{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T23:22:36Z","timestamp":1789946556900,"version":"4.0.1"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2013,6,4]],"date-time":"2013-06-04T00:00:00Z","timestamp":1370304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Experimental Physiology"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:title>New Findings<\/jats:title><jats:p><jats:list list-type=\"explicit-label\">\n<jats:list-item><jats:p><jats:bold>What is the central question of this study?<\/jats:bold><\/jats:p><jats:p>A transcranial magnetic stimulation (TMS)\u2010induced twitch applied on isolated single breaths over the motor cortex somatotopic representation of the tongue briefly recruits submental muscles and improves airflow dynamics of flow\u2010limited respiratory cycles without arousing sleep apnoea patients. However, the mechanical impact of the TMS\u2010induced twitch applied during consecutive breathing cycles on airflow dynamics remains unknown.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p><jats:bold>What is the main finding and what is its importance?<\/jats:bold><\/jats:p><jats:p>Our results show that application of TMS with the stimulator output set at the sleep submental motor threshold intensity on consecutive respiratory cycles increases inspiratory flow and reduces the turbulent airflow component. These results indicate an improvement of airflow pattern after two single consecutive TMS\u2010induced twitches without arousing sleep apnoea patients.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><jats:p>Transcranial magnetic stimulation (TMS)\u2010induced twitches applied on isolated breaths briefly recruit upper airway dilator muscles and improve airflow and inspiratory volume without arousing apnoeic patients from sleep, but the effects of applying such twitches consecutively on airflow dynamics is unknown. The objective of this study was to quantify the effects of five consecutive TMS\u2010induced twitches applied on sleep\u2010induced obstructive hypopnoeic breaths in 10 obstructive sleep apnoea patients. Submental muscle motor threshold (SUB<jats:sub>MT<\/jats:sub>) and motor\u2010evoked potential were measured during wakefulness and sleep. The TMS\u2010induced twitches were applied during stable non\u2010rapid eye movement (NREM) sleep, at the beginning of inspiration of consecutive flow\u2010limited respiratory cycles, with the stimulator output set at sleep SUB<jats:sub>MT<\/jats:sub>. Maximal inspiratory flow, inspiratory volume, inspiratory time, shifts of electroencephalogram frequency and pulse rate variability were assessed. During sleep, SUB<jats:sub>MT<\/jats:sub> increased (wakefulness, 25.3 \u00b1 4.9%; NREM sleep, 27.0 \u00b1 6.2%; <jats:italic>P<\/jats:italic>= 0.02). During each series of stimulations there was a rise in maximal inspiratory flow (from 306.7 \u00b1 123.2 to 359.8 \u00b1 154.1 ml s<jats:sup>\u22121<\/jats:sup>; <jats:italic>P<\/jats:italic>= 0.0002) and in inspiratory volume (from 346.1 \u00b1 128.1 to 414.9 \u00b1 171.2 ml; <jats:italic>P<\/jats:italic>= 0.02) without differences in thoraco\u2010abdominal efforts and inspiratory time. These responses were observed in the absence of arousals and ceased immediately after TMS interruption. Transcranial magnetic stimulation\u2010induced cortical and\/or autonomic arousal was observed in 30.2% of all series of stimulation. Consecutive twitch TMS of submental muscles may lead to arousals in a minority of patients but can be applied on consecutive respiratory cycles during sleep and can significantly improve maximal inspiratory flow and inspiratory volume of flow\u2010limited cycles.<\/jats:p>","DOI":"10.1113\/expphysiol.2013.073072","type":"journal-article","created":{"date-parts":[[2013,5,4]],"date-time":"2013-05-04T04:24:41Z","timestamp":1367641481000},"page":"1366-1375","source":"Crossref","is-referenced-by-count":19,"title":["Consecutive transcranial magnetic stimulation twitches reduce flow limitation during sleep in apnoeic patients"],"prefix":"10.1113","volume":"98","author":[{"given":"C\u00e9sar Augusto","family":"Melo\u2010Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Gakwaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Rousseau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"S\u00e9ri\u00e8s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,6,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2869.2003.00379.x"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/15.2.173"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2011.06.008"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00713.2011"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00581.2002"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00043.2008"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2008.06.012"},{"key":"e_1_2_5_9_1","first-page":"406","article-title":"The tongue and its control by sleep state\u2010dependent modulators","volume":"149","author":"Horner RL","year":"2011","journal-title":"Arch Ital Biol"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1997.83.3.851"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01319.2003"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2005.12.003"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1113\/expphysiol.2012.070359"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-980X(96)96598-4"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00042412"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2010.10.003"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2008.06.006"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201109-1614OC"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1113\/expphysiol.2007.039610"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.90894.2008"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-2614"}],"container-title":["Experimental Physiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1113%2Fexpphysiol.2013.073072","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/pdf\/10.1113\/expphysiol.2013.073072","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T16:49:32Z","timestamp":1697647772000},"score":1,"resource":{"primary":{"URL":"https:\/\/physoc.onlinelibrary.wiley.com\/doi\/10.1113\/expphysiol.2013.073072"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,6,4]]},"references-count":20,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2013,9]]}},"alternative-id":["10.1113\/expphysiol.2013.073072"],"URL":"https:\/\/doi.org\/10.1113\/expphysiol.2013.073072","archive":["Portico"],"relation":{},"ISSN":["0958-0670","1469-445X"],"issn-type":[{"value":"0958-0670","type":"print"},{"value":"1469-445X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,6,4]]}}}