{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:14:18Z","timestamp":1790734458960,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T00:00:00Z","timestamp":1727481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MED-EL Elektromedizinische Ger\u00e4te GmbH, Innsbruck, Austria","award":["GU-463\/12-1"],"award-info":[{"award-number":["GU-463\/12-1"]}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft (DFG)","doi-asserted-by":"publisher","award":["GU-463\/12-1"],"award-info":[{"award-number":["GU-463\/12-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Competence Center for Interdisciplinary Prevention (Kompetenzzentrum f\u00fcr Interdisziplin\u00e4re Pr\u00e4vention; KIP) of the Friedrich Schiller University Jena","award":["GU-463\/12-1"],"award-info":[{"award-number":["GU-463\/12-1"]}]},{"name":"Berufsgenossenschaft Nahrungsmittel und Gastgewerbe (BGN)","award":["GU-463\/12-1"],"award-info":[{"award-number":["GU-463\/12-1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Facial palsy causes severe functional disorders and impairs quality of life. Disturbing challenges for patients with acute facial palsy, but also with those with chronic facial palsy with synkinesis, are the loss of the ability to smile and insufficient eyelid closure. A potential treatment for these conditions could be a closed-loop electro-stimulation system that stimulates the facial muscles on the paretic side as needed to elicit eye closure, eye blink and smile in a manner similar to the healthy side. Methods: This study focuses on the development and evaluation of such a system. An artificial intelligence (AI)-based auricular-triggered algorithm is used to classify the intended facial movements. This classification is based on surface electromyography (EMG) recordings of the extrinsic auricular muscles, specifically the anterior, superior, and posterior auricular muscle on the paretic side. The system then delivers targeted surface electrical stimulation to contract the appropriate facial muscles. Results: The evaluation of the system was conducted with 17 patients with facial synkinesis, who performed various facial movements according to a paradigm video. The system\u2019s performance was evaluated through a simulation, using previously captured data as the inputs. The performance was evaluated by means of the median macro F1-score, which was calculated based on the stimulation signal (output of the system) and the actual movements the patients performed. Conclusions: This study showed that such a system, using an AI-based auricular-triggered algorithm, can support with a median macro F1-score of 0.602 for the facial movements on the synkinetic side in patients with unilateral chronic facial palsy with synkinesis.<\/jats:p>","DOI":"10.3390\/diagnostics14192158","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T04:00:04Z","timestamp":1727668804000},"page":"2158","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Electro-Stimulation System with Artificial-Intelligence-Based Auricular-Triggered Algorithm to Support Facial Movements in Peripheral Facial Palsy: A Simulation Pilot Study"],"prefix":"10.3390","volume":"14","author":[{"given":"Katharina","family":"Steiner","sequence":"first","affiliation":[{"name":"Department of Medical Engineering, University of Applied Sciences Upper Austria, 4020 Linz, Austria"},{"name":"MED-EL Elektromedizinische Ger\u00e4te GmbH, 6020 Innsbruck, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4027-465X","authenticated-orcid":false,"given":"Marius","family":"Arnz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany"},{"name":"Facial-Nerve-Center, Jena University Hospital, 07747 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1245-6331","authenticated-orcid":false,"given":"Gerd Fabian","family":"Volk","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany"},{"name":"Facial-Nerve-Center, Jena University Hospital, 07747 Jena, Germany"},{"name":"Center for Rare Diseases Jena University Hospital, 07747 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9671-0784","authenticated-orcid":false,"given":"Orlando","family":"Guntinas-Lichius","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany"},{"name":"Facial-Nerve-Center, Jena University Hospital, 07747 Jena, Germany"},{"name":"Center for Rare Diseases Jena University Hospital, 07747 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.anl.2023.04.007","article-title":"Physical therapy for peripheral facial palsy: A systematic review and meta-analysis","volume":"51","author":"Nakano","year":"2023","journal-title":"Auris Nasus Larynx"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Guntinas-Lichius, O., Prengel, J., Cohen, O., M\u00e4kitie, A.A., Poorten, V.V., Ronen, O., Shaha, A., and Ferlito, A. 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