg reflex activity was invariably observed in only one subject. No relationship was found between steady increase or abrupt fall in expiratory flow and the presence or the absence of a reflex activity of genioglossus during sudden application of NEP at the beginning of expiration. Our results show that a reflex activity of genioglossus is elicited much more commonly during application of NEP at the end rather than at the onset of expiration. These findings also suggest that when NEP is applied in early expiration to detect intrathoracic flow limitation the absence of upper airways narrowing does not imply the occurrence of a reflex-mediated activation of genioglossus and vice versa.
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Emara, Tarek Abdelzaher, Tharwat Abdelzaher Omara, and Waheed Mohamed Shouman. "Modified Genioglossus Advancement and Uvulopalatopharyngoplasty in Patients with Obstructive Sleep Apnea." Otolaryngology–Head and Neck Surgery 145, no. 5 (August 2, 2011): 865–71. http://dx.doi.org/10.1177/0194599811416745.
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Objective. To describe modification of the originally described genioglossus muscle advancement and its clinical assessment in the treatment of patients with obstructive sleep apnea. Study Design. Prospective study. Setting. University medical hospital. Subjects and Methods. Twenty-three patients with obstructive sleep apnea underwent modified genioglossus muscle advancement with uvulopalatopharyngoplasty. All patients were evaluated before and 6 months after surgery by history taking, clinical examination, Epworth Sleepiness Scale evaluation, fiber-optic nasopharyngoscopy, cephalometry, panoramic X-ray, and nocturnal polysomnography. Results. Postoperative mean ± SD apnea-hypopnea index (AHI) decreased from 40.7 ± 17.4 to 15.4 ± 10.7 ( P = .00; 95% confidence interval [CI], 18.4 to 32.27). With a success rate defined as AHI <20 and a 50% decrease in AHI of the preoperative value, the surgical success rate was 86.9%. Cephalometry analysis showed a significant difference between preoperative and postoperative findings, including a posterior airway space that increased a mean ± SD from 8.1 ± 2.5 to 12.3 ± 3.7 mm ( P = .00; 95% CI, −5.89 to −3.0), position of the mandible to the cranial base (SNB degree) that increased from 77.3 ± 2.7 to 78.5 ± 1.3 ( P = .005; 95% CI, −2.11 to −0.4), and improved palatal parameters. The mean (SD) average depth of the osteotomy and genioglossus advancement was 11.8 ± 2.6 mm. None of the 23 patients had mandible fracture, aesthetic changes of the chin, or detachment of the advanced genioglossus muscle. Conclusion. The modification described in this technique permits complete and safe capture and advancement of the whole genioglossus muscle, leading to satisfactory expansion of the retrolingual airway without stripping, detachment of the advanced genioglossus muscle, mandible fracture, or aesthetic changes of the chin.
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van Lunteren, E., and P. Manubay. "Contractile properties of feline genioglossus, sternohyoid, and sternothyroid muscles." Journal of Applied Physiology 72, no. 3 (March 1, 1992): 1010–15. http://dx.doi.org/10.1152/jappl.1992.72.3.1010.
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Despite a wealth of information about the respiratory behavior of pharyngeal dilator muscles such as the genioglossus, sternohyoid, and sternothyroid muscles, little is known about their contractile and endurance properties. Strips of these muscles (as well as of the diaphragm) were surgically removed from anesthetized cats and studied in vitro at 37 degrees C. The isometric contraction times of the muscles were 38 +/- 1, 31 +/- 1, 28 +/- 2, and 35 +/- 1 ms for genioglossus, sternothyroid, sternohyoid, and diaphragm, respectively. Contraction times were significantly longer for the genioglossus than for the sternohyoid and sternothyroid muscles and significantly longer for the diaphragm than for the sternohyoid muscle. Twitch-to-tetanic ratios were largest for the diaphragm and lowest for the sternohyoid muscle, and the force-frequency relationship of the sternohyoid was most rightward positioned and that of the diaphragm was most leftward positioned. During repetitive stimulation, the decrement in force was greatest for the diaphragm and least for the genioglossus muscle, with the force loss of the two hyoid muscles being intermediate in magnitude. The Burke fatigue index was significantly greater for the genioglossus than for the diaphragm, despite similar tension-time indexes during repetitive stimulation. These data indicate heterogeneity among pharyngeal dilator muscles in their contractile and endurance properties, that certain pharyngeal dilator muscle properties differ from diaphragmatic properties, and that pharyngeal muscles have relatively fast contractile kinetics yet reasonable endurance characteristics.
