title: Whisking recovery after automated mechanical stimulation during facial nerve regeneration.
abstract: IMPORTANCE Recovery from facial nerve transection is typically poor, but daily mechanical stimulation of the face in rats has been reported to remarkably enhance functional recovery after facial nerve transection and suture repair. This phenomenon needs additional investigation because of its important clinical implications. OBJECTIVE To determine whether automated mechanical stimulation of the whisker pad improves whisking recovery after facial nerve transection and repair in a rat model. DESIGN AND SETTING Sixty-one rats underwent unilateral facial nerve transection and suture repair and were randomized into 8 groups. Six groups received daily automated whisker or whisker pad mechanical stimulation including 0.5-, 1.5-, and 8.0-Hz patterns. Two control groups received restraint without stimulation. Treatment started on postoperative day 8, occurred 5 days per week, and lasted throughout 15 weeks of recovery. Whisking amplitude, velocity, and acceleration were quantified weekly for 15 weeks. INTERVENTIONS Unilateral facial nerve transection, suture repair, and, for 6 groups, daily automated whisker or whisker pad mechanical stimulation. MAIN OUTCOMES AND MEASURES Quantification of whisking amplitude, velocity, and acceleration. RESULTS Rats receiving the low frequencies of stimulation of the whiskers or whisker pad did not demonstrate enhanced whisking recovery, and rats receiving stimulation at 8.0 Hz showed significantly worse whisking recovery compared with controls and previously published groups receiving lower dose manual stimulation. CONCLUSIONS AND RELEVANCE Although daily manual whisker pad stimulation has been shown to enhance whisking recovery, rats in this study did not demonstrate improved whisking recovery after automated mechanical stimulation across a wide range of driving frequencies. Moreover, faster stimulation (8.0 Hz) was actually detrimental to recovery. Further work is needed to understand the relationship between stimulation patterns and the physiologic mechanisms underlying improved or worsened functional outcomes after facial nerve transection and repair.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston3Department of Otorhinolaryngology/Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Ingrid J
authors.initials: IJ
authors.lastname: Kleiss
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Knox
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Juan S
authors.initials: JS
authors.lastname: Malo
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
authors.forename: Henri A M
authors.initials: HA
authors.lastname: Marres
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Tessa A
authors.initials: TA
authors.lastname: Hadlock
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Boston.
authors.forename: James T
authors.initials: JT
authors.lastname: Heaton
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001331:Automation; D004195:Disease Models, Animal; D005154:Facial Nerve / Q000601:surgery; D020220:Facial Nerve Injuries / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D009416:Nerve Regeneration / Q000502:physiology*; D010812:Physical Stimulation / Q000379:methods*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D020127:Recovery of Function; D012016:Reference Values; D013997:Time Factors; D016896:Treatment Outcome; D014738:Vibrissae / Q000294:innervation*