0714 Effect of One-Week Velopharyngeal-Task Training on Genioglossus Corticomotor Excitability and Sleep Apnea Severity. (27th May 2020) - Li, W
Abstract: Introduction: The effectiveness of the contraction of the UA dilator muscles plays a crucial role in the maintenance of UA patency. This study aimed to assess the effects of one-week velopharyngeal-task training (VTT) on sleep apnea severity and its genioglossus (GG) corticomotor excitability. Methods: Ten patients with sleep apnea underwent 1 h VTT on seven consecutive days. During the VTT protocol, subjects were asked to develop repetitive intra-oral positive pressure using cheek-bulging maneuvers while wearing a mouth piece to keep the jaw opened and maintaining an exclusive nasal breathing. They were encouraged to generate approximately 4% of Max pressure by maintaining the pressure inside the corresponding pre-set pressure target window for 2 sec every 10 sec. PSG recording and GG transcranial magnetic stimulation (TMS) response was obtained before and after the one-week VTT. Results: One-week VTT was associated with a global AHI decrease by 33.8% (pre-VTT: 34.5±31.9 n/h; post-VTT: 25.5±26.7 n/h; p < 0.05) and progressed from moderate/severe to mild/moderate in 40% of patients. Although the bulging pressure remained unchanged (pre-VTT: 17.1±5.6 kPa, post-VTT: 19.4±5.4 kPa, p > 0.05), the amplitude of GG motor evoked potential in response to TMS significantly increased after the one-week VTT (pre-VTT: 639.4±380.9mV; post-VTT: 1128.5±623.9mV; p < 0.05). Conclusion: One-week VTT is sufficient to confer clinical benefits on patients with sleep apnea. VTT protocol is not oriented toward strength gain, but rather toward an enhancement in the upper airway muscle cortical excitability and improvement in the coordination of their contraction. The authors consider these results to be potentially clinically relevant and worthy of further investigation in a large randomized trial. Support: National Natural Science Foundation of China, Grant/Award Number: 81670085.