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Goh, Yau Hong, Victor Abdullah, and Sung Wan Kim. "Genioglossus Advancement and Hyoid Surgery." Sleep Medicine Clinics 14, no. 1 (March 2019): 73–81. http://dx.doi.org/10.1016/j.jsmc.2018.10.009.
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Sood, Sandeep, Eric Raddatz, Xia Liu, Hattie Liu, and Richard L. Horner. "Inhibition of serotonergic medullary raphe obscurus neurons suppresses genioglossus and diaphragm activities in anesthetized but not conscious rats." Journal of Applied Physiology 100, no. 6 (June 2006): 1807–21. http://dx.doi.org/10.1152/japplphysiol.01508.2005.
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Although exogenous serotonin at the hypoglossal motor nucleus (HMN) activates the genioglossus muscle, endogenous serotonin plays a minimal role in modulating genioglossus activity in awake and sleeping rats (Sood S, Morrison JL, Liu H, and Horner RL. Am J Respir Crit Care Med 172: 1338–1347, 2005). This result therefore implies that medullary raphe neurons also play a minimal role in the normal physiological control of the HMN, but this has not yet been established because raphe neurons release other excitatory neurotransmitters onto respiratory motoneurons in addition to serotonin. This study tests the hypothesis that inhibition of medullary raphe serotonergic neurons with 8-hydroxy-2-(di- n-propylamino)tetralin (8-OH-DPAT) suppresses genioglossus and diaphragm activities in awake and sleeping rats. Ten rats were implanted with electrodes to record sleep-wake states and genioglossus and diaphragm activities. Microdialysis probes were also implanted into the nucleus raphe obscurus (NRO). Experiments in 10 anesthetized and vagotomized rats were also performed using the same methodology. In anesthetized rats, microdialysis perfusion of 0.1 mM 8-OH-DPAT into the NRO decreased genioglossus activity by 60.7 ± 9.0% and diaphragm activity by 13.3 ± 3.4%. Diaphragm responses to 7.5% CO2 were also significantly reduced by 8-OH-DPAT. However, despite the robust effects observed in anesthetized and vagotomized rats, there was no effect of 0.1 mM 8-OH-DPAT on genioglossus or diaphragm activities in conscious rats awake or asleep. The results support the concept that endogenously active serotonergic medullary raphe neurons play a minimal role in modulating respiratory motor activity across natural sleep-wake states in freely behaving rodents. This result has implications for pharmacological strategies aiming to manipulate raphe neurons and endogenous serotonin in obstructive sleep apnea.
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Lewis, Michael R., and Yadranko Ducic. "Genioglossus Muscle Advancement with the Genioglossus Bone Advancement Technique for Base of Tongue Obstruction." Journal of Otolaryngology 32, no. 03 (2003): 168. http://dx.doi.org/10.2310/7070.2003.40315.
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Shintani, T., A. R. Anker, I. Billig, J. P. Card, and B. J. Yates. "Transneuronal tracing of neural pathways influencing both diaphragm and genioglossal muscle activity in the ferret." Journal of Applied Physiology 95, no. 4 (October 2003): 1453–59. http://dx.doi.org/10.1152/japplphysiol.00558.2003.
