{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,25]],"date-time":"2025-10-25T19:02:46Z","timestamp":1761418966185,"version":"3.37.3"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,3,21]],"date-time":"2015-03-21T00:00:00Z","timestamp":1426896000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"CIHR","doi-asserted-by":"crossref","award":["89985"],"award-info":[{"award-number":["89985"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:sec><jats:title>New Findings<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item>\n<jats:p><jats:bold>What is the central question of this study?<\/jats:bold><\/jats:p>\n<jats:p>Can repetitive transcranial magnetic stimulation (rTMS) of the genioglossus enhance the beneficial effects observed with transcranial magnetic stimulation single twitches on upper airway mechanical properties?<\/jats:p>\n<\/jats:list-item>\n<jats:list-item>\n<jats:p><jats:bold>What is the main finding and its importance?<\/jats:bold><\/jats:p>\n<jats:p>We found that both inspiratory and expiratory rTMS protocols induce a different activation pattern of upper airway muscles, with evidence for an increase in genioglossus corticomotor excitability in response to rTMS. This is of major importance because it might open the door for rTMS protocols with the goal of increasing corticomotor excitability and, thus, possibly increasing the tonic genioglossus activity, which is known to be diminished during sleep in subjects with sleep apnoea.<\/jats:p>\n<\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Stimulation of upper airway (UA) muscles during sleep by isolated transcranial magnetic stimulation (TMS) twitch can improve airflow dynamics without arousal, but the effect of repetitive TMS (rTMS) on UA dynamics is unknown. Phrenic nerve magnetic stimulation (PNMS) can be used to produce painless experimental twitch\u2010induced flow limitation during wakefulness. The aim of this study was to quantify the effects of rTMS applied during wakefulness on UA mechanical properties using PNMS in subjects with obstructive sleep apnoea (OSA). Phrenic nerve magnetic stimulation was applied to 10 subjects, with and without simultaneous rTMS, during inspiration and expiration. Flow\u2010limitation characteristics and UA obstruction level were determined [maximal (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/eph1611-math-0001.png\" xlink:title=\"urn:x-wiley:09580670:eph1611:equation:eph1611-math-0001\"\/>and minimal inspiratory airflow (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/eph1611-math-0002.png\" xlink:title=\"urn:x-wiley:09580670:eph1611:equation:eph1611-math-0002\"\/><jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/eph1611-math-0003.png\" xlink:title=\"urn:x-wiley:09580670:eph1611:equation:eph1611-math-0003\"\/> flow drop (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/eph1611-math-0004.png\" xlink:title=\"urn:x-wiley:09580670:eph1611:equation:eph1611-math-0004\"\/>oropharyngeal (<jats:italic>P<\/jats:italic><jats:sub>Oro,peak<\/jats:sub>) and velopharyngeal peak pressures, oropharyngeal <jats:italic>k<\/jats:italic><jats:sub>1<\/jats:sub>\/<jats:italic>k<\/jats:italic><jats:sub>2<\/jats:sub> ratios with <jats:italic>k<\/jats:italic><jats:sub>1<\/jats:sub> and <jats:italic>k<\/jats:italic><jats:sub>2<\/jats:sub> determined by the polynomial regression model between instantaneous flow and pharyngeal pressure and UA resistance]. Both genioglossus and diaphragm root mean squares and motor\u2010evoked potential amplitudes (geniolossus, GG<jats:sub>Amp<\/jats:sub>) and latencies were computed. A flow\u2010limitation pattern always occurred after PNMS. A decrease in <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/eph1611-math-0005.png\" xlink:title=\"urn:x-wiley:09580670:eph1611:equation:eph1611-math-0005\"\/> and an increase in <jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/eph1611-math-0006.png\" xlink:title=\"urn:x-wiley:09580670:eph1611:equation:eph1611-math-0006\"\/> occurred following rTMS applied during inspiration, and <jats:italic>P<\/jats:italic><jats:sub>Oro,peak<\/jats:sub> values were more negative with both inspiratory and expiratory rTMS. The GG<jats:sub>Amp<\/jats:sub> also increased significantly from the second to the last rTMS expiratory train twitch. All other parameters remained unchanged. These results suggest the following conclusions: (i)\u00a0rTMS does not improve UA mechanical properties in awake subjects with OSA; (ii)\u00a0the activation pattern of UA muscles differs following isolated twitch and repetitive cortical stimulation of the genioglossus; and (iii)\u00a0rTMS applied during expiration induces corticomotor facilitation.<\/jats:p><\/jats:sec>","DOI":"10.1113\/ep085005","type":"journal-article","created":{"date-parts":[[2015,2,13]],"date-time":"2015-02-13T13:20:04Z","timestamp":1423833604000},"page":"566-576","source":"Crossref","is-referenced-by-count":9,"title":["Mechanical effects of repetitive transcranial magnetic stimulation of upper airway muscles in awake obstructive sleep apnoea subjects"],"prefix":"10.1113","volume":"100","author":[{"given":"Eric","family":"Rousseau","sequence":"first","affiliation":[{"name":"Unit\u00e9 de recherche en pneumologie Centre de recherche Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Universit\u00e9 Laval Qu\u00e9bec  QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Gakwaya","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de recherche en pneumologie Centre de recherche Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Universit\u00e9 Laval Qu\u00e9bec  QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9sar Augusto","family":"Melo\u2010Silva","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de recherche en pneumologie Centre de recherche Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Universit\u00e9 Laval Qu\u00e9bec  QC Canada"},{"name":"Laboratory of Respiratory Physiology University of Bras\u00edlia \u2013 UnB  Bras\u00edlia \u2013 DF Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9ric","family":"S\u00e9ri\u00e8s","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de recherche en pneumologie Centre de recherche Institut Universitaire de Cardiologie et de Pneumologie de Qu\u00e9bec Universit\u00e9 Laval Qu\u00e9bec  QC 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