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In prior experiments that employed the transneuronal transport of isogenic recombinants of pseudorabies virus (PRV), we demonstrated that neurons located ventrally in the medial medullary reticular formation (MRF) of the ferret provide collateralized projections to both diaphragm and abdominal muscle motoneurons as well as to multiple abdominal muscle motoneuron pools. The goal of the present study was to determine whether single MRF neurons also furnish inputs to diaphragm motoneurons and those innervating an airway muscle with inspiratory-related activity: the tongue protruder genioglossus. For this purpose, PRV recombinants expressing unique reporters (β-galactosidase or enhanced green fluorescent protein) were injected into either the diaphragm or the genioglossal muscle. The virus injections produced transneuronal infection of overlapping populations of MRF neurons. A small proportion of these neurons (<15%) was infected by both PRV recombinants, which indicated that they provide collateralized inputs to genioglossal and diaphragm motoneurons. These findings show that, whereas some MRF neurons simultaneously influence the activity of upper airway and respiratory pump muscles, other cells in this brain stem region independently contribute to diaphragm and genioglossal muscle contraction regulation.
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Harris, Daniel P., Arvind Balasubramaniam, M. Safwan Badr, and Jason H. Mateika. "Long-term facilitation of ventilation and genioglossus muscle activity is evident in the presence of elevated levels of carbon dioxide in awake humans." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 291, no. 4 (October 2006): R1111—R1119. http://dx.doi.org/10.1152/ajpregu.00896.2005.
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We hypothesized that long-term facilitation (LTF) of minute ventilation and peak genioglossus muscle activity manifests itself in awake healthy humans when carbon dioxide is sustained at elevated levels. Eleven subjects completed two trials. During trial 1, baseline carbon dioxide levels were maintained during and after exposure to eight 4-min episodes of hypoxia. During trial 2, carbon dioxide was sustained 5 mmHg above baseline levels during exposure to episodic hypoxia. Seven subjects were exposed to sustained elevated levels of carbon dioxide in the absence of episodic hypoxia, which served as a control experiment. Minute ventilation was measured during trial 1, trial 2, and the control experiment. Peak genioglossus muscle activity was measured during trial 2. Minute ventilation during the recovery period of trial 1 was similar to baseline (9.3 ± 0.5 vs. 9.2 ± 0.7 l/min). Likewise, minute ventilation remained unchanged during the control experiment (beginning vs. end of control experiment, 14.4 ± 1.7 vs. 14.7 ± 1.4 l/min). In contrast, minute ventilation and peak genioglossus muscle activity during the recovery period of trial 2 was greater than baseline (minute ventilation: 28.4 ± 1.7 vs. 19.6 ± 1.0 l/min, P < 0.001; peak genioglossus activity: 1.6 ± 0.3 vs. 1.0 fraction of baseline, P < 0.001). We conclude that exposure to episodic hypoxia is necessary to induce LTF of minute ventilation and peak genioglossus muscle activity and that LTF is only evident in awake humans in the presence of sustained elevated levels of carbon dioxide.
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Ruscic, Katarina Jennifer, Janne Bøgh Stokholm, Johann Patlak, Hao Deng, Jeroen Cedric Peter Simons, Timothy Houle, Jürgen Peters, and Matthias Eikermann. "Supplemental Carbon Dioxide Stabilizes the Upper Airway in Volunteers Anesthetized with Propofol." Anesthesiology 129, no. 1 (July 1, 2018): 37–46. http://dx.doi.org/10.1097/aln.0000000000002239.
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Abstract Background Propofol impairs upper airway dilator muscle tone and increases upper airway collapsibility. Preclinical studies show that carbon dioxide decreases propofol-mediated respiratory depression. We studied whether elevation of end-tidal carbon dioxide (Petco2) via carbon dioxide insufflation reverses the airway collapsibility (primary hypothesis) and impaired genioglossus muscle electromyogram that accompany propofol anesthesia. Methods We present a prespecified, secondary analysis of previously published experiments in 12 volunteers breathing via a high-flow respiratory circuit used to control upper airway pressure under propofol anesthesia at two levels, with the deep level titrated to suppression of motor response. Ventilation, mask pressure, negative pharyngeal pressure, upper airway closing pressure, genioglossus electromyogram, bispectral index, and change in end-expiratory lung volume were measured as a function of elevation of Petco2 above baseline and depth of propofol anesthesia. Results Petco2 augmentation dose-dependently lowered upper airway closing pressure with a decrease of 3.1 cm H2O (95% CI, 2.2 to 3.9; P < 0.001) under deep anesthesia, indicating improved upper airway stability. In parallel, the phasic genioglossus electromyogram increased by 28% (23 to 34; P < 0.001). We found that genioglossus electromyogram activity was a significant modifier of the effect of Petco2 elevation on closing pressure (P = 0.005 for interaction term). Conclusions Upper airway collapsibility induced by propofol anesthesia can be reversed in a dose-dependent manner by insufflation of supplemental carbon dioxide. This effect is at least partly mediated by increased genioglossus muscle activity.
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Cai, Mingshu, Elizabeth C. Brown, Alice Hatt, Shaokoon Cheng, and Lynne E. Bilston. "Effect of head and jaw position on respiratory-related motion of the genioglossus." Journal of Applied Physiology 120, no. 7 (April 1, 2016): 758–65. http://dx.doi.org/10.1152/japplphysiol.00382.2015.
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Head and jaw position influence upper airway patency and electromyographic (EMG) activity of the main upper airway dilator muscle, the genioglossus. However, it is not known whether changes in genioglossus EMG activity translate into altered muscle movement during respiration. The aim of this study was to determine the influence of head and jaw position on dilatory motion of the genioglossus in healthy adult men during quiet breathing by measuring the displacement of the posterior tongue in six positions—neutral, head extension, head rotation, head flexion, mouth opening, and mandibular advancement. Respiratory-related motion of the genioglossus was imaged with spatial modulation of magnetization (SPAMM) in 12 awake male participants. Tissue displacement was quantified with harmonic phase (HARP) analysis. The genioglossus moved anteriorly beginning immediately before or during inspiration, and there was greater movement in the oropharynx than in the velopharynx in all positions. Anterior displacements of the oropharyngeal tongue varied between neutral head position (0.81 ± 0.41 mm), head flexion (0.62 ± 0.45 mm), extension (0.39 ± 0.19 mm), axial rotation (0.39 ± 0.2 mm), mouth open (1.24 ± 0.72 mm), and mandibular advancement (1.08 ± 0.65 mm). Anteroposterior displacement increased in the mouth-open position and decreased in the rotated position relative to cross-sectional area (CSA) ( P = 0.002 and 0.02, respectively), but CSA did not independently predict anteroposterior movement overall ( P = 0.057). The findings of this study suggest that head position influences airway dilation during inspiration and may contribute to variation in airway patency in different head positions.
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Cheng, S., J. E. Butler, S. C. Gandevia, and L. E. Bilston. "Movement of the human upper airway during inspiration with and without inspiratory resistive loading." Journal of Applied Physiology 110, no. 1 (January 2011): 69–75. http://dx.doi.org/10.1152/japplphysiol.00413.2010.
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The electromyographic (EMG) activity of human upper airway muscles, particularly the genioglossus, has been widely measured, but the relationship between EMG activity and physical movement of the airway muscles remains unclear. We aimed to measure the motion of the soft tissues surrounding the airway during normal and loaded inspiration on the basis of the hypothesis that this motion would be affected by the addition of resistance to breathing during inspiration. Tagged MR imaging of seven healthy subjects was performed in a 3-T scanner. Tagged 8.6-mm-spaced grids were used, and complementary spatial modulation of magnetization images were acquired beginning ∼200 ms before inspiratory airflow. Deformation of tag line intersections was measured. The genioglossus moved anteriorly during normal and loaded inspiration, with less movement during loaded inspiration. The motion of tissues at the anterior border of the upper airway was nonuniform, with larger motions inferiorly. At the level of the soft palate, the lateral dimension of the airway decreased significantly during loaded inspiration (−0.15 ± 0.09 and −0.48 ± 0.09 mm during unloaded and loaded inspiration, respectively, P < 0.05). When resistance to inspiratory flow was added, genioglossus motion and lateral dimensions of the airway at the level of the soft palate decreased. Our results suggest that genioglossus motion begins early to dilate the airway prior to airflow and that inspiratory loading reduces the anterior motion of the genioglossus and increases the collapse of the lateral airway walls at the level of the soft palate.
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Adachi, K., G. M. Murray, J. C. Lee, and B. J. Sessle. "Noxious Lingual Stimulation Influences the Excitability of the Face Primary Motor Cerebral Cortex (Face MI) in the Rat." Journal of Neurophysiology 100, no. 3 (September 2008): 1234–44. http://dx.doi.org/10.1152/jn.90609.2008.
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The mechanisms whereby orofacial pain affects motor function are poorly understood. The aims were to determine whether 1) lingual algesic chemical stimulation affected face primary motor cerebral cortex (face MI) excitability defined by intracortical microstimulation (ICMS); and 2) any such effects were limited to the motor efferent MI zones driving muscles in the vicinity of the noxious stimulus. Ketamine-anesthetized Sprague–Dawley male rats were implanted with electromyographic (EMG) electrodes into anterior digastric, masseter, and genioglossus muscles. In 38 rats, three microelectrodes were located in left face MI at ICMS-defined sites for evoking digastric and/or genioglossus responses. ICMS thresholds for evoking EMG activity from each site were determined every 15 min for 1 h, then the right anterior tongue was infused (20 μl, 120 μl/h) with glutamate (1.0 M, n = 18) or isotonic saline ( n = 7). Subsequently, ICMS thresholds were determined every 15 min for 4 h. In intact control rats ( n = 13), ICMS thresholds were recorded over 5 h. Only left and right genioglossus ICMS thresholds were significantly increased (≤350%) in the glutamate infusion group compared with intact and isotonic saline groups ( P < 0.05). These dramatic effects of glutamate on ICMS-evoked genioglossus activity contrast with its weak effects only on right genioglossus activity evoked from the internal capsule or hypoglossal nucleus. This is the first documentation that intraoral noxious stimulation results in prolonged neuroplastic changes manifested as a decrease in face MI excitability. These changes appear to occur predominantly in those parts of face MI that provide motor output to the orofacial region receiving the noxious stimulation.
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Fogarty, Matthew J., and Gary C. Sieck. "Tongue muscle contractile, fatigue, and fiber type properties in rats." Journal of Applied Physiology 131, no. 3 (September 1, 2021): 1043–55. http://dx.doi.org/10.1152/japplphysiol.00329.2021.
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For the individual tongue muscles, relatively little quantification of uniaxial force, fatigue, and fiber type-specific properties has been documented. Here, we assessed uniaxial-specific force generation, fatigability, and muscle fiber type-specific properties in the superior and inferior longitudinal muscles, the transversalis, and the genioglossus in Fischer 344 rats. The longitudinal muscles produced the greatest isometric tetanic-specific forces. The genioglossus was more fatigue resistant and comprised higher proportions of I and IIa fibers.
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Bailey, E. Fiona. "Activities of human genioglossus motor units." Respiratory Physiology & Neurobiology 179, no. 1 (October 2011): 14–22. http://dx.doi.org/10.1016/j.resp.2011.04.018.
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McSharry, David, Ciara O’Connor, Triona McNicholas, Simon Langran, Michael O'Sullivan, Madeleine Lowery, and Walter T. McNicholas. "Genioglossus fatigue in obstructive sleep apnea." Respiratory Physiology & Neurobiology 183, no. 2 (August 2012): 59–66. http://dx.doi.org/10.1016/j.resp.2012.05.024.
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Chou, Joli C. "Genioglossus Advancement via Segmental Mortised Genioplasty." Journal of Oral and Maxillofacial Surgery 64, no. 9 (September 2006): 65–66. http://dx.doi.org/10.1016/j.joms.2006.06.127.
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Wirtz, Nicholas, and David Hamlar. "Genioglossus advancement for obstructive sleep apnea." Operative Techniques in Otolaryngology-Head and Neck Surgery 26, no. 4 (December 2015): 193–96. http://dx.doi.org/10.1016/j.otot.2015.08.003.
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Woodmansee, VA, Aurelio Rodriguez, Stuart Mirvis, and Bryan Fitzgerald. "Genioglossus hemorrhage after blunt facial trauma." Annals of Emergency Medicine 21, no. 4 (April 1992): 440–44. http://dx.doi.org/10.1016/s0196-0644(05)82669-1.
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Takemoto, Hironori. "Morphological Analyses of the Human Tongue Musculature for Three-Dimensional Modeling." Journal of Speech, Language, and Hearing Research 44, no. 1 (February 2001): 95–107. http://dx.doi.org/10.1044/1092-4388(2001/009).
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Skilled movements of the tongue in speech articulation reflect complex formation of the tongue musculature, although its description in the anatomical literature is rather limited for developing a realistic computational model of the tongue. This study presents detailed descriptions of the muscular structure of the human tongue based on macroscopic and microscopic observations and provides threedimensional schemata of the tongue musculature. Histologic examination revealed that the tongue consists of five strata, stacked along the courses of the fibers of the genioglossus muscle in proximal-distal directions. This stratum structure exists in the entire tongue tissue, indicating that the lingual musculature can be divided into the inner and outer regions. The former consisted of the "stem" and "core," and the latter of the "cover" and "fringe." In gross dissection, the tongue was cut into wedge-like blocks along the course of the genioglossus muscle to examine muscle fiber arrangement. Using this approach, it was determined that serial repetitions of "structural units" composed the inner musculature of the tongue. Each unit consisted of a pair of thin muscle fiber laminae; one was composed of the genioglossus and vertical muscles, and the other of the transverse muscle. In the apex, the laminae lacked the fibers of the genioglossus. These findings have been incorporated in three-dimensional schemata of the tongue musculature.
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Herbstreit, Frank, Daniela Zigrahn, Christof Ochterbeck, Jürgen Peters, and Matthias Eikermann. "Neostigmine/Glycopyrrolate Administered after Recovery from Neuromuscular Block Increases Upper Airway Collapsibility by Decreasing Genioglossus Muscle Activity in Response to Negative Pharyngeal Pressure." Anesthesiology 113, no. 6 (December 1, 2010): 1280–88. http://dx.doi.org/10.1097/aln.0b013e3181f70f3d.
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Background Reversal of residual neuromuscular blockade by acetylcholinesterase inhibitors (e.g., neostigmine) improves respiratory function. However, neostigmine may also impair muscle strength. We hypothesized that neostigmine administered after recovery of the train-of-four (TOF) ratio impairs upper airway integrity and genioglossus muscle function. Methods We measured, in 10 healthy male volunteers, epiglottic and nasal mask pressures, genioglossus electromyogram, air flow, respiratory timing, and changes in lung volume before, during (TOF ratio: 0.5), and after recovery of the TOF ratio to unity, and after administration of neostigmine 0.03 mg/kg IV (with glycopyrrolate 0.0075 mg/kg). Upper airway critical closing pressure (Pcrit) was calculated from flow-limited breaths during random pharyngeal negative pressure challenges. Results Pcrit increased significantly after administration of neostigmine/glycopyrrolate compared with both TOF recovery (mean ± SD, by 27 ± 21%; P = 0.02) and baseline (by 38 ± 17%; P = 0.002). In parallel, phasic genioglossus activity evoked by negative pharyngeal pressure decreased (by 37 ± 29%, P = 0.005) compared with recovery, almost to a level observed at a TOF ratio of 0.5. Lung volume, respiratory timing, tidal volume, and minute ventilation remained unchanged after neostigmine/glycopyrrolate injection. Conclusion Neostigmine/glycopyrrolate, when administered after recovery from neuromuscular block, increases upper airway collapsibility and impairs genioglossus muscle activation in response to negative pharyngeal pressure. Reversal with acetylcholinesterase inhibitors may be undesirable in the absence of neuromuscular blockade.
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Liu, Stanley Yung-Chuan, Leh-Kiong Huon, Soroush Zaghi, Robert Riley, and Carlos Torre. "An Accurate Method of Designing and Performing Individual-Specific Genioglossus Advancement." Otolaryngology–Head and Neck Surgery 156, no. 1 (October 22, 2016): 194–97. http://dx.doi.org/10.1177/0194599816670366.
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There is too much individual patient variation in mandibular anatomy for any single described genioglossus advancement technique to be used consistently. Virtual surgical planning allows surgeons to design genioglossus osteotomy that captures the structures of interest. Intraoperative osteotomy and positioning guides mitigate known risks of the procedure while maximizing the reproducibility and efficacy of the procedure. In this report, we demonstrate the protocol step by step as it had been used on 10 patients, and we highlight 3 clinical scenarios that exemplify its utility.
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Berry, Richard B., David P. White, John Roper, Giora Pillar, Robert B. Fogel, Michael Stanchina, and Atul Malhotra. "Awake negative pressure reflex response of the genioglossus in OSA patients and normal subjects." Journal of Applied Physiology 94, no. 5 (May 1, 2003): 1875–82. http://dx.doi.org/10.1152/japplphysiol.00324.2002.
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We hypothesized that the response of the genioglossus to negative pressure during wakefulness should be intact in obstructive sleep apnea (OSA) patients despite published evidence showing impairment of the response of palatal muscles (Mortimore IL and Douglas NJ. Am J Respir Crit Care Med156: 867–873, 1997). Thus the response of the genioglossus to brief nasal negative pressure applications (NPAs) in early inspiration was compared between OSA patients and an age-matched group of normal subjects at two study sites ( n = 11 per group in Long Beach, n = 14 per group in Boston). Subjects were studied in the sitting (Long Beach) or supine (Boston) posture, and the genioglossus electromyogram (EMGgg) was measured with an intraoral surface electrode (Long Beach) or intramuscular electrode (Boston). The response of the EMGgg was expressed as the percent change from baseline where the baseline EMGgg was the value at the onset of the NPA. In Long Beach, the EMGgg response was significantly higher in the OSA patients at a lower suction pressure of ∼10 cmH2O (75.2 ± 8.4 vs. 37.4 ± 4.0% increase; P < 0.001) but not at a higher suction pressure of ∼20 cmH2O. In Boston, the response in the OSA patients was also greater (107.2 ± 25.9 vs. 46.3 ± 8.3%; P < 0.05) at a suction pressure of ∼13 cmH2O. We conclude that the response of the genioglossus to NPA during wakefulness is not impaired in OSA patients compared with normal subjects and is greater at low suction pressures.
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Srinivasan, Ilavajady, Samuel Strantzas, and Mark W. Crawford. "Phasic Genioglossus and Palatoglossus Muscle Activity during Recovery from Sevoflurane Anesthesia." Anesthesiology 119, no. 3 (September 1, 2013): 562–68. http://dx.doi.org/10.1097/aln.0b013e318295a27b.
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Abstract Background: Inhalational anesthetic effects on upper airway muscle activity in children are largely unknown. The authors tested the hypothesis that phasic inspiratory genioglossus and palatoglossus activity increases during recovery from sevoflurane anesthesia in a dose-dependent manner in children. Methods: Sixteen children, aged 2.0 to 6.9 yr, scheduled for elective urological surgery were studied. Electromyogram recordings were acquired using intramuscular needle electrodes during spontaneous ventilation. After a 15-min period of equilibration, electromyogram activity was recorded over 30 s at each of three end-tidal concentrations, 1.5, 1.0, and 0.5 minimum alveolar concentration (MAC), administered in sequence. Results: Phasic genioglossus activity was noted in four children at 1.5 MAC, five at 1.0 MAC, and six children at 0.5 MAC sevoflurane. Phasic palatoglossus activity was noted in 4 children at 1.5 MAC, 6 at 1.0 MAC, and 10 children at 0.5 MAC sevoflurane. Both the proportion of children exhibiting phasic activity, and the magnitude of phasic activity increased during recovery from anesthesia. For the genioglossus, decreasing the depth of sevoflurane anesthesia from 1.5 to 1.0 MAC increased phasic activity by approximately 35% and a further decrease to 0.5 MAC more than doubled activity (median [range] at 1.5 and 0.5 MAC: 2.7 μV [0 to 4.0 μV] and 8.6 μV [3.2 to 17.6], respectively; P = 0.029). A similar dose-related increase was recorded at the palatoglossus (P = 0.0002). Conclusions: Genioglossus and palatoglossus activity increases during recovery from sevoflurane anesthesia in a dose-dependent manner over the clinical range of sevoflurane concentrations in children.
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Cotter, L. A., H. E. Arendt, S. P. Cass, B. J. Jian, D. F. Mays, C. J. Olsheski, K. A. Wilkinson, and B. J. Yates. "Effects of postural changes and vestibular lesions on genioglossal muscle activity in conscious cats." Journal of Applied Physiology 96, no. 3 (March 2004): 923–30. http://dx.doi.org/10.1152/japplphysiol.01013.2003.
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Previous studies in humans showed that genioglossal muscle activity is higher when individuals are supine than when they are upright, and prior experiments in anesthetized or decerebrate animals suggested that vestibular inputs might participate in triggering these alterations in muscle firing. The present study determined the effects of whole body tilts in the pitch (nose-up) plane on genioglossal activity in a conscious feline model and compared these responses with those generated by roll (ear-down) tilts. We also ascertained the effects of a bilateral vestibular neurectomy on the alterations in genioglossal activity elicited by changes in body position. Both pitch and roll body tilts produced modifications in muscle firing that were dependent on the amplitude of the rotation; however, the relative effects of ear-down and nose-up tilts on genioglossal activity were variable from animal to animal. The response variability observed might reflect the fact that genioglossus has a complex organization and participates in a variety of tongue movements; in each animal, electromyographic recordings presumably sampled the firing of different proportions of fibers in the various compartments and subcompartments of the muscle. Furthermore, removal of labyrinthine inputs resulted in alterations in genioglossal responses to postural changes that persisted until recordings were discontinued ∼1 mo later, demonstrating that the vestibular system participates in regulating the muscle's activity. Peripheral vestibular lesions were subsequently demonstrated to be complete through the postmortem inspection of temporal bone sections or by observing that vestibular nucleus neurons did not respond to rotations in vertical planes.
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Amirali, Asif, Lian-Cai Mu, Hingxi Su, and Ira Sanders. "Respiratory Activity of Geniohyoid and Genioglossus Motoneurons." Otolaryngology–Head and Neck Surgery 131, no. 2 (August 2004): P199. http://dx.doi.org/10.1016/j.otohns.2004.06.372.
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Mu, Linn-Cai, and Ira Sanders. "42: Neuromuscular Compartments of the Canine Genioglossus." Otolaryngology–Head and Neck Surgery 115, no. 2 (August 1996): P91. http://dx.doi.org/10.1016/s0194-5998(96)80666-8.